Placental Abruption...Is a vaginal delivery possible? - Mothering Forums

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#1 of 8 Old 08-07-2013, 08:54 PM - Thread Starter
 
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Hi there, 

I have been looking and looking and searching and searching for information about being able to have a vaginal birth even though I have a placental abruption. I DO NOT want to have a Cesarean, but I also don't want something to happen to my baby because I chose to do a vaginal birth. So here is the 411...

When I was around 18-19 weeks pregnant I switched doctors and they found through the ultra-sound that I had a placental abruption of 20%. I have had 4 different visits since then and each time the number has changed.  The 1st visit it was 20%, 2nd it was 40%, 3rd to my relief it went down to 30%, but this last visit (this last Monday) it was up to 50%. This last month I have been COMPLETELY stressed out and although I have been trying to be careful, obviously the stress has taken its toll. But I am just barely starting my 33rd week of pregnant today, so I have at least 8 more full weeks of pregnancy. My doctor unfortunately is very cesarean-friendly, and would rather give everyone a cesarean because he owns his own practice. And it means more money obviously for him. But due to the current circumstances we are not going to be able to change doctors. So we are just trying to make the most of it. My husband and I do NOT want a Cesarean, I've done LOADS of research of whats best for baby, whats best for mommy, whats best for recovery, whats best for everything basically. And have decided I want a natural birth, so NO induction, NO pain meds, NO episiotomy, No nothing like that. Natural ALL the way!! :D 

Anyways, I have been looking for information on if a natural birth is possible, I still have 8 full weeks to get my current situation better, which I am very hopeful that I can. But I want to know if its actually safe. I have read a few places that its ok and then a few places say a cesarean is better just for the 'what-if' and 'better-safe-then-sorry' scenarios. But I don't want that one bit. 

Have any of you personally or heard of a women having a placental abruption and still successfully having a natural birth? What degree was the placental abruption? Where there any complications, even if small ones, what were they? I want to be sure about doing what is the best for my lil man. :) Please let me know what you think and know!!

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#2 of 8 Old 08-08-2013, 02:38 AM
 
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I know it is disappointing, but with a partial abruption there is no way I would try for a vaginal birth. I would count my lucky stars that we are in the 21st century and plan for a baby friendly cesarean. Question, do you mean previa, with the potential for abrupt ion, or has the placenta already started detaching and there is evidence of bleeding? Previas sometimes resolve, abruptions at 33 weeks, probably not.
http://summaries.cochrane.org/CD003247/interventions-for-treating-placental-abruption

Good luck and safe birthing!
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#3 of 8 Old 08-08-2013, 03:35 AM
 
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I love natural childbirth and even though it didn't work out for me to have one, I did birth both my girls vaginally. Vaginal birth is wonderful, don't get me wrong BUT if I had a placental abrupt ion, I wouldn't consider it. There are too many risks for my comfort - both to baby and mom. My number one priority would be a safe, hopefully predictable birth. I would want to avoid an emergency c section at all costs since there are more risks with general anesthesia not to mention feeling groggy and ill for hours. In a planned c section, you could be having skin to skin time with baby while the surgeon stitches you up and although recovery will be harder than after most vaginal births, it will be easier than after an emergency C. I have not read anywhere that a vaginal birth is recommended or considered safe with an abruption. I wouldn't take the chance. I understand that it is not the birth you want but if something did go wrong and baby suffered then the most beautiful natural birth won't make up for that.
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#4 of 8 Old 08-08-2013, 02:05 PM
 
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If your goal is a living baby you need a C-Section.
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#5 of 8 Old 08-08-2013, 08:14 PM
 
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If you are concerned about recovery what do you think about hiring a postpartum doula?  What are your other concerns with c-section?

 

It might be wise to seek a second opinion from another ob if you are wondering about your ob's motivations for recommending c-section.  I would also have a frank conversation wiht ob about how you are nervous about c-section and want to know if there are any circumstances where a vaginal delivery would be ok.  And if s/he has ways to make the c-section mom and baby friendly.

 

Placental abruption is a high risk condition, and you are lucky to know about it ahead of time.  Children and mothers who survive abruptions do so because they are caught early.  Your abruption may be relatively stable now, but labor can change that.  Abruption and acute blood loss during labor can cause clotting issues in the mother, brain damage in baby, and even death.  

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#6 of 8 Old 08-09-2013, 01:47 AM
 
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Here are a couple of links with information:

 

http://www.nlm.nih.gov/medlineplus/ency/article/000901.htm

http://library.med.utah.edu/kw/human_reprod/seminars/seminar3B2.html

http://americanpregnancy.org/pregnancycomplications/placentalabruption.html

http://www.betterhealth.vic.gov.au/bhcv2/bhcarticles.nsf/pages/Placental_abruption

 

It looks like lots of medical sources say that vaginal birth may be possible, given careful monitoring. This is one circumstance where I think that continuous fetal monitoring would be important during labor. 

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#7 of 8 Old 08-15-2013, 11:01 AM - Thread Starter
 
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No I mean abruption. It got a little better for a time but then it got worse. Because I tried to do to much with and for my other boys. 

 

i am currently in Mexico so although we are in the 21st century they are still somewhat behind here. They still recommend C sections over natural birth just because it is better for the doctor, and faster, and they make more money. All the doctors in this city are the same. Doulas do NOT happen here, luckily my mother is a doula and she is going to help me. BUT her situation does not allow her to help MUCH.

 

I read a previous forum on this site and saw that many people said it was possible to have a natural birth with a placenta abruption and that it should be fine and no complications. This is why I asked again, putting my own circumstances into it. The other forum gave no specifics. And although the choice does come down to me and my husband, I wanted to see what others thought about it, seeing as the forum was a few years ago.

 

@phathui5 THANK YOU!! I am going to read all of these articles on my lunch break. :)  

 

Also NO BLEEDING whatsoever. 

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#8 of 8 Old 08-16-2013, 10:32 AM
 
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I’m a huge advocate for natural birth and was fortunate enough to deliver my first naturally in a freestanding birthing center. However, after researching the topic ofplacental abruption, I feel that my own personal choice would be to go forward with a scheduled CS, given the number of risks involved. From what I have read, whether or not you’re experiencing vaginal bleeding, you are experiencing bleeding if the diagnosis of abruption is correct – you’re simply bleeding into the uterus. If you’re not experiencing an exceptional amount of pain, I understand how it could be difficult to really wrap your head around the fact that there is a very serious problem.

 

My thoughts are this – A planned CS is much less risky than an emergency one (which may come to be necessary anyway), for both the mother and the baby. With a planned C-section, a local anesthetic can be used rather than a general anesthetic, and, if there aren’t serious complications which place your health or the baby’s health at risk, you may be able to hold/bond with the baby right away. This simply will not happen with an emergency CS. And, as you mention that your doctor is CS-friendly, at least you are with someone who is experienced in CS and that will give you the better chance at the best outcome.

 

My heart goes out to you and I really wish I had another answer for you. I simply don’t think the risks involved to you and the baby (which still leaves a large chance of needing the emergency CS), is worth it. While my preferences are also for natural birth, my first priority would be avoiding an emergency CS at all costs, and it seems that a scheduled CS is really the only way to ensure that.

 

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