# Successful Vaginal Birth for Placenta Previa?



## arcingpath (Oct 27, 2006)

Do these always end in c-section? I'm not talking about if you were told you had placenta previa early on, but then the placenta moves off the cervix. I'm talking about previa during labor. Thanks.


----------



## tessie (Dec 6, 2006)

If you're talking complete previa at the time of labour then yes, a c/section is the only option.


----------



## wombjuice (Feb 22, 2007)

I'm hesitant to say this because we all know what happens to stories as they are passed down the generations, but my great-grandmother has said that when her son (my mom's dad, my grandfather) was born, he came vaginally right through the placenta (she had placenta previa). Supposedly, after the birth, the doctors wouldn't let her stand up or move (she was hemorrhaging), but the sun was in her eyes, so she jumped up to close the curtains, and a huge piece of her placenta came out, and the hemorrhaging stopped. She lived, and so did her son (obviously).

I don't know if all of this is even possible, but my Nana was not one to lie, and this is the story she has told. Very scary, and definitely not something I'd recommend, as she said she honestly almost died.


----------



## alegna (Jan 14, 2003)

Yep. It's one of the real life-saving cases for a c-section.

-Angela


----------



## zonapellucida (Jul 16, 2004)

I have delivered vaginally with partial previa. I have read about ripping through the placenta and have it saved in favorites but I am not on my computer. Doubt an OB would do it and there are time constriants.


----------



## Romana (Mar 3, 2006)

~


----------



## barefoot mama (Apr 30, 2006)

Placenta previa is one of the very few situations I absolutely would have a c- section.


----------



## mytwogirls (Jan 3, 2008)

They would have to section you definitely.


----------



## cathicog (May 7, 2005)

:








And thier diagnosis should be confirmed by u/s no earlier than 36-38 weeks. That way, if they said it was previa during pg, it would have time to move, as the uterus grows. But a previa at 38 weeks, is still gonna be there and there is no other safe way to get thru it. You can see a complete previa on u/s easily. I would ask them to let you see the screen, and not just take thier word for it.


----------



## ReikiMommy07 (Dec 13, 2007)

Quote:


Originally Posted by *alegna* 
Yep. It's one of the real life-saving cases for a c-section.

-Angela

Why is this? Do you have links/resources/studies/evidence?

Also, what about UP'ers? If you UP'd, you wouldn't know beforehand, if you had no prenatal care incl. no U/S. So what would the procedure be then? How would you recognize complete previa (or any previa, for that matter) during labor? Are there any risk factors for previa?
Thanks mamas!


----------



## Rockies5 (May 17, 2005)

Quote:


Originally Posted by *ReikiMommy07* 
Why is this? Do you have links/resources/studies/evidence?

Also, what about UP'ers? If you UP'd, you wouldn't know beforehand, if you had no prenatal care incl. no U/S. So what would the procedure be then? How would you recognize complete previa (or any previa, for that matter) during labor? Are there any risk factors for previa?
Thanks mamas!









Pain and bleeding during late pregnancy would be a tip off for one.


----------



## maxmama (May 5, 2006)

Quote:


Originally Posted by *Rockies5* 
Pain and bleeding during late pregnancy would be a tip off for one.

Actually, previa bleeding is classically painless. It's part of the differential diagnosis for previa v. abruption with bleeding in the third trimester.


----------



## arcingpath (Oct 27, 2006)

To the pp wondering how UPer's would have early diagnosis:

I'm UPing, it's my first pg, and so I had this same question. If you search the forum for "placenta previa" you can find some earlier threads that tell you how to look and listen and feel for the placenta without having to get an ultrasound. Then you would only need the ultrasound if you couldn't find it or suspected it was covering the cervix.


----------



## Romana (Mar 3, 2006)

~


----------



## alegna (Jan 14, 2003)

Quote:


Originally Posted by *ReikiMommy07* 
Also, what about UP'ers? If you UP'd, you wouldn't know beforehand, if you had no prenatal care incl. no U/S. So what would the procedure be then? How would you recognize complete previa (or any previa, for that matter) during labor? Are there any risk factors for previa?
Thanks mamas!










Serious bleeding in labor. And that is a sign to transfer.

