my friend is having a hrad pregnancy and facing a csec.

[LionessMom]

her placenta is covering her cervix. she is 23 weeks. it has gotten worse. before they said it was getting close but now they say it is on it. she is afraid of having a csection and having a preemie. she is afraid she wont be able to nurse her baby. i tried to reassure her, but i am not sure what to say. she was afraid it would mean a csec if she wanted to have another one. this is her third and she never had any problems before. i tried to tell her that she can most certainly vbac. and that she can pump for baby if she is too ealry to nurse. i am really hoping she can carry baby closer to term. i am really afraid for her. i can only imagine how she feels.

[CherryBomb]

If she has a complete previa that doesn't resolve, she'll need a c/s. She won't necessarily have a premie. They'll put her on pelvic rest and if she follows it, she should be able to get to term. There's no reason she can't vbac in the future. Good luck to your friend!

[turnquia]

I had a friend recently deliver at 28 weeks via c-section for a partial placenta abruption that caused IUGR and other issues.

She was terrified of the C-section. But she got through it and she was lucky to have an awesome doc who really strived to calm her fears as well. She actually freaked out during the c-section and they were going to put her under general. The doc did a time out from the surgery went over and talked with her. She was able to get my friend to calm down and relax and she had a great expereince from there. The doc even worked hard to get her a normal incision vs the T like for most premies.

Now baby is at 36wks gestation and they are starting to nurse and should be bringing baby home soon.

She's had some struggles with pumping but has been tough and fighting through it.

If she delivers early or even via c-section.... its not the easiest road. But she will make it and do it. Being there to support her is sooo important. If she's on bedrest helping out with other kids, meals and household chores is awesome. As well as being soemone to cry on, talk to and hug!

[karen1968]

Please point her toward the ICAN website and perhaps a local ICAN chapter where she can talk to someone about her fears. C-section is scary, but complete previa is scarier - if she goes into labor with a complete previa, hemorrhage is a real concern.

If it is within her budget, she can also try acupuncture and traditional chinese medicine to get the placenta to shift. Has she had any bleeds? 23 weeks is awfully early to worry about a c-section from a previa. Many, if not most, previas that are diagnosed at that stage resolve by term. She should have another scan scheduled for 32-36 weeks to check again.

(I currently have a complete previa that didn't resolve between 19 & 32 weeks. I'm trying TCM to get it to shift. Although my previa is "complete" in that it covers the entire cervical os, it is only the edge of the placenta that is that low. If her placenta is centered on or near her cervix, that is more serious.)

[wombatclay]

Big hugs to your friend! I had a low lying placenta with bleeding in my first pregnancy... it's scary. And I can't imagine trying to stay rested and off your feet with other little kiddos to care for.

If she has a true previa, a c/s really is her safest choice. But she may not need to deliver until 36 weeks or so... early yes, but maybe not as bad as she fears? And if her placenta isn't smack dab on the cervix and if she has a history of slooooooow labors at or after 40weeks they may consider waiting longer as long as everyone is growing/feeling ok.

One thing might be to find a copy of The Essential C-Section Guide. It's focus is very specific (it doesn't cover vbac) but it's the best book I've found for c/s. It doesn't sugarcoat the process or the recovery period, but it isn't scary either. It's not really "crunchy" but it is informative, kind, and might answer some of her worries.

A website like Cesarean Voices may help... they have an "ideal c/s" example that is a bit over the top for me but again, it may help her approach the possibility with less uncertainty?

A local ICAN group will have BTDT moms who can help as well... different providers and different hospitals have different approaches to c/s and recovery. She may find that one will suit her better than others. And the ICAN moms might be able to suggest pp doulas or LCs with c/s experience.

[turtlewomyn]

I third the ICAN recommendation. There are ICAN white papers that talk about what happens during a cesarean. Also, there are good resources on having a family centered cesarean on the ICAN website and through Birthing from Within. I realize it might be affected by how early the c-section is and if it is emergency or scheduled, but that might be helpful to her.

If she hasn't, she should try to get in touch with La Leche League, other breastfeeding support groups, or a lactation counselor now. They can give her good information on breastfeeding a preemie and breastfeeding after a cesarean. They can prepare her in advance and help handle her fears.

Also, VBAC for future pregnancies is entirely possible. I don't know if the previa or prematurity will affect the type of incision on her uterus though, but that is something to ask the doctor about in advance, and then discuss with ICAN as they can give her information on different risks of the different types of incisions.

[jecombs]

When you have to have a c/s, I think it's important to have the most Mom/baby-friendly c/s possible. A woman in my birth club had an amazing c/s... check out her story here. She found her OB through ICAN.

[MeepyCat]

Originally Posted by CherryBomb

She won't necessarily have a premie. They'll put her on pelvic rest and if she follows it, she should be able to get to term.

Please do not tell a woman with previa that she "should be able to get to term." Please.

Many women with previa don't make it to term. The condition is inherently unstable, and the placenta and the cervix can get into nasty feedback loops.

IF your friend is 23 weeks with a complete previa, IMO, she should be making some emergency. She can hope not to need them, but she should have them just in case. She should pack an emergency bag to keep by the door or in the car, and she should recruit someone (neighbor, family member, good friend, whoever) who can either come stay or come over at a moment's notice to take care of the kids.

For the rest: when I was dealing with previa, I sometimes found the things that people tried to say to reassure me to be very alarming. Really, what was going on was that I was immensely anxious about the whole situation, and any time someone stepped in with yet another fact about how it was likely to turn out, I got more anxious. I got along much better with people who could hear me out and say things like "that sounds really scary," or "I can see why you're worried." "How can I help?" is a classic too. Always worth a try.

And if she doesn't know, may I suggest:
- Laundry
- Yardwork
- Taking her underfoot kids out for the afternoon
- Helping her to pack up her black and red panties and promising that you'll give them back to her after she delivers. These colors look bloody when wet. They're a bad wardrobe choice in certain kinds of complicated pregnancies.

[StarMama]

I feel for your friend mama, I just got out of the hospital for a previa bleed myself at 32 weeks and was so scared I was going to be having a preemie. 23 weeks, hopefully it will move out of the way for her before birth... but again I know that nailbiting time until 32 weeks for the ultrasound to check on it (I bleed the day after my 32 week ultrasound). At least in my hospital if the bleeding stops and mom/baby is ok you 'get' 3 bleeds before they decide that's it time for delivery.