Vaginal Birth with Low Lying Placenta - Mothering Forums

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#1 of 11 Old 05-06-2010, 11:34 PM - Thread Starter
 
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Hi,

I had a question for those who are planning to deliver vaginally or have already delivered vaginally with a low lying placenta. In my case, I've gone from a partial previa at 21 weeks to a marginal at 34 weeks to a low lying (1.1 cm from cervix) at 36 weeks. My OB would like a 2 cm clearance to okay vaginal birth. I'm really hoping that happens by week 39. I haven't had a bleed all through my pregnancy. So these were my questions to those of you who have gone through or are in a similar situation.

1) Have any of your obs/midwives okayed vaginal birth at less than 2 cm from OS?

2) For those who have been cleared for vaginal birth, are there any special precautions that your care provider is taking? (I'd still prefer an unmedicated birth but would take a controlled/medicated vaginal over c-section if that's possible.)

3) Those of you who had successful vaginal births or attempted vaginal births, what was your delivery like? Were there issues with bleeding/detachment of the placenta after baby was delivered?

4) Finally, those of you who had c-sections, when was your surgery scheduled for? 38 or 39 weeks? Were any of you allowed to start labor on your own?



Thanks!!!
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#2 of 11 Old 05-08-2010, 01:42 AM
 
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I'm 35 weeks on Monday, so I can't answer all your questions.

On Wednesday, the placenta was 1.7 cm from the os, and the OB unequivocally cleared me for vaginal birth. I recently read some studies indicating past 1 cm is current recommended range for vaginal birth. Less than 1 cm is still c-section.

I am still waiting to hear about special precautions. What my CNM thinks will happen is probably more fetal monitoring than I'd probably prefer, a heplock in case I need iv fluids, carefully monitoring for excessive bleeding. She's had me on pelvic rest and partial bedrest since 20 weeks.

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#3 of 11 Old 05-28-2010, 12:04 AM
 
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Sorry I have no answers, I am only 22 weeks with a marginal placenta previa but wanted to bump your thread. I hope you find your answers.
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#4 of 11 Old 05-28-2010, 12:10 AM
 
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I was found to have partial at my ultrasound. Neither my dr nor my midwife are concerned and have both told me if im concerned they will get me another ultrasound but otherwise... Im free to do my homebirth as long as I do not have any bleeding between now and then.

If I start bleeding I have to go on pelvic rest and call them, but both are completely certain its not a risk.

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#5 of 11 Old 05-28-2010, 12:28 AM
 
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The freestanding birth center where I had my first son told me that to give birth there, my placenta has to be at least 2 cm away from os. The midwife I talked to on the phone did say however that to have a vaginal birth - at least with them - it has to be that far but from that statement I saw a glimpse of hope that perhaps even if my placenta doesn't move away that far, I could have a vaginal birth somewhere else. I haven't had an appoitment at the birth cente since I got the news yet, so I haven't explored this issue further.
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#6 of 11 Old 05-28-2010, 09:15 PM
 
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with baby #2, my placenta was a little over 2cm from the os. IDK what their exact criteria was (this was 10 yrs ago and I had a midwife but hosp. birth). Once the placenta was far enough away from the os, they treated it like it was a non-issue and wasn't mentioned again. I think that happened around 32 wks. I didn't have any trouble with the birth or bleeding afterward or anything. In fact, it was probably one of my better births (I've had 6 so far.) Started spontaneously at 40+6 with membrane rupture and exactly two hours later she was born. Very textbook as far as details are concerned.
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#7 of 11 Old 05-28-2010, 09:33 PM
 
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Have you read this thread?

http://www.mothering.com/discussions....php?t=1118466

There is a study cited somewhere in there that indicated a c/s for <1cm, a trial of labor with 1 to 2cm, and "cleared" after 2cm. Your OB could be on the very conservative side. You might try looking around for another opinion (switching OBs) or discuss precautions that could be put in place for your OB to be comfortable with you attempting a vaginal birth.

Good luck!

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#8 of 11 Old 05-28-2010, 09:42 PM
 
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Moved from I'm Pregnant.

Stay-at-home mom to 2 beautiful.busy.boisterous boys b. 08.17.05 & 12.29.08
Nirvana is . . . the living happiness of a soul which is conscious of itself and conscious of having found its own abode in the heart of the Eternal. --Gandhi
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#9 of 11 Old 07-29-2010, 06:04 PM
 
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Interesting to read about all of this. I had a pretty big overlap at 30 weeks, but I'm still hoping that it will move. The local hospital wants 5 cm clearance. Has anyone ever heard of this?
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#10 of 11 Old 07-29-2010, 06:11 PM
 
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No, I have not heard of a 5 cm clearance. If that was widespread, the c-section rate would probably be 80%! Fortunately, my placenta has moved away and was 3.4 cm away at the u/s at 28 weeks. As soon as the tech saw it, not knowing the birth center's requirement of 2 cm, she said that I was fine. So I assume less than what I had was okay with most practitioners. I hope your placenta will still move. The midwives have told me that they had many instances when at 28 weeks, the placenta still has not moved but would move by 34 weeks or so. Wishing you the best.
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#11 of 11 Old 07-31-2010, 07:15 PM
 
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I'm only 36 weeks, so I can't answer all of the questions, but I was Dxed with marginal previa at 20 weeks that was still there at 30 weeks.

At 30 weeks it was just around 1 cm away so that was still a c-section.

At 34 weeks it was around 2 cm so I was cleared for a vaginal birth in the hospital but not for the birth center. My m/w said I would need continuous fetal monitoring and a heplock as well.

At 35+4 I was seen by the back-up ob who gives clearance for the birth center and he took several measurements and all of them were a bit over 2.5 cm and I was cleared for a vaginal birth at the birth center. He wants me to have one more u/s in 2 weeks, but he said there would be no issues as of now.

If I had needed a c-section they would have scheduled me for 39 weeks, but only because it was low lying. If it had been a previa it would have been schedule earlier and they would not have wanted me to go into labor because of the increased risk of placental abruption.

Erica
DD September 2010, m/c October 2009
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