Retained placenta accounted for 35% of maternal deaths at the Alotau Provincial Hospital in Papua New Guinea between 2014 and 2022. This retrospective study analysed 180 cases from 13,731 deliveries over 8 years (2014–2022). The incidence of retained placenta was 1.9%. The mortality rate was 0.6% with most emergencies arising from unsupervised village births, despite the increase in supervised deliveries.