-Angela


----------



## Nan'sMom (May 23, 2005)

Quote:


Originally Posted by *alegna* 
Serious bleeding in labor. And that is a sign to transfer.

-Angela

I know someone who had complete previa, no u/s during pregnancy. Mw dx'd it at homebirth (I think due to severe bleeding), she transferred, had a c-section and baby and mother were fine, aside from trauma of c-section, etc. So I've always thought, as Alegna posted, that you'd be getting some pretty clear signs of something wrong, even with no mw there to evaluate it.


----------



## Romana (Mar 3, 2006)

~


----------



## mwherbs (Oct 24, 2004)

depends on degree of previa- complete not very likely that the baby will survive- there probably is some rare % that do and have but not a big percentage also risk to mom is greater because blood is being lost directly from the placental site-- a low lying placenta that would be 3 cm from the cervical opening when it is completely closed probably going to be fine- trans-vaginal ultrasound would be a way to have a look-see

take care


----------



## frontierpsych (Jun 11, 2006)

It has been done-- I believe I read about it on unassistedliving.com , but it's one of those things that I think even 99% of potential UC'ers would go for a c-section for.


----------



## ReikiMommy07 (Dec 13, 2007)

Quote:


Originally Posted by *arcingpath* 
To the pp wondering how UPer's would have early diagnosis:

I'm UPing, it's my first pg, and so I had this same question. If you search the forum for "placenta previa" you can find some earlier threads that tell you how to look and listen and feel for the placenta without having to get an ultrasound. Then you would only need the ultrasound if you couldn't find it or suspected it was covering the cervix.

Many thanks!








And thanks for the links and other great info, too!


----------



## Kidzaplenty (Jun 17, 2006)

I'm like most pp. A previa is a big reason to transfer and get a c/s. Like I tell my children, if something is blocking the door, the baby can't get out. If it is complete, it covers the entire opening, and to have it torn or detach on one side would almost certainly have the baby suffocate before birth or mom bleed to death. Though like stated, there are rare chances where perhaps that did not happen. But those risks are more than I am generally willing to take. A partial is another story.

That is why I always get a 20 wk u/s. I believe the risks of u/s are out weighted by the benefits (that is one u/s at 20 wks for placenta check and basic baby check, not necessarily many u/s).


----------



## alegna (Jan 14, 2003)

Quote:


Originally Posted by *Kidzaplenty* 
That is why I always get a 20 wk u/s. I believe the risks of u/s are out weighted by the benefits (that is one u/s at 20 wks for placenta check and basic baby check, not necessarily many u/s).

And see, IMO a 20 wk u/s is next to useless to diagnose previa. It can *eliminate* it as a possibility, but if they see previa at 20 weeks it's pretty much meaningless.

-Angela


----------



## maxmama (May 5, 2006)

Quote:


Originally Posted by *alegna* 
And see, IMO a 20 wk u/s is next to useless to diagnose previa. It can *eliminate* it as a possibility, but if they see previa at 20 weeks it's pretty much meaningless.

-Angela

Why not eliminate it as a possibility? Many women choose to have an US for anatomy anyway.


----------



## alegna (Jan 14, 2003)

Quote:


Originally Posted by *maxmama* 
Why not eliminate it as a possibility? Many women choose to have an US for anatomy anyway.

Because if it's NOT eliminated then you've basically just signed up for a bunch more u/s.

I choose not to do any u/s without medical reason.

I have yet to read of a case of placenta previa that presented with NO bleeding by labor.

-Angela


----------



## maxmama (May 5, 2006)

Quote:


Originally Posted by *alegna* 
Because if it's NOT eliminated then you've basically just signed up for a bunch more u/s.

I choose not to do any u/s without medical reason.

I have yet to read of a case of placenta previa that presented with NO bleeding by labor.

-Angela

And there are those who do consider screening to be a medical reason. Do you have your midwife use a fetoscope for prenatals? Dopplers are much higher-energy US than a standard scan.


----------



## alegna (Jan 14, 2003)

Quote:


Originally Posted by *maxmama* 
And there are those who do consider screening to be a medical reason. Do you have your midwife use a fetoscope for prenatals? Dopplers are much higher-energy US than a standard scan.

Absolutely. No doppler without medical reason either.

