"Your placenta can detach!" as a reason to induce??

[RoseDuperre]

I'm talking to someone about home births, and her previous birth was induced because she was a week overdue. She wants to know what a home birth midwife would do if she were overdue again, claiming that it wasn't safe for her to be overdue because "your placenta can detach". I'm sure her OB told her that as a scare tactic, but I want to know what the ACTUAL risk is for something like that.

Is this in any way a common risk? I mean, I think I know the answer, but I certainly don't know everything.

[aylaanne]

I've never even heard of that. I mean, I've heard of placental abruption, but not because of postdates. That's the first I've heard PA used as a scare tactic for induction.

eta: my HBMWs kept me home for three weeks after my due date, and when we went in, it was because I was ruptured for 12 hours, not in active labor, and we were worried about infection. When I tell people that, they say, "see! You should have just gone to the hospital!" but I tell them that the HB system worked the way it was supposed to, and when the risk got too high for me and my midwives to feel comfortable staying at home, we went to the hospital. That's what it's for.

[JamieCatheryn]

http://www.theivp.com/tiki-index.php...ion+recurrence

Placental abruption complicates about 1% of pregnancies...Risk factors for abruption include prior abruption, smoking, trauma, cocaine use, multifetal gestation, hypertension, preeclampsia, thrombophilias, advanced maternal age, preterm premature rupture of the membranes, intrauterine infections, and hydramnios.

Postdates is not listed as a risk, nor is macrosomia (baby getting big). If she had a previous abruption, it's more likely to happen again, and this study showed many of recurrent abruptions happen 1-3 weeks earlier than they happened last time. With no history or major risk factors, it's not an issue to worry about.

[UnassistedMomma]

I've heard this one. The explanation is that when you start going post-dates, the placenta is aging out and deteriorating and can therefore not just become less healthy and useful for providing for the child, but can also pull away.

I've also heard that the beginning of deterioration of the placenta is what can signal your body to begin labor.

I've not heard of it actually happening though, that a placenta detached just because of an 'over due' gestation. I think it's largely fear mongering.

[sweeetpea]

actually, the placenta is more likely to abrupt as a RESULT of the induction, not the other way around. Another iatrogenic emergency c-section, saving mama and baby.

[barefootpoetry]

Yeah, I've never heard of this either. Abruption, yes. Placenta detaching in any other way after EDD and prior to birth, no. I agree with a PP - this sounds like scaremongering. The placenta doesn't know what day the CP assigned the pregnancy to be over - it's not going to pop off the uterine wall as soon as "time" is up.

I kinda laughed when I saw this thread title, because I thought, "Isn't the placenta SUPPOSED to detach?"

[RoseDuperre]

I kinda figured on all the above. Thanks for the specifics, ladies.

Originally Posted by barefootpoetry

I kinda laughed when I saw this thread title, because I thought, "Isn't the placenta SUPPOSED to detach?"

Right??

[layla983]

My cousins wife had this happen...during an induction at a hospital the day after her due date. She almost bled to death & we were all worried she wasn't going to make it. I don't know all the facts, but I do know that she wanted induced with their 2nd baby, but her doctor refused because he put the induction at fault for the abruption the first time around.

So, according to at least one case I know...induction was faulted for the abruption.

[Full Heart]

Its such a rare complication that if it were truly was associated with being overdue (not post dates thats after 42 weeks and thats not even listed as a risk factor) then every dr would be telling their patients that. What a great way to get moms to induce!

[cathicog]

Originally Posted by sweeetpea

actually, the placenta is more likely to abrupt as a RESULT of the induction, not the other way around. Another iatrogenic emergency c-section, saving mama and baby.

Took the words right out of my mouth! Also, smokers are more likely to abrupt than non-smokers, if that is a risk..I think induction chemically alters and physically shortens the uterus (during the induction) and is more likely to lead to abruption, as the uterus is not being gradually shortened, but having to do it quickly...and unnaturally severely, not like it would with a short natural labor.The fibers have a chance to clamp down properly in a natural labor, I don't know if they would respond the same with chemical induction...

[zak]

My HBMW believes my placenta became detached as/right before I started pushing. I only pushed for 10 minutes so it wasn't a concern. I was 41w1d (LMP) or 40w2d (DOC). My baby was 9lbs 5oz, very "well done" (footprints, etc), I only had about 1.5 cups of amniotic fluid and my placenta had begun to calcify. We were all fine tho. I don't think my MW (or anyone else for that matter) would have been able to predict that the placenta would detach when it did. I couldn't imagine I had any reason to think an induction would have been a good thing for me for that birth. He was born on HIS perfect birth day!

[Full Heart]

Originally Posted by zak

My HBMW believes my placenta became detached as/right before I started pushing. I only pushed for 10 minutes so it wasn't a concern. I was 41w1d (LMP) or 40w2d (DOC). My baby was 9lbs 5oz, very "well done" (footprints, etc), I only had about 1.5 cups of amniotic fluid and my placenta had begun to calcify. We were all fine tho. I don't think my MW (or anyone else for that matter) would have been able to predict that the placenta would detach when it did. I couldn't imagine I had any reason to think an induction would have been a good thing for me for that birth. He was born on HIS perfect birth day!

That happened with my 6th. I was quite post dates I think 43 weeks. Actually in that case its a good thing we didn't induce. Imagine harder contractions the placenta could have separated much earlier which would have been a disaster. But thats different than what I think the op is talking about, which is abruption prior to or at the onset of labor.