Bleeding, placenta previa, steroids and transfer of care... oh my! - Mothering Forums

Bleeding, placenta previa, steroids and transfer of care... oh my!

parsley's Avatar parsley (TS)
08:45 AM Liked: 70
#1 of 22
12-08-2011 | Posts: 773
Joined: May 2011

I wanted to take a few minutes to give an update, get some advice and also document my experience in case others are searching for info in the future.


I've had a very stressful week!  I think I last posted a week ago complaining about poor treatment from my midwife practice, an earache and anxiety about who would care for DD when the baby comes.  Well, my earache is better, I transferred my care to an OB practice yesterday and at the moment I'll be grateful to anyone who can come rushing to our aid if/when we need them.  I don't think I'm actually in a state of emergency-- but I'm pretty certain that many docs would say that I was!


So, I spent the rest of last week thinking about my options regarding my care and how to deal with the placenta previa.  I talked with my doula (who is amazing!) and my husband and I decided to a) get an anestheseologist consult to put a good c-section plan into place and b) interview a doc from a practice my doula recommends so that I could consider whether or not I wanted to transfer my care.  On Sat. we did a children's hospital class-- which was awful, they were pushing formula, diapers, and babes in the nursery on little kids!-- and we broke the news to DD that I would have to stay in the hospital overnight when the baby came.  She was pretty crushed but we started to develop a plan and she was doing well by the end of the day Sat. 


Sunday we had a fun day hiking in unseasonably warm weather.  When we came home though I noticed that I was spotting again.  And, there was a flow rather than dry spots.  This happened a few times over an hour and I decided to call my midwife practice.  I got a midwife on the phone and she was totally noncommittal.  Said something like, well it wouldn't be wrong to go in to triage and get checked at this point...  I told her I would wait a little longer and see if it continued.  I had one more small gush (like a teaspoon) and decided to go to the hospital.  I was told that since the baby seemed fine I would just be checked out, put on the monitor for a bit and then go home.  We got my sister over to watch DD and we headed out.  (around 6 pm). 


I get to the hospital, get into a gown, give a urine sample, etc... and see that there hasn't been anymore blood at all in the last 30-45 minutes.  I start to calm down.  But, then the hospital craziness starts.  A nurse comes in and says, the resident wants me to put two big ivs in you so I think that means you'll be staying the night--> this is before anyone checks anything!  I say I'd like to be seen first and then the resident comes in with another nurse and I agree to one hep-lock but not two and no fluids all at the same time that I'm being questioned by the resident.  Next thing I know, I'm hooked up to fluids, on the fetal monitor, having my vitals measured and having a speculum exam.


The good news is that everything appeared fine.  No obvious problem, but still they kept trying to keep me overnight.  I refused and promised to self-monitor and pointed out that I never sleep more than 3 hours at a time, I'm not currently bleeding and I live 10 minutes from the hospital.  Eventually my midwife arrived but she was totally defensive and suggested that I was risking killing myself or the baby.  They then started pushing me to get the steroid shots and were arguing that I was at high risk of going into preterm labor.  I asked some questions about the shots that neither the midwife nor the resident could answer and then did some research (which was hard to find).  Eventually, a much more sr. doc came in and talked with me about my concerns about the steroids, persuaded me to take them, and agreed that there was no reason to stay over night as I had been observed for 4 hours without any bleeding. 


In case anyone is reading this because they are trying to decide about taking steroid shots.  I'd like to summarize that based on my research and talking with docs, they are most effective 48 hours to one week after the first shot, their effectiveness runs out completely after 2 weeks, but many docs (backed up by research studies) find that a third shot after the two week mark can be highly effective.  The shots help lung development but also aid in brain development, GI development and decrease the chance of fetal death.  I was told that the side effects for the mother were "none".  In my experience (3 days after the first and 2 days after the second shot) the side effects were very rapid heart rate, intense emotional reactions, insomnia, anxiety, being incredibly hot, and having rigid muscles and aching pain.   I have not found any info about side effects on the baby at all.  Though I'm certain that she's been flooded with cortisol based on my own anxiety level. 