-Angela


----------



## Rockies5 (May 17, 2005)

Quote:


Originally Posted by *alegna* 
Because if it's NOT eliminated then you've basically just signed up for a bunch more u/s.

This is true. We had a UC/ (mainly) UP and because of some symptoms I was having _*AND*_ to rule out DP little doubts about the plan I agreed to a 20weeks US.

This was my third pregnancy and I hadn't had ultrasounds before 30weeks with any of them.

I think I went in at 20 week and what do they find? "placenta previa" that wasn't. But now, we had to go back one more time to see that it had resolved...because I agree a previa is a reason for a c-section even if I would have prefeered a UC/homebirth.

at the 33 week u/s the previa had resolved, but now they see another "normal but maybe not" thing they need to check on again at a later US. (possible kidney refluxing, but they weren't certain)

I never went back and had my UC.

This is one of the risks of spying on the unborn, unfinshed forming fetuses. Since babies don't all develop at the same rate, and some placentas take longer to migrate to the top 1/3 of the unterus, you wind up with unecessary serial ultrasounds, extra costs to your insurance company and alot of stress.

I now think that if you want to check on your pre-born (and we like to, I think it's a great diagnostic tool when used properly) do it as late as possible.

with my next pregnancy, I planned the 20week one then kept rescheduling until I thought it was late enough, that I wold not have to repeat it. I think I was like 30 odd weeks.


----------



## Rioe (Jan 12, 2006)

You know how sometimes you read a historical novel, and a woman dies in childbirth and the midwives all wring their hands and say "there was too much blood." That's basically the situation. If you try to deliver vaginally, the placenta is in the way and comes out first during labour, then the mother hemmorhages and the baby suffocates because of still being in there with no oxygen supply. There are stories of emergencies where the placenta is successfully cut to allow the baby through, but in my limited knowledge, I believe these would probably have been the fastest, easiest labours had the previa not been present.

Quote:

I have yet to read of a case of placenta previa that presented with NO bleeding by labor.
I had complete placenta previa with my first pregnancy, and I never bled at all. I had the cesaerean at 38 weeks, so I'm not sure what would have happened had I gone to term. My doctors all told me to rush to hospital if I bled, or felt any signs of labour, but everything was perfectly normal. Had I been avoiding ultrasounds for whatever personal reasons, the previa would not have been caught, and I and my son would have been tragic characters out of a novel.

Now I'm pregnant again, just had an ultrasound at 18 weeks, and guess what. Previous previa and prior cesaereans are both risk factors.


----------



## Mindi22 (Jun 28, 2005)

I've got a complete previa, and am having a c-section in just over a week for it. I wanted to have a home birth, but DH wasn't comfortable with that, and we compromised with a water birth at a nearby birth center with midwives. Then, a previa was discovered at my 20 week U/S, which I nearly refused, and I'm glad at this point that I didn't. I had another U/S at 29 weeks, and another at 35 weeks (just looking at the placenta, no baby measurements). The placenta hadn't moved at all in either case, so I think the benefits of a section are undeniable at this point.

I'm sure that it could happen, but I think that a vaginal birth, especially with a complete previa is an almost guaranteed death sentence for mom and baby without proper care. If the placenta is supplying oxygen to baby, and the placenta detatches or is broken, unless baby is very close to coming out, baby is going to die (or be seriously brain damaged) without oxygen. With my first child, I pushed for over three hours, so there is no guarantee that even if you're at the pushing stage, birth will be over quickly enough to make sure baby survives.

Also with a complete previa, as mom dilates, there is a risk of the placenta detaching, as there is a larger and larger hole behind where the placenta is attached. That detachment can not only lead to the issues I just mentioned with the baby, but also to mom hemorrhaging. And that hemorrhaging can happen incredibly quickly.

As I said before, I'm glad that I've had the U/S studies, because I haven't had any symptoms. I'm 36 ish weeks pregnant, and I am still working, haven't had any spotting or bleeding. Without the U/S, I could be heading for a disaster that I didn't even know was coming.


----------



## alegna (Jan 14, 2003)

Quote:


Originally Posted by *Rioe* 
I had complete placenta previa with my first pregnancy, and I never bled at all. I had the cesaerean at 38 weeks, so I'm not sure what would have happened had I gone to term. My doctors all told me to rush to hospital if I bled, or felt any signs of labour, but everything was perfectly normal. Had I been avoiding ultrasounds for whatever personal reasons, the previa would not have been caught, and I and my son would have been tragic characters out of a novel.

