VBAC w/Anterior Placenta - Info or Experience Please! (and "T" Incision)

[Kimrose]

I''m doing my best not to feel overwhelmed or upset and would love anyone's info. re: VBAC'ing w/an anterior placenta - esp. w/a classical or T incision...

After much, much research, I was adamant that I would never had an automatic repeat cesarean - had found and hired a wonderful homebirth midwife and felt at peace for the first time in my pregnancy.
We had our 20 week ultrasound last week/only one and found out that baby looks great (YAY) - but that the placenta is anterior. The radiologist actually said "see - your cesarean scar is down here and the placenta's up here." (as in "no worries".) Somehow that was all my brain let register then as I was still taking in all the "healthy baby" info as well. Only later did I think/realize that of course she didn't know that I had a "T" incision from my cesarean - so my scar goes up up vertically as well.
After I let my midwife know about the anterior placenta and thoughts back and forth - she let me know today that she's not comfortable with the T incision and anterior placenta/that it's out of her scope of experience, etc. I understand/respect her position - but am extremely daunted to be at square 1 and feel all the uncertainty again. My thinking now is that the "hope" is to have another/later ultrasound to see where the placenta ends up as the uterus expands/how far away from my scar. Regardless, I'm completely without care now and need to restart that search - and am terrified that I'll have to hear "no" and then try to fight a hospital system.

My cesarean 5 years ago was a "scarring" experience in every way. I went into labor naturally - had long, HARD all-in-my-back labor,/no pain meds and had started pushing - when they realized my son was breech and did an emergency cesarean. From hours of feeling pain in order to have a natural birth - to unconscious delivery. Five years and one beautiful growing boy later and the pain is no less. Birth matters - and I know it - so I have every intention of VBAC'ing if I feel the risks of it are reasonable - of course would not be cavalier w/my safety as an already-Mom or the safety of our new baby. That said - I know the struggle to find the right provider is crucial - and I'm daunted about restarting the task.

Does anyone know if they can actually see/tell scar tissue on u/s??? I'm concerned that I have my records but have never seen the measurment anywhere - so I'm hoping it's actually "visible" and we'll be able to have confirmation that the placenta is not near/on it.

Also - ANY provider referral re: VBAC'ing w/vertical scars or anterior placentas would be GREAT - I'm in central MA.

Sorry to be so long - I'm trying to step back and get over my emotions of possibly losing my VBAC way before labor's even an issue.... Right now I keep thinking if the placenta's way away from the scar it shouldn't be an issue...RIGHT? If I'm right I guess my work (again) is finding someone who sees it the way I do and has the experience and comfort level to support me.

If anyone has ANY input for my frenzied fragile nerves and heart, it would be MUCH appreciated!!!

[cairomama]

My friend had a VBAC with Inverted T incision and an Anterior Placenta. The doctor said that if anything, there might be a problem with retained placenta. As it was, her placenta has its own birth story as it passed 29 hours after the birth. Upon examination it was completely in tact.

There is an Inverted T support group:
http://groups.yahoo.com/group/Life_After_InvT/join

[Katielady]

I had a horizontal incision for my c-section. I did have an anterior placenta with my next pregnancy. It was discovered at the 20 week ultrasound. I tried to go back for a follow-up at around 36 weeks to check placenta position and attachment- my midwife said they can look at how deeply the placenta is attached to the wall. Then I got into a huge fight with the people at the hospital because they were insisting on doing another full scan, checking every single thing, when the prescription from my midwife specifically said to check placenta only. The head of radiology talked with her on the phone and finally assented to my wishes. Then the tech started the scan and was like, "Here's the aorta...." I just gave up at that point and submitted to the scan. I felt so powerless. And then they never checked the placenta attachment- they checked position, but not attachment, as it wasn't on their stupid list of what to check during a level II scan. The placenta was still anterior.

During my next midwife appointment she asked me what I wanted to do next, and I said I just wanted to proceed with our plans. No way was I going back for another ultrasound, and from what I'd read, the risks of retained placenta weren't worth changing my birth plans (ie switching to a hospital birth, and risking another section and all the potential complications.) So we just tried to put it out of mind.

My birth was amazing. The placenta came out no problem. Afterwards my midwife told me that she had been a bit concerned about the placenta because she'd had a hospital transfer recently for retained placenta, but that I had been so calm and resolute about continuing with our birth plans that she decided to trust my wisdom. She said she learned a lot from me, and said I was a great teacher. I thanked her so much for trusting me and trusting my body.

I'm sorry you're having trouble with this! I don't have much experience with T-incisions but I do know that Henci Goer's writings include some info that shows vbac is safe with a t or classical incision. You may want to look that up and share it with your midwife. And if you decide you still want your VBAC and she won't do it, find someone who will.

[Kimrose]

Thank you both for your input! I did just speak with an "expert" on VBAC's/MW - won't name just b/c I know that naming isn't great to do here - and everyone has different input about people. The good news is that her reaction was "I wouldn't be worried about that" and she absolutely would have taken us as clients, but is away our whole due date month ;( So good news and not-as-good news...but I'll be talking w/her again Tuesday and hopefully will get referrals for "best VBAC" MW who won't be thrown by the presence of an anterior placenta/T incision. Hopefully this is just another step on our twisty road to a wonderful VBAC!!!! (At least I'm feeling hopeful again! ♥

[Kwgrlup]

Praying you get a wonderful provider who will support you....

[Kimrose]

Kwgrlup - THANK YOU!!!

[MNHall]

Originally Posted by Kimrose

Thank you both for your input! I did just speak with an "expert" on VBAC's/MW - won't name just b/c I know that naming isn't great to do here - and everyone has different input about people. The good news is that her reaction was "I wouldn't be worried about that" and she absolutely would have taken us as clients, but is away our whole due date month ;( So good news and not-as-good news...but I'll be talking w/her again Tuesday and hopefully will get referrals for "best VBAC" MW who won't be thrown by the presence of an anterior placenta/T incision. Hopefully this is just another step on our twisty road to a wonderful VBAC!!!! (At least I'm feeling hopeful again! ♥

Well that's reassuring news though! Hopefuly this mw can refer you to someone else with a similar thought process!

Good luck!!

[HeatherB]

Glad you found a good resource, at least! My first HBAC was with an anterior placenta and there were no issues. If your placenta is "up here" versus "down there" for your scar, I wouldn't be concerned, either. I'm assuming that your inverted-T is not bordering on a classical incision and therefore would still be contained rather close to the standard bikini cut area. A fundal placental attachment should be nowhere nearby.

[Kimrose]

HeatherB - Thanks It's nice to hear positive outcomes! I'm hoping just as you said - that scar and placenta end up not close and I at least have the non-surgical birth I've worked for. I'm hoping we can find out more somehow re: specific length of the scar/where the placenta ends up - REALLY hoping as you said that the vertical portion's low enough to allow lots of space between it and the placenta... Here's hoping HBAC's still on the table!