So, now I'm very nervous.  I've been told that based on the location of my placenta it is highly unlikely that this will resolve and my best case scenario is a scheduled c-section at 37 weeks (though if it clears, this new OB practice is totally VBAC supportive) and a possible (but no idea how likely) emergency c-section before that.  I'm trying to come to terms with all of this and plan as best as I can.  I'm wondering if anyone has any advice for preparing for a potential premature baby, dealing with transfer of care to a new practice so late in pregnancy (I'm 29w5d), things to remember for my current emergency hospital bag or more organized future bag, or anything else. 


Thanks for reading this.  I feel really frustrated right now.  I had been thoroughly enjoying this pregnancy and have felt completely healthy and good about my body.  Now, I'm worried about the stress to DD and the baby and wishing this would all go away (one way or another).  I'm trying to get back on a path of calmness and peace and I so appreciate having this DDC as one place to connect.  Hope you all are feeling well!


I'm still a Feb '12 mama even if she comes early, right?



hildare's Avatar hildare
09:03 AM Liked: 382
#2 of 22
12-08-2011 | Posts: 2,680
Joined: Jul 2009

i've been worried about you!  you've been going through so much.  :( 

i hate that this is happening. 

will bedrest help?  are you on bedrest?


atomicrocket's Avatar atomicrocket
09:20 AM Liked: 17
#3 of 22
12-08-2011 | Posts: 251
Joined: Feb 2011

Oh my gosh, Parsley!  That is a lot to deal with.  I really hope things quiet down for you. 

I don't have any advice, just hug2.gif


parsley's Avatar parsley (TS)
09:41 AM Liked: 70
#4 of 22
12-08-2011 | Posts: 773
Joined: May 2011

Thanks for the support, Hildare and AtomicRocket. 


So I asked about bed rest yesterday and I was told that they only really recommend it if standing up is what makes you bleed.  Otherwise, there's no real purpose.  I've been trying to take it easy though.  The other potential benefit of bedrest is that it would get me out of my teaching obligations.  Fortunately, though, the last day of classes is today and we have finals next week so I don't have much more to make it through on that front.  If it were earlier in the semester I think I would need the medical excuse to get off teaching-- it's very stressful to do it under these circumstances.  So, I'm thinking that I'm going to be putting myself on maternity leave after I submit grades next week.  I have a lot of research obligations coming up but I think I'm going to feel physically and emotionally better if I focus on myself, DD, DH, baby and getting ready for baby for awhile instead. 


The bright spot... it's at least possible that the spotting I'm having this week (Sunday and then some this morning) are caused by my placenta moving.  Something to hope for, anyway. 

FrannieM's Avatar FrannieM
10:43 AM Liked: 20
#5 of 22
12-08-2011 | Posts: 330
Joined: Jan 2011

Wow, parsley, what a ride!  Thank you for sharing!  And good luck to you!

Right of Passage's Avatar Right of Passage
11:02 AM Liked: 65
#6 of 22
12-08-2011 | Posts: 2,313
Joined: Jul 2007

((((hugs)))) Parsley, I'll be thinking of you. I really hope that she can stay put until at least 37 weeks. And of course you're a feb '12 mama! <3

1blueheron's Avatar 1blueheron
12:54 PM Liked: 21
#7 of 22
12-08-2011 | Posts: 450
Joined: Aug 2009

Oh my, parsley!  You sound so brave and clear-headed describing all of this.  I wish you strength and good luck.  hug.gif

Ramzubo's Avatar Ramzubo
01:23 PM Liked: 19
#8 of 22
12-08-2011 | Posts: 423
Joined: Aug 2010

hug2.gifWishing you all the best, Parsley. What a rough ride this has been. Thanks for sharing your story too. I went in to the doc last week with some preterm labor symptoms. They're thinking that it was brought on by dehydration and I've been doing well since then, but now I'm concerned about an early delivery. They didn't put me on a strict bed-rest, but they did suggest laying down as much as possible. I'm worried enough without placenta previa ,so I can not imagine how stressful this must be for you. Sending lots of positive vibes that you little one stays in as long as possible!

TeamGR's Avatar TeamGR
01:52 PM Liked: 13
#9 of 22
12-08-2011 | Posts: 175
Joined: Jul 2011

Glad that the semester's almost over and hope you can take a small break from research to focus on yourself.... thinking of you!!  hug2.gif

parsley's Avatar parsley (TS)
10:45 AM Liked: 70
#10 of 22
12-09-2011 | Posts: 773
Joined: May 2011

Thanks for all the hugs!  I really appreciate it. 


