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Forum: Natural Childbirth

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  #1  
January 7th, 2011, 07:17 AM
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I was lurking in a DDC and saw a post by someone that got me thinking. If a mom has placenta previa, what is the best way to handle that situation? Do you need to deliver as soon as the baby is ready or are the risks less than what the doctors make them out to be?
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  #2  
January 7th, 2011, 07:42 AM
FusionGirl's Avatar Formerly TTC#1inNC
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I was found to have previa at my 20 week u/s. My placenta is completely covering the cervix. It is fairly common to be found at that stage of pregnancy and with 90% of cases it moves with the uterus as it grows. It needs to be monitored to see if it moves. I will be having another u/s at 28 weeks and another one after that if the 28 week u/s still shows it to be to low. If it doesn't move I will have to have a c-section as there is no other way for the baby to get out. I don't know if the Dr would wait for the woman to go into labor or just schedule a c-section. It seems a scheduled c-section would probably be best as you never know how fast a labor is going to progress.

There are some scary risks associated with it including heavy bleeding to the point where some women have to get a hysterectomy to stop it. I had to stop reading about it because it was stressing me out. I'll worry about it when I know for sure it is a problem.

Also most women with previa will be put on pelvic rest - no jumping around, no heavy lifting, no intercourse because of the increased risk of bleeding.
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Last edited by FusionGirl; January 7th, 2011 at 07:45 AM.
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  #3  
January 7th, 2011, 10:12 AM
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A few women in the DDC I'm in had it and all but one had it move up already I believe. The one who hasn't had it move up, its that it hasn't moved up enough, but has moved. So I think chances are pretty darn good that things will move.

I believe a c-sec is scheduled if things do not move up.
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  #4  
January 7th, 2011, 10:13 AM
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what she said

many women are told they have placenta previa at an early stage of pregnancy, and sometimes they are never checked again even though MOST of the time the placenta moves out of the way.
However, if you have full placenta previa at the end of pregnancy the best course of action is usually a scheduled c/s.
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  #5  
January 7th, 2011, 11:20 AM
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I had a partial placenta previa with Anna early on and it moved up, so I did look into it a little bit at that point.

What I'm looking at (if you're in this DDC, you'll probably know what I'm talking about) is someone who is almost full term and her doc is pushing for an amnio, so if the lungs are developed, they can do an immediate c-section. I know there is the risk of bleeding, but does that mean you must do a c-section super early because of it or can you wait until 39-40 weeks providing nothing goes wrong?
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  #6  
January 7th, 2011, 12:03 PM
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The body changes so much towards the end of pregnancy that often the placenta moves up. In a small percentage it doesn't, in which case a c-section (preferably scheduled IMO) is the only option.
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  #7  
January 7th, 2011, 12:36 PM
mgm78's Avatar Zoe's mom Meredith
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I had "low lying placenta" which did move by 26-8 weeks, and my research found that most low lying or partially covering placentas do move by 28-32 weeks. I do not see any reason to do an amnio and open yourself up to all the risks involved when you can just wait it out and do a scheduled c closer to the due date.
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  #8  
January 7th, 2011, 01:57 PM
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If the woman has a history of early labor then immediate c-section is a viable option. My mom had previa with my youngest brother, she had 4 of her 6 natural deliveries about 2-3 weeks early and this was her 7th. Because of her history of going into labor early they took him at 36 weeks, he had lung issues as a result even though his lungs were deemed mature enough. He was also a good size at 7 lb 3 oz.

If it were me, I would opt to go on hospital bedrest until 38-39 weeks, that way if labor started and I were to bleed a lot a c-section could be performed immediately. I personally would not risk a late term premie.
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  #9  
January 7th, 2011, 01:59 PM
FusionGirl's Avatar Formerly TTC#1inNC
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I didn't read anything about Dr's doing an amnio - I would insist to my Dr that we wait until closer to the due date. I don't like the risks associated with an amnio.
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  #10  
January 7th, 2011, 02:13 PM
QueenCrafty's Avatar Courtney
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Quote:
Originally Posted by NutMeg76 View Post