Now I'm pregnant again, just had an ultrasound at 18 weeks, and guess what. Previous previa and prior cesaereans are both risk factors.

I can not imagine that you wouldn't have had bleeding at the beginning of labor- telling you that you needed further care. You then would have had time to go to a hospital in all likely hood.

-Angela


----------



## Rockies5 (May 17, 2005)

Quote:


Originally Posted by *alegna* 
I can not imagine that you wouldn't have had bleeding at the beginning of labor- telling you that you needed further care. You then would have had time to go to a hospital in all likely hood.

-Angela

probably. But we don't know.

But with the knowledge of the previa the mom can anticipate and plan the birth she desires. She can wrap her head around surgery and all that means when her plans were for a homebirth.

That's quite a leap to have to make on the fly (hands off homebirth to high tech surgical birth).

Can you imagine suddenly bleeding, scared and with all your birth dreams out the window when you get checked out and it's a no-option situation?


----------



## Mindi22 (Jun 28, 2005)

Quote:


Originally Posted by *alegna* 
I can not imagine that you wouldn't have had bleeding at the beginning of labor- telling you that you needed further care. You then would have had time to go to a hospital *in all likely hood*.

-Angela

(bolding mine.) that's just not a risk that some of us are willing to take. And yes, bleeding at the beginning of labor might be the first sign of a previa for someone. But given how quickly that can go downhill for both mom and baby, that's a situation that I don't want to fool around with at all!

We each have to go with what feels right to us in any situation, but I would personally never feel good about playing the odds with a previa.


----------



## alegna (Jan 14, 2003)

Quote:


Originally Posted by *Rockies5* 
probably. But we don't know.

But with the knowledge of the previa the mom can anticipate and plan the birth she desires. She can wrap her head around surgery and all that means when her plans were for a homebirth.

That's quite a leap to have to make on the fly (hands off homebirth to high tech surgical birth).

Can you imagine suddenly bleeding, scared and with all your birth dreams out the window when you get checked out and it's a no-option situation?









Each mom has to make her own decisions.

Routine u/s has not ever been shown to improve outcomes.

-Angela


----------



## alegna (Jan 14, 2003)

Quote:


Originally Posted by *Mindi22* 
(bolding mine.) that's just not a risk that some of us are willing to take. And yes, bleeding at the beginning of labor might be the first sign of a previa for someone. But given how quickly that can go downhill for both mom and baby, that's a situation that I don't want to fool around with at all!

We each have to go with what feels right to us in any situation, but I would personally never feel good about playing the odds with a previa.

Again- each mom has to make their own choices.

However it is important to note that no studies have ever shown an overall improvement in outcomes due to routine u/s.

-Angela


----------



## mwherbs (Oct 24, 2004)

although a 20 week ultra sound if it says there is NO previa then it is accurate the problem is that diagnosing a previa at 20 weeks is about 80% false positives if not more so if it seems like there is a previa at 20 weeks you will need to be re-checked later because it is probably wrong-- so if you are looking of information on placenta previa the more accurate screen would be 30+ weeks if there aren't bleeding events before that


----------



## Rockies5 (May 17, 2005)

Quote:


Originally Posted by *alegna* 
Each mom has to make her own decisions.

Routine u/s has not ever been shown to improve outcomes.

-Angela

I'm aware of this. However I can see how in this particular case it would improve outcomes. Knowledge _creates_ choice.

I know for me, planning the birth and anticipating welcoming the baby is *everything*. Loosing my birth plans because of something mainly unpreventable (like sudden bleeding from a previa--while I'm in labor) would have been devastating. But knowing in advance would give me the chance to plan the safest best birth possible.

I could then choose my caregiver, hospital, pack my cloth diapers, get the best care set up for the other kids etc.

an ambulance ride would be tramatizing.