Rambuzo, sorry you're stressing about preterm too!  I don't know why (lucky or naive, I guess) but I never thought of it before this week.  It's so scary to imagine a babe coming so long before s/he is ready.  Hope your symptoms have all subsided. 

atomicrocket's Avatar atomicrocket
12:34 PM Liked: 17
#11 of 22
12-09-2011 | Posts: 251
Joined: Feb 2011

Originally Posted by parsley View Post
So, I'm thinking that I'm going to be putting myself on maternity leave after I submit grades next week.  I have a lot of research obligations coming up but I think I'm going to feel physically and emotionally better if I focus on myself, DD, DH, baby and getting ready for baby for awhile instead. 


I think this is a really good idea, I'm glad to hear that you're going on leave early.


Ramzubo - sorry to hear about your preterm labor symptoms!  I hope everyones' babies stay put for at least another 5 or 6 weeks.

mamashannon's Avatar mamashannon
06:05 PM Liked: 17
#12 of 22
12-09-2011 | Posts: 130
Joined: Mar 2010

Oh my goodness Parsley! You have got a lot going on! I'm glad to hear that you'll have the opportunity to be home soon. I'll be thinking of you!

frogautumn's Avatar frogautumn
02:59 PM Liked: 20
#13 of 22
12-20-2011 | Posts: 1,356
Joined: May 2007

Hi Parsley,


Thinking of you and please keep us updated! If you don't mind sharing (and forgive me if you've already posted in another thread), what is the position of your placenta? I just found out today that I might risk out of homebirth due to a low lying placenta. I'm kind of blindsided and feeling very sorry for myself, but we still have a few weeks to wait-and-see.


Sending "moving on up" vibes to both of us!! goodvibes.gifplacenta.gif

parsley's Avatar parsley (TS)
11:49 AM Liked: 70
#14 of 22
12-21-2011 | Posts: 773
Joined: May 2011

Thanks, Frogautumn for checking in on me.  And, sorry to hear that you have a low-lying placenta.  From the excessive research I've been doing, it sounds like you still have a GREAT chance of it moving up and out of the way by delivery.  In my case, I have complete placenta previa.  At each u/s, my placenta has been centered over my cervix.  I have another scan scheduled for next week and will do one between 36 -37 weeks as well.  While I've heard stories of people with complete placenta previa clearing up late in pregnancy, it seems like it's unlikely that my placenta will move enough and quickly enough.  Low-lying placenta should move up.  The lower part of the uterus is the last to pop out so it takes the longest for placentas attached down at the bottom to move out of the way.  Good luck!


All in all, I"m doing ok.  I've had 4 spotting episodes since the initial triage visit.  None of them were heavy enough to warrant me calling my OB so that's good.  I've been taking it easy as much as possible, cooking food to fill the freezer, trying to get things washed and organized for the baby, etc...  And, I'm pretty optimistic that we're going to make it to 37 weeks for a scheduled c-section.  I talked with DD's pediatrician earlier this week and he was very reassuring about the baby being fine even if she comes early.  He felt like 32 weeks was a major changing point.. and that babies born between 32-35 weeks were "late-preemies" and generally had short NICU stays and showed no long-term adverse effects.  I also had an appt with an anestheseologist so I'm feeling as good as possible about the c-section.  And, my "emergency" hospital bag is packed and ready.   Weekends are stressful though as my biggest concern right now is scaring the hell out of DD with another "emergency".  During the week, she has school-- with exceptional teachers-- so I know she has GREAT care.  During the weekend, we'd call my sister or a friend and the care is caring but not exceptional shrug.gif.  I hate the idea of leaving her home and worrying.  These next two long weekend are going to be tough! 

Gunter's Avatar Gunter
01:59 PM Liked: 13
#15 of 22
12-22-2011 | Posts: 3,076
Joined: May 2005

parsley- i am so sorry that you are having to go through this.  i am thankful that you have some holiday time off from school to be able to rest!  my dear friend had previa with her last babe; her first was born at home.  the previa did resolve and it totally moved out of the way clearing her for a vaginal birth.  we still felt comfortable in the hospital vs. home for this birth and it was fabulous!!!  she had a great care provider, lots of excellent support and such a short pushing phase.  it was a wonderful birth after much rest for a very active marathon runner mama. 


hope that you can get all of your needs met in this season and that your precious babe stays in while your placenta moves on up!


