Previous adhered placenta

[ema-adama]

I had a home water birth with my DS that ended in a transfer for an adhered placenta.

My previous placenta was in an anterior fundal position, and this time it is in a posterior position. I have been told this is a good thing by my Gynae, as there is a smaller risk for it adhering again if it is in a different position. Although there is no reason why it adhered. I have no scar tissue in my uterus, have never had an abortion or c-section. The placenta was manually removed, with a small piece requiring D&C. There is no evidence of scar tissue from the D&C.

Anyway, I have an appointment with a midwife next week and I will talk to her about the risks of a planned homebirth given my birth history. The Gynae has said the risk is smaller with the placenta in a different position, but she would recommend a hospital birth non the less.

I have a major university hospital 5-7 minutes away from where I live, making a transfer relatively straight forward should I need it- but it is also something I would rather avoid.

I am not a good candidate for hospital births. I have a very real fear of my body being controlled by others against my will (past sexual abuse) and I just do not think I could handle the constant invasions of privacy that happen in hospitals where I live.

I am just wondering if there are any other mamas who have BTDT when it comes to choosing where to birth after a retained/adhered placenta.

[minkymama]

Hi Ema, I had an adhered placenta (or at least retained placenta) and had to transfer after my homebirth to hospital. I've since had a complicated miscarriage with adhered placenta and am expecting a baby at the end of Sept - and have decided to birth at the large teaching hospital in my region (no other hospital will take me due to history). The only reason I am not homebirthing is my distance from the hospital (40+ minutes). For my homebirth, I was 5 minutes from the hospital and in terms of how quickly I was treated there was no difference between transferring from home and birthing in hospital - they knew I was coming and were prepared.
Is the issue that you will haemorrage if you have adhered placenta? Could they have blood for your type all ready to go at the hospital so you can transfer by ambulance from home if you need to?
I have similar birthing issues to you and its been really hard giving up a homebirth when the problem isn't with the baby and my labor/delivery, its my body afterwards!
If I was as close to the hospital as you, I'd be tempted to birth at home.

[ema-adama]

I did not haemorrage with the adhered placenta. I know there is a risk of haemorrage with placenta accreta, but that is not what I had, and I do not have any scar tissue, making me think that I am not at a particular risk for haemorrage, although that obvisouly is still a risk.

Where I live homebirth is considered extremely dangerous and hospital staff have been known to 'teach the mother a lesson' when she comes in during a homebirth. (as in are just very rough and rude). I experienced a bit of that, although the gynae attending the homebirth transfered me and had the OT prepped for me and I did not need to deal with rude doctors until after the surgery.

I guess I'll see how things progress and of course listen to the professional opinion of a couple of homebirth midwives, in addition to my Gynae.

Thanks so much for replying, and best of luck to you in September.

[minkymama]

Thanks Ema - best of luck to you too, your hospital sounds mean!

FWIW, if there's no haemorrage risk and it's a matter of getting the adhered bit out - with my m/c, a scan showed up the adherered bit. I was offered the choice of surgical management, medical management (cytotec), or expectant management. I chose expectant, with a close eye out for signs of infection, and it all came out a month later with my first period after m/c. So if you have choices, you could choose medical or expectant management.

Sounds like delivering in hospital won't change the outcome vis a vis adhesion - you'll either need surgery for that or you won't, no matter where you deliver.