----------



## Kidzaplenty (Jun 17, 2006)

Yeah, knowing ahead of time that a c/s is necessary would be much preferred, to me, than the last minute "complication" of bleeding once labor started. My fastest labor was barely over an hour with my longest 6 (an average of 4), that is just not a lot of time for me to prepare mentally to go to the hospital (I have NEVER been a patient in a hospital before other than my own birth, and it would take a bit of mental prep work), and it is also not a lot of time for me to find suitable child care for my other children and prepare the household to run without me for a couple of days or more.

I have also had seven children, with six of them having a 20-23 wk u/s and all of them ruling out previa. It may not be that way for everyone, and may not even be that way for me forever, but I have good experience in that area, and have never had a further u/s for any reason.

And a u/s in the instance of a complete previa has a very huge potential to improve the outcome by knowing what it expected. Again, I don't think it is "necessary" but it can really help in this particular circumstance.


----------



## mamabadger (Apr 21, 2006)

Quote:


Originally Posted by *frontierpsych* 
It has been done-- I believe I read about it on unassistedliving.com , but it's one of those things that I think even 99% of potential UC'ers would go for a c-section for.

I had a C-sec for PP which was only diagnosed at 40 weeks. The OB discussed one other possibility with me. He said that, if the previa were only partial, and the fetal head was well engaged, the pressure of the fetal head would prevent bleeding until after the birth. He said he would attend a birth under those circumstances only if (1) I had an ultrasound to confirm the exact position of the placenta, and (2) I laboured on an epidural, so he could do a section at a moment's notice. He only made these allowances because I felt strongly about having a vaginal birth if at all possible. I still opted for the C-section, since I agree that placenta previa is a good reason for a section if ever there was one; but I thought I would mention the other possibility. This was twenty years ago; I doubt if an OB today would consider it.


----------



## Ironica (Sep 11, 2005)

Quote:


Originally Posted by *alegna* 
Again- each mom has to make their own choices.

However it is important to note that no studies have ever shown an overall improvement in outcomes due to routine u/s.

You know, something just occurred to me... I've heard this mentioned several times. But... what does that *mean*? Has that been shown across all birth situations? I mean, I can totally believe it in a full-service hospital setting, where anything that could have been diagnosed prenatally can be handled as it comes up... but has it also been shown for homebirth, or rural hospitals without all the bells and whistles?

Also, there's the question of what an "outcome" is. It seems like, in most clinical research, "outcome" just takes into account whether everyone's alive, whether any injuries were sustained, and whether there's any permanent physical damage. Plus, we don't count certain things... having a giant wound across your abdomen isn't counted as a negative "outcome" of a c-section. But do we look at the psychological state of the birthing mother? The attachment between mother and child? The impact on the family? As someone mentioned earlier in the thread, a mother might have a significantly different experience if she has to plan a c-section ahead of time for previa, than if she goes about her birthing business and then, suddenly, when labor begins, there's "too much blood" and she's rushed off for an emergency c-section. Do the outcome measures capture that difference?


----------



## Storm Bride (Mar 2, 2005)

Quote:


Originally Posted by *Romana9+2* 
Just wanted to add in response to one of the questions that I believe a prior c/s is a risk factor. Not 100% certain but I think it's more likely if you've had a c/s (probably something to do with the scar and attachment of the placenta?).

Yes, it is. I don't have the numbers in front of me, but the Landon study looked at this. It also showed that each c-section increases the risk of developing previa in subsequent pregnancies (there's a big jump at...fourth section, I think - oh, goodie for me). A history of c-section also increases the odds that a mom with previa will develop accreta, and that risk also goes up with each subsequent section. If I recall correctly, after four sections, a mother with previa in a subsequent pregnancy had a 67% chance of developing placenta accreta. (Of course, the absolute numbers were getting so small by that point that it's hard to say how statistically relevant that is...I think the study included 3 moms with four previous sections who had placenta previa, and 2 of them developed accreta.)


----------



## Storm Bride (Mar 2, 2005)

Quote:


Originally Posted by *Ironica* 
As someone mentioned earlier in the thread, a mother might have a significantly different experience if she has to plan a c-section ahead of time for previa, than if she goes about her birthing business and then, suddenly, when labor begins, there's "too much blood" and she's rushed off for an emergency c-section. Do the outcome measures capture that difference?

In my experience - no - they don't even think about them. No matter what the circumstances, we're just supposed to smile brightly, say "oh, what a cute baby" and forget it ever happened.