Rambuzo- I, too worry about pre-term labor mainly b/c my first was born a bit early and i've had some intense BHs in the past few weeks.  even though i was well-hydrated and well-rested, they came on stronger that i expected.  it totally caught me off guard.  then, i had a dream the babe was born at 34 weeks and another that the babe was born at 31 weeks.  well, i've made it past 31 and babe is still inside so let's keep hoping the wee one stays in as close to my EDD as possible!  hoping the same for you!

parsley's Avatar parsley (TS)
10:16 AM Liked: 70
#16 of 22
12-28-2011 | Posts: 773
Joined: May 2011

Posting an update... but it's not good news.  Had my ultrasound earlier today and my placenta has not moved at all.  It is still completely covering-- surrounding, really-- my cervix.  At this point, it is incredibly unlikely that it will move and the chances of it being placenta accreta seem higher.  I don't yet know what that means with possibility of hemmoraging during the c-section or the risk of hysterectomy.  I'm hoping both are small, and I'm not doing an googling to find out more (!).  I have enough to worry about as is. 


In all, I'm feeling pretty bummed and worried and find myself just wanting this all to be over and done with.  Hoping that I'll feel more cheerful, relaxed and optimistic in a few days time.  


On a positive note (I suppose), it seems there's nothing for me to worry about with not gaining any weight in the past four weeks.  The baby is HUGE.  Estimated at 5lb8oz, 89% percentile.  I can only assume the steroids had something to do with me growing a giant as she was 75% percentile at 27 weeks and DD always measured somewhere around there as well.  I think though that size is an advantage if she's born premature so that's some good news. 

mtn.mama's Avatar mtn.mama
03:48 PM Liked: 16
#17 of 22
12-28-2011 | Posts: 3,110
Joined: Mar 2007

That's awesome news.  At 29 weeks, my baby was only 3.5#.  All of this is happening for a reason.  I'm wishing you rest and peace, and hoping this little one can stay in as long as possible.


hildare's Avatar hildare
03:13 PM Liked: 382
#18 of 22
12-29-2011 | Posts: 2,680
Joined: Jul 2009

parsley, glad the babe's getting to be bigger.  i do think that's very positive.  kup about the rest though... 


Ramzubo's Avatar Ramzubo
02:54 PM Liked: 19
#19 of 22
01-01-2012 | Posts: 423
Joined: Aug 2010

Sorry your placenta isn't cooperating Parsley, but wow that's great baby progress!

Gunter's Avatar Gunter
07:32 PM Liked: 13
#20 of 22
01-01-2012 | Posts: 3,076
Joined: May 2005

so sorry your placenta is not moving, parsley!  there is some peace of mind knowing that your healthy girl is growing strong in there!!!  i hope that you can work your wishes and desires into a great birth plan since you will know in advance how the placenta affects things. 

ryan'smom's Avatar ryan'smom
12:31 PM Liked: 13
#21 of 22
01-03-2012 | Posts: 416
Joined: Jan 2007

*hugs* Parsley!  You are in my thoughts!

parsley's Avatar parsley (TS)
09:12 AM Liked: 70
#22 of 22
01-04-2012 | Posts: 773
Joined: May 2011

Thanks, everyone.  I'm feeling very good about how strong and healthy this babe seems to be.  It was good to watch the practice breathing on the u/s last week and know that she's in good shape developmentally. 


I had an appt with my OB yesterday and it's really clear that my placenta isn't going to move enough for vaginal delivery since it's still a complete previa and it moves posterior to anterior and thus the uterus stretching isn't going to be in the posterior area so even that further growth will likely not make a difference to the placentas location.  So, we've scheduled the c-section for 1/27 and I'm now putting the details into place.  I also am going to have an MRI (!) done tomorrow to check and see if we can rule out placenta accreta.  They weren't able to rule it out on the u/s.  


Despite this not being the pregnancy or birth I was hoping for, I can feel the fear being replaced by the excitement about having my baby in my arms in just a little more than 3 weeks!  And, I'm taking some comfort in being able to offer DD such a concrete date and information on what to expect.  Now I just have to hope there aren't any emergencies in the next 3 weeks (and two days)... 


Thanks again for your support and concern.   I really appreciate it!

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