"Low-lying placenta"

[Jennisee]

I am in the process of switching from hospital-based midwives to homebirth midwives. I had the 20-week ultrasound that looks at organs, umbilical cord, placenta, etc., and the hospital midwives told me that I have a "low-lying placenta," but not actual placenta previa. They said that the placenta would probably move up as the uterus grows bigger, but they wanted to do another ultrasound at 30 weeks to make sure. They also asked about spotting, but I haven't spotted at all, not even after intercourse.

I want to switch to the homebirth midwives immediately, mostly because the hospital is 70 miles away, but for other reasons as well. However, that will mean bypassing the 30 week ultrasound to look at the placenta. My homebirth midwife didn't seem concerned and said that it was my decision, but I don't feel like I have enough information right now to make an informed decision. I will ask more at my next homebirth midwife appointment, but I'm hoping to go into it a little more prepared.

So, that brings me to my questions and why I posted in this forum. I was wondering why are the hospital midwives so worried about the low-lying placenta, but the homebirth midwife isn't? How is this managed during birth? What is likely to happen, what isn't likely to happen, and what is the worst that can happen? I really want to have a homebirth, but I often see placenta previa and "low placenta" as one of the factors that would rule out a homebirth, and I don't want to make a reckless decision.

TIA.

[homewithtwinsmama]

I currently have this supposedly as well, but my homebirth midwife isn't worried. She says they always grow up enough by 30ish weeks and that if it doesn't I will see some spotting around week 31 or 32. I also consulted a couple other midwives I know and they suggested I take homeopathic Cinnamomum 30C twice a day for three days. This has been successful with a number of their clients who had partial and even full previas as well. I went ahead and did this just to give myself some insurance on it. I do NOT plan to go back for a 30 week US. (I was seeing a perinatalogist because my last baby died of a chromosomal abnormality and I wanted to have some testing done for the early part of this pregnancy)

[MsBlack]

the placenta can be low, even very low, but as long as it's a couple of centimeters away from the cervix, it will not cause problems. Yes, you can pretty much count on spotting or breakthrough bleeds as pregnancy progresses, if placenta is on/too close to cervix. This is not a condition that is going to sneak up on you with surprise catastrophes during birth--you would have warning, and time to review your plans before labor ever starts, if that placenta does not shift upward--but really, they most often do, by far.

Also, your hbmw can listen with fetoscope and/or doppler to verify that placenta is not too close (she should be able to, I should say).

As a mom, I would not let this keep me in medical care--if anything, it would make me run faster from hospital birth, because the response to this 'risk' will be far more conservative than is warranted (read: likely a needless caesarian). As a mw, I would be more carefully observant as the weeks progressed, but not worried until signs told me there was a reason to worry.

[guestmama9944]

I doubt the hospital midwives are much more "worried" about it than the homebirth midwives, since it's pretty common and almost always resolves itself or was a non-issue to begin with. The difference is that the hospital midwives are relying on technology, and the homebirth midwives are relying more on assessment. The hospital is just trying to keep their covered

[JunipersMom]

There would more than likely be other signs that the placenta has not moved out of the way if was partially covering the cervix - but yours isn't.. its just low lying. So no worries. I agree its probably just a combination of liability issues and because they can as they have the machine right there.

[ZoeyZoo]

Low lying placenta and placenta previa are really common at the 20 week ultrasound. I hope someone has the link (I don't have access to them right now) but it's a very small chance that the placenta won't move up and the hospital MWs are trying to CYA. If I remember right, it's only something like 1% of placentas won't move higher. There are usually other signs (other than doing an ultrasound) to see if it has moved. I'm sure your HB MW will keep an eye out for that but since the chance is so small that there would be a problem, I'm sure that's why she isn't too worried.

[groovynaturemama]

i had a low lying placenta at 20 weeks too (according to u/s). i delivered dd and my placenta just fine at 37 weeks. i did have a steady trickle of blood after giving birth, and my midwife just watched me closely. it never lasted long enough for her to worry- it seems my body just took care of things on its own. who knows if that was even caused by my low lying placenta, really, or if my placenta was low-lying at 37 weeks. IME, it wasn't a problem.

[Jennisee]

Thank you, this really helps.

[mwherbs]

low lying placenta is a typical finding in a 20 week ultrasound- it means nothing, unless it is completely covering the os-- but now you are worried and they have to do another ultrasound to rule out their dubious finding--on line I am sure that there are several articles on the subject--