Of course, I always seem to be the freak, as I found both of my scheduled sections to be light years more traumatic than either of my emergency ones. (Losing Aaron was the worst trauma of all, but that was separate from the trauma of the surgery itself, if that makes sense.)


----------



## Mindi22 (Jun 28, 2005)

Quote:


Originally Posted by *alegna* 
Again- each mom has to make their own choices.

However it is important to note that no studies have ever shown an overall improvement in outcomes due to routine u/s.

-Angela

But when did this become a thread about the merits of routine u/s??

I think that if a woman is comfortable having an u/s to rule out a previa, it's up to her, and with my current experience, I would definitely recommend it. And I agree with Rockies5, knowing in advance for me is far better than planning and hoping for an idyllic home birth and then being transferred last minute in an emergency situation. Is it possible to detect a previa without an u/s? I'm sure that there are ways with a doppler or fetoscope depending on the position of the placenta. Mine is a complete previa and posterior, so since I haven't had any bleeding, I doubt it would have been picked up on any other way besides the u/s.


----------



## AndrewsMother (Jul 30, 2007)

I had a placenta previa that was diagnosed at 14 weeks when I went to the E.R. for cramping and intense pain. I do not think that my son would have survived if he had been born vaginally, and I was not willing to take the risk.


----------



## Shelsi (Apr 4, 2005)

Quote:


Originally Posted by *alegna* 
Again- each mom has to make their own choices.

However it is important to note that no studies have ever shown an overall improvement in outcomes due to routine u/s.

-Angela

I chose not to have any u/s for my homebirth so you can see where I am coming from BUT I'm 99.9% positive those studies would have been done during a hospital birth and therefore with more immediate emergency care. I've always wondered what those types of studies would show if they did all homebirths?


----------



## Dido (Jan 7, 2006)

Quote:


Originally Posted by *alegna* 
I have yet to read of a case of placenta previa that presented with NO bleeding by labor.

-Angela

I had complete placenta previa and I never bled. Any review of the medical literature on previa will quickly reveal that while asymptomatic previa is less common, it still occurs.


----------



## savithny (Oct 23, 2005)

Quote:


Originally Posted by *Shelsi* 
I chose not to have any u/s for my homebirth so you can see where I am coming from BUT I'm 99.9% positive those studies would have been done during a hospital birth and therefore with more immediate emergency care. I've always wondered what those types of studies would show if they did all homebirths?

The study showing no improvements in outcomes from ultrasound is a very large study (10,000+ cases) from Ireland (I think? -- european country, anyway). It's *not* of people in labor, though I don't know if it includes homebirthers or not. It's looking at those who have a 20-week "anatomy" ultrasound or not, and whether that correlates with improved outcomes in the form of more live babies -- which it does not. The very, very few things that an early ultrasound can find that make a real difference in outcome are so rare that they don't affect outcomes, statistically. Since *most* previas present with bleeding before labor or in early labor, even early detection of them with ultrasound doesn't make a *statistically significant* different in outcomes *when measured over a very large population.* Meanwhile, the early ultrasounds often lead to higher-intervention pregnancies and births, with worse outcomes for the babies without those few rare conditions.


----------



## Kidzaplenty (Jun 17, 2006)

While I agree that it is highly possible that an u/s will not affect the final outcome of a complete previa (baby is born by c/s and both mom and baby survive), it can affect the birth tremendously. It can make the difference of planing a birth that is calm and exciting and something you have been waiting for to having a frightening and stressful time needing to be rushed to the hospital, maybe via 911 and ambulance, to have an emergency c/s at a moments notice to save both mom and baby.

Sure, in the end, they both may survive. But I think the early moments of life for the baby and mother will be severely impacted in a very negative way.

Yes, it could be don't but that does not mean it is the "best" way to have it done. But again, everyone has to make those decisions on their own.


----------



## alegna (Jan 14, 2003)

Quote:


Originally Posted by *Dido* 
I had complete placenta previa and I never bled. Any review of the medical literature on previa will quickly reveal that while asymptomatic previa is less common, it still occurs.

Did you go into labor?

-Angela


----------



## Kidzaplenty (Jun 17, 2006)

I would think that most bleeding for previas occur because dilation occurs before labor, sometimes slowly over the course of days or weeks, thus making the bleeding start.

