Marginal placenta previa & natural birth

[skg_7]

If I may, I'd like to hear the opinions of some of you midwives on my situation. I'm getting so much differing advice and feedback....

At 31 weeks (now), placenta is 1.6cm from the os. It was detected on ultrasound at 20 weeks and so I was re-checked, and it was found to have not moved at all. No bleeding at all. I'll be re-checked at 36 weeks.

I also have a two-vessel cord that doesn't seem to be of any consequence (IE, baby's heart and other organs look perfect).

The questions I have are:

-- If it's still at 1.6cm from os at 36 weeks, would you allow me t go full-term and attempt a natural delivery?
-- If so, would you allow it to be a homebirth (with 2 midwives)?
-- Is there anything I can do to help the uterus/placenta expand upwards in the remaining weeks? Babe is measuring a little small (35th percentile). I wonder if I need to eat more protein, for example.

Thanks.

[MsBlack]

Just read a discussion on another midwifery list about previa (haven't dealt with it myself). While some HCPs believe that placenta should be at least 2 or 2.5cm from the os to be safe, others said that their sole criterion for vag/homebirth is the amount of bleeding. That is, they are go for homebirth *unless* mom has anything more than normal bloody show during final weeks and during labor itself.

And as for your baby's size...well, yes, more protein could help baby grow larger. However, it might be that with a marginal placenta, you/your body/your baby have a positive intention in making a smaller babe....could be easier on that placenta maybe?

Aside from diet, I add that stress can well impact baby's growth. Are you experiencing a ton of stress over this previa issue? I mean, anyone might! Just to say that along with diet, attention to de-stressing/relaxation and positive visualization might also help w/baby's growth if stress is indeed an issue for you with this pregnancy/previa.

all the best with this....

[wumanh]

Whatever happens, I would eat very well. Your placenta will be healthy, the uterus will grow as much as needed and the baby will have reserves to cope with labor or surgery and so will you. Proper nourishment will give you the best chance for the placenta to grow up with the uterus. Do not skimp on good food! or good clean water.

I agree with MsBlack that the criteria she mentions is what most homebirth pracs might go by. I would also consider how far from a hospital you are.

Keep picturing that placenta moving up!

[majikfaerie]

I'll third the visualisation vote.
focus on your placenta moving up, and well clear of the os.
I agree with what ms black said about bleeding as well. if you go into labour just fine without any unusual blood loss, then go ahead (assuming you have your MWs supporting). just be prepared to transfer quicksmart if there is any suspicion of abruption, etc.

[skg_7]

Excellent. Thank you.

Have just seen my midwife and she seems to agree, though we may opt for a midwife-controlled birth in a small hospital where the agreement is that the docs and nurses stay out of the picture unless the midwife needs to transfer care. IE -- it's like borrowing their facilities.

Will see what the placenta has done by the next check.

Thanks again!