puppy placentas

Question
My dog had her puppies yesterday, she has had four. The first two I had to help her deliver, the first one she didn't know what to do.  She kept staring at her private but never tried to break the sack or anything.  I let her try for a few minutes but was taking too long. So I helped her out, then for the last two she did all on her own.  

The only thing is after the firt two were out and she wasn't taking care of them I had rub them down and keep them warm while she kept licking her private and cleaning herself up.  The secnod two she delivered she licked and licked her private area again.  I tried to see a placenta, but never saw one.  She wouldn't let me check but kept sitting and licking.  I have no idea if she passed all the placentas.  SHe bled for a few minutes after each puppy, but then stopped bleeding after fairly quickly.  So after all puppies were born, she didn't bleed much at all.  Is there a way to make sure everything is out (puppies, placentas)?  I feel a lump in her belly still but it's under her nipple so I dont know if it is a puppy or just her milk ducts or something else.  What does the vet do to make sure everything is out and normally how much does it cost (just an average) for them to remove all placentas incase she hasn't passed some.

Answer
Hi Becca. You can take her to the vet to get the clean out shot. This is what I would highly suggest. The price depends on the vet. Some, like mine, doesn't charge much at all for it. However, the vet may want to do an x-ray to see exactly what's going on. The shot works in most cases, and may help her milk come down. If it doesn't work, and the placentas stay inside of her, they may have to do a surgery to remove them. You need to get her in fast though. If anything is left inside of her for long, then it can set up a nasty infection, and even cause death. Good luck.