However, for my labors, let me take one in particular, this is not true. The day before I went into labor I was 0-effaced and 0-dilated. Meaning, that if bleeding occurs because of those factors, I would have had no bleeding at all. And when the first contraction hit, I had barely over an hour before my daughter joined the world. So, if she had been a previa baby, I would have had a lot of trouble, with tons of bleeding, very suddenly, and little time to get to the hospital that was not overly close. Time would have been a big factor in her healthy outcome. And as such, knowing ahead of time could possibly have changed the outcome drastically.


----------



## mwherbs (Oct 24, 2004)

Quote:


Originally Posted by *Kidzaplenty* 
I would think that most bleeding for previas occur because dilation occurs before labor, sometimes slowly over the course of days or weeks, thus making the bleeding start.

However, for my labors, let me take one in particular, this is not true. The day before I went into labor I was 0-effaced and 0-dilated. Meaning, that if bleeding occurs because of those factors, I would have had no bleeding at all. And when the first contraction hit, I had barely over an hour before my daughter joined the world. So, if she had been a previa baby, I would have had a lot of trouble, with tons of bleeding, very suddenly, and little time to get to the hospital that was not overly close. Time would have been a big factor in her healthy outcome. And as such, knowing ahead of time could possibly have changed the outcome drastically.

I think that you have got a very good point and how I think about why there is bleeding in some women and not in others-- if there isn't dilation or effacement why would there be bleeding?


----------



## moodymaximus (Nov 13, 2007)

Quote:


Originally Posted by *mwherbs* 
I think that you have got a very good point and how I think about why there is bleeding in some women and not in others-- if there isn't dilation or effacement why would there be bleeding?

how likely is it not to be dilated even a bit with a third baby?


----------



## maxmama (May 5, 2006)

Quote:


Originally Posted by *moodymaximus* 
how likely is it not to be dilated even a bit with a third baby?

It happens. One of the first things I learned working with birthing women is that with the third baby, all bets are off.


----------



## Kidzaplenty (Jun 17, 2006)

Quote:


Originally Posted by *moodymaximus* 
how likely is it not to be dilated even a bit with a third baby?

The baby in example (where I had 0-D & 0-E), was baby number six. And I had excellent prenatal care, so I know exactly how my cervix was. Surprisingly enough, that was my only baby that I saw an OB right up to 40 wks. Most I stopped seeing at early third trimester.


----------



## Rioe (Jan 12, 2006)

I found out something today I thought I'd add to the discussion. Apparently with complete previa, you are less likely to have bleeds. Having a partial previa means only an edge of the placenta is over the cervix, and it's more likely to get tears and bleed. But with the complete previa, the middle of the placenta is over the cervix and is less likely to separate enough to bleed.

So the worst case scenario for delivering vaginally is the most likely to produce no symptoms until labour.


----------



## cj'smommy (Aug 14, 2003)

I had complete Previa with DS#2 that resulted in a c-section. (DS#1 was a vaginal birth but I did have a subchorionic hemorrhage with him that cleared up by 20 weeks)

At the 20 week ultrasound it was low but I was told there was still plenty of time for it to move. I had bleeding on and off from about 30 weeks on. I had another u/s at 36 weeks and it was complete. My OB said if it hadn't been complete, they would have let me try a vaginal birth but that we would need to schedule a c-section. It was scheduled about a week or so before I was due. At just over 37 weeks I started bleeding heavily, I mean heavily. I went to the hospital and they admitted me. I had been contracting on and off through the night but I didn't even know it. When the OB came in the next morning she said she didn't want to push it anymore, I was bleeding enough and with the contractions she didn't want to wait until I was in labor and have a bigger problem. So I was having the c-section ASAP. It wasn't an emergency, but it was rushed. DH had about a 20 minute ride and he got there just in time. Honestly the c-section went well and both of us did fine. Holden had no problems and I recovered extremely well.

I am happy we knew ahead of time. Though the c-section wasn't when I thought it would be, I was prepared that I might not make it that far. I had knowledge of what Previa was and what the complications were. I had bleeding with my first, but it was nothing compared to the bleeding I had before DS#2 was born, that was scary.