If it were me, I would opt to go on hospital bedrest until 38-39 weeks, that way if labor started and I were to bleed a lot a c-section could be performed immediately. I personally would not risk a late term premie.
That's the approach I would take. I understand they wouldn't want her to go into labor on her own just in case she has a fast delivery that could cause problems, but to talk about doing amnios so they can do a c/s ASAP seems over the top to me. Mom and baby aren't in immediate danger right now, so what's the hurry?
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  #11  
January 7th, 2011, 02:17 PM
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Yes, there are a lot of risks associated with going into labor with previa. An early c/s can be totally warrented depending on circumstances. Even with the risk of an early preemie, I wouldn't be comfortable going past 38. You will never, ever hear me say this, but better a few weeks in NICU than a stillbirth. The consequences, especially if mom were to dilate quickly, have a high potential of being catastrophic.
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  #12  
January 7th, 2011, 02:53 PM
NutMeg76's Avatar Platinum Supermommy
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Quote:
Originally Posted by Sk8ermaiden View Post
Yes, there are a lot of risks associated with going into labor with previa. An early c/s can be totally warrented depending on circumstances. Even with the risk of an early preemie, I wouldn't be comfortable going past 38. You will never, ever hear me say this, but better a few weeks in NICU than a stillbirth. The consequences, especially if mom were to dilate quickly, have a high potential of being catastrophic.

This is why I would opt to go on hospital bedrest until 39 weeks if possible. Well, for me 38 because I had my last two live births at about 38.5, with 1-2 weeks of prodromal labor.
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  #13  
January 7th, 2011, 03:16 PM
Sk8ermaiden's Avatar Platinum Supermommy
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I would totally do that too if we had tons of money and no kids. It just doesn't seem viable for us. Especially since I baked a 42 weeker.
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  #14  
January 7th, 2011, 03:36 PM
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Well, I was just lurking so I'm not sure of the specifics of her last birth, etc. I figured if there was a history of fast or early labor that's a good reason to do it (I believe this woman was 36 weeks). However, the doctor also didn't seem to be pushing it, but leaving the decision up to her, so that seems to say that there isn't, and they are leaving it up to her on doing the amnio now or waiting to schedule the section in the next few weeks. This is just one of those things I'm curious to know, even though I shouldn't have to deal with it (I hope!)

I have learned over the past few years that doctors do sometimes blow things out of proportion and are quick to push an induction or section when there's no rush, for thier own convienence. I was curious if there truely was a reason to rush getting the baby out (how long it would take the situation to go bad if the mom did go into labor or her water broke) or if the doctors were making things seem worse than they are.
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  #15  
January 8th, 2011, 07:58 PM
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Quote:
Originally Posted by andi2284 View Post
Well, I was just lurking so I'm not sure of the specifics of her last birth, etc. I figured if there was a history of fast or early labor that's a good reason to do it (I believe this woman was 36 weeks). However, the doctor also didn't seem to be pushing it, but leaving the decision up to her, so that seems to say that there isn't, and they are leaving it up to her on doing the amnio now or waiting to schedule the section in the next few weeks. This is just one of those things I'm curious to know, even though I shouldn't have to deal with it (I hope!)

I have learned over the past few years that doctors do sometimes blow things out of proportion and are quick to push an induction or section when there's no rush, for thier own convienence. I was curious if there truely was a reason to rush getting the baby out (how long it would take the situation to go bad if the mom did go into labor or her water broke) or if the doctors were making things seem worse than they are.
Sorry to bust in (I'm mainly a lurker on this board, hehe... planning a drug-free hospital birth for #1!), but I did look into this issue quite a bit, since I had some early bleeding and was told it could end up being placenta previa. It's true that early (like early 2nd trimester) previas have a good chance of moving up, and many of them seem to move out of the way just in time. But if they DON'T... it is a complication that can not only cause a stillbirth, but maternal death as well (from blood loss/hemorrhaging), if you go into active labor and the placenta ruptures and you aren't in a hospital when this happens. Even if you were in a hospital, they would be hustling to save your life. I really WOULD NOT put it in the category of "oh, doctors blowing it out of proportion" - it is definitely one of those really, really bad complications to have, and an early c-section is totally warranted if it hasn't resolved by about 38 weeks, as a PP stated. Having one at 36 weeks is bad news - it's reasonable to think about scheduling a c-section soon and actively monitoring things via u/s in the meantime.

I am all for NCB just like everyone here, but we have to be careful not to throw out the baby with the bathwater, as it were - some situations are risky enough to warrant full-on medical intervention, and this is one of them. I'm an ectopic pregnancy survivor and would have died without my emergency surgery and blood transfusions, for another example.
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  #16  
January 8th, 2011, 08:51 PM
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Dr.'s do blow things out of proportion, but from what this Dr.'s is saying... leaving the majority of the decision up to the mother, I think 1.) Either this Dr. is blowing things out of proportion (meaning it's not as bad a previa as what it's sounding) or 2.) The Dr. is really letting the mother in on all the details and letting her understand the situation to decide what is best for herself. I have a feeling it's number 2, and that's awesome, and rare

Wish the best for the mom. This is one of those cases where it does warrant medical attention if not corrected before labor!!!
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  #17  
January 8th, 2011, 09:21 PM
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I had it with Noah. It had moved enough out of the way 31 weeks so I ddint need a c/s
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