Jody824...Hi there, I saw your post and wanted to respond. Generally, no sex with a pp means nothing in the vagina and usually no orgasm as well. When the placenta covers the cervical os there is risk for bleeding and possibly hemmorhage (extreme bleeding.) Anything inserted into the vagina has the potential to come in contact with the placenta and cause a bleed. Or cause the cervix to dilate (thereby causing the cervix to potentially pull away from the cervix and cause bleeding.) Orgasm, the same in terms of its effect on the cervix. You want to avoid anything that makes the uterus contract, including orgasm. Did your doctor tell you whether your pp was complete or partial?? A complete pp covers the entire cervical opening and puts you at both greater risk for bleeding and greater likelihood of the placenta not migrating.
That said, at 20 weeks your risk of bleeding is pretty low. Usually a bleed occurs as the uterus grows upward, pulling the placental edges away from the cervix. Or as the cervix dilates and does the same. Typically bleeds with a continued pp occur after 28 weeks. The GREAT news is that over 90% of diagnosed pp's do migrate away from the cervical os as the pregnancy progresses and the majority of them go on to deliver vaginally. Many docs will not actually diagose a pp until after 20 weeks because of this.
Your level of activity restriction will vary dependent upon your practitioner and his or her familiarity with placenta previa. Often minimal restrictions from 20 weeks to 28 weeks (i.e. no sex/orgasm or heavy lifting but all else okay as long as not bleeding.) and restrictions increase after 28 weeks, with complete bedrest if any bleeding but modified otherwise. (i.e. rest as much as possible with feet up, but okay to be up in house and do light activity...maybe okay to work depending upon job...okay to drive.) Some docs are much more restrictive, especially if they have limited experience with this condition. They should be doing serial ultrasounds to determine placental migration...
It is very tempting to get on the internet and search for information...but be wary as you will find the horror stories, when the reality is that there is most often a good outcome for both mother and baby! There is a great placenta previa thread under pregnancy complications on the Baby Center community...it was a world of much needed support for me!
Even if your pp continues, your baby should do great! The downside is that you have to have a c-section with a pp that doesn't migrate (or at least it was a downside for me!) and that your baby will probably be born a little on the early side (35-37 weeks gestation.) Typically you would have an amniocentesis around 35- 36 weeks to check for fetal lung maturity and a c-section scheduled dependent on those results. There is a greater risk of maternal hemmorhage during the c-section and of hysterectomy because they often have to cut into the placenta itself...however, these risks are well planned for and most women do just fine. ( I wouldn't even mention it...but my OB brought it up and completely freaked me out, so I want you to be aware.)
My story is as follows: Early pregnancy with intermittent bleeding but baby okay...PP diagnosed at 20 week ultrasound as a complete, bowl shaped previa (centrally located over my cervix and the least likely to resolve.) Light activity/no sex/orgasm and light duty at work (I'm an ICU nurse,) from 20-24 weeks. Small bleed at 24 weeks...off work, modified bedrest at home (well as modified as possible with a 2 year old dd.) Increased bedrest at 28 weeks and a bleed at 32 weeks that landed me in the hospital for a week...with some contractions. Allowed home on strict complete bedrest only since I was within 10 minutes of hospital and with many promises to call 911 with any bleeding. ( First bleed with pp tends to be light and subsequent bleeds sudden and much heavier, tending to put person into premature labor.) Amnio at 35 weeks with c-section scheduled next day...LUNGS NOT MATURE ( I did whig out completely when they called to tell me baby was not going to be born the next day.) and Finally c-section at 36 weeks... Healthy baby boy born at a hefty 7 pounds, 4 ounces...had a collapsed lung, but spent one day in NICU. C-section for mom with lots of bleeding, a slight accreta (where placenta attatches more firmly to the uterus,) but I was okay and they were able to control bleeding without any complications (which is usually how it goes!) It was scarey and bedrest was brutal...but what counts now is my beautiful baby boy and I'd go through that all again!
Hope this helps...feel free to e-mail me privately. Chandra