This time around I was planning a VBAC which was fine with my OB and was happy to hear my placenta was up high. Unfortunately at the 20 week u/s we found out the baby has some complications so it will be another c-section for me. This has nothing to do with the placenta. So while there is a chance that once you have complete previa, you may have it again but it's not always the case - don't give up hope for your next birth!

If you have any questions, let me know and I'll be happy to help!


----------



## Finn&CalsMommy (Mar 21, 2006)

Here's my experience, for what it's worth.

I have had two vaginal deliveries - in the hospital but no drugs whatsoever. Gave birth naturally each time to 9lb babies. Wonderful births, as far as hospitals go. I was able to labor on my own with virtually no intervention other than checking my blood pressure and monitoring baby's heartbeat. I called all the shots and everyone listened. Perfect births for me!

With my third baby (born 10 days ago!) I had placenta previa. Diagnosed via 20wk ultrasound and then followed until 39 weeks. Never moved far enough away to have a safe birth (it was 1.7cm away from cervix...too risky for us). I never had spotting at all at any point during my pregnancy. We planned a c-section for 39wks 3days. I was so bummed. But I knew it was the right thing to do.

At 39 weeks I wasn't even effaced, let alone dialated. This was my third baby! Why wasn't my cervix getting ready at ALL? Why was she still riding so incredibly high? Why didn't I feel "labory" in the slightest? My previous births I did and all signs were there that I was going to have a baby. With my third, the only sign was that there was a baby in there but there were no signs she was comin' out any time soon! I am certain, absolutely certain that this was my body's way of keeping her safe as long as possible - my body is smart. It knew that things weren't right and she didn't have a safe way out. If I had been allowed to labor and try to give birth, I really wonder what that labor would have been like. My guess is that it would have been a very start-stop-start-stop kind of labor with little to no progress occuring 1-2wks after my EDD, with more bleeding than normal (I'm not sure the quantity but I know there is a specific # of ounces that is considered going into unsafe territory...we made sure to get the info in case I went into labor early at home since we live on an island and need to ferry into the city), signaling that something was up.

I am really bummed that I had to have a c-section, especially after having two beautiful natural vaginal births. But I shiver to think of the possibilities if I hadn't done it. Things can go bad REALLY fast and it wasn't worth it, even in a hospital setting where there's an OR right there just in case. In the time it would have taken them to prep me for surgery and get my baby out, she could have suffered brain damage or even worse, died. Even if it was just a matter of a few minutes.

Geneva
Momma to three beauties
Finnegan 6yrs
Callahan 3yrs
Lakelan born 1/31/08


----------



## JavaFinch (May 26, 2002)

CJ'sMommy, are you saying your placenta was only low-lying at 20 weeks but moved OVER your cervix?

I asked my doctor about that, because mine has been right on the edge of my cervix and it is posterior and I was worried that as I grew 'out' that maybe my uterus would stretch more in the anterior direction and it could pull the placenta MORE over my cervix, and he said that 'never' happens, that they either stay put or they move away from the cervix - never toward/over.

I'm 31 weeks tomorrow and will be having another u/s to check my placenta in a few weeks. I sure don't want to find out it moved over my cervix and I'm in for a C-section for sure









Also, my OB said as long as it's not 'covering' the cervix at all, it's safe to do vaginal birth. Geneva - with yours 1.7 cm away, what did your doctor say the risks were? I just have this horrible picture of the baby 'blocking' the hemmorage while in the cervix/vagina and then coming out and a huge tidal wave of blood coming after her - not sure if that is irrational or not. Any info you can share on the risks would be so helpful! How many cm away would you have felt comfortable with?


----------



## cj'smommy (Aug 14, 2003)

Quote:


Originally Posted by *JavaFinch* 
CJ'sMommy, are you saying your placenta was only low-lying at 20 weeks but moved OVER your cervix?

It was partial at 20 weeks and then at the 36 week ultrasound they said it was complete.







Maybe it was just really close, I don't know. I do know that unless it was too close she would have let me try for a vaginal birth. She told me to no circumstances to let anyone do an internal on me because of the chance that fingers could poke a hole in the placenta.

At 20 weeks they told me it would probably move up and the chance for complete previa was rare. Wouldn't you know....my body is odd though so it doesn't surprise me.


----------

