Successful Vaginal Birth for Placenta Previa? - Mothering Forums
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#1 of 58 Old 01-16-2008, 04:20 PM - Thread Starter
 
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Do these always end in c-section? I'm not talking about if you were told you had placenta previa early on, but then the placenta moves off the cervix. I'm talking about previa during labor. Thanks.
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#2 of 58 Old 01-16-2008, 04:28 PM
 
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If you're talking complete previa at the time of labour then yes, a c/section is the only option.
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#3 of 58 Old 01-16-2008, 04:51 PM
 
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I'm hesitant to say this because we all know what happens to stories as they are passed down the generations, but my great-grandmother has said that when her son (my mom's dad, my grandfather) was born, he came vaginally right through the placenta (she had placenta previa). Supposedly, after the birth, the doctors wouldn't let her stand up or move (she was hemorrhaging), but the sun was in her eyes, so she jumped up to close the curtains, and a huge piece of her placenta came out, and the hemorrhaging stopped. She lived, and so did her son (obviously).

I don't know if all of this is even possible, but my Nana was not one to lie, and this is the story she has told. Very scary, and definitely not something I'd recommend, as she said she honestly almost died.

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#4 of 58 Old 01-16-2008, 04:53 PM
 
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Yep. It's one of the real life-saving cases for a c-section.

-Angela
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#5 of 58 Old 01-16-2008, 05:08 PM
 
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I have delivered vaginally with partial previa. I have read about ripping through the placenta and have it saved in favorites but I am not on my computer. Doubt an OB would do it and there are time constriants.

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#6 of 58 Old 01-16-2008, 05:32 PM
 
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#7 of 58 Old 01-16-2008, 05:49 PM
 
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Placenta previa is one of the very few situations I absolutely would have a c- section.
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#8 of 58 Old 01-16-2008, 05:53 PM
 
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They would have to section you definitely.
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#9 of 58 Old 01-16-2008, 09:08 PM
 
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And thier diagnosis should be confirmed by u/s no earlier than 36-38 weeks. That way, if they said it was previa during pg, it would have time to move, as the uterus grows. But a previa at 38 weeks, is still gonna be there and there is no other safe way to get thru it. You can see a complete previa on u/s easily. I would ask them to let you see the screen, and not just take thier word for it.
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#10 of 58 Old 01-17-2008, 02:50 AM
 
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Originally Posted by alegna View Post
Yep. It's one of the real life-saving cases for a c-section.

-Angela
Why is this? Do you have links/resources/studies/evidence?

Also, what about UP'ers? If you UP'd, you wouldn't know beforehand, if you had no prenatal care incl. no U/S. So what would the procedure be then? How would you recognize complete previa (or any previa, for that matter) during labor? Are there any risk factors for previa?
Thanks mamas!
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#11 of 58 Old 01-17-2008, 03:03 AM
 
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Why is this? Do you have links/resources/studies/evidence?

Also, what about UP'ers? If you UP'd, you wouldn't know beforehand, if you had no prenatal care incl. no U/S. So what would the procedure be then? How would you recognize complete previa (or any previa, for that matter) during labor? Are there any risk factors for previa?
Thanks mamas!
Pain and bleeding during late pregnancy would be a tip off for one.

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#12 of 58 Old 01-17-2008, 03:05 AM
 
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Pain and bleeding during late pregnancy would be a tip off for one.
Actually, previa bleeding is classically painless. It's part of the differential diagnosis for previa v. abruption with bleeding in the third trimester.

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#13 of 58 Old 01-17-2008, 04:18 AM - Thread Starter
 
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To the pp wondering how UPer's would have early diagnosis:

I'm UPing, it's my first pg, and so I had this same question. If you search the forum for "placenta previa" you can find some earlier threads that tell you how to look and listen and feel for the placenta without having to get an ultrasound. Then you would only need the ultrasound if you couldn't find it or suspected it was covering the cervix.
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#14 of 58 Old 01-17-2008, 12:00 PM
 
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#15 of 58 Old 01-17-2008, 12:52 PM
 
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Originally Posted by ReikiMommy07 View Post
Also, what about UP'ers? If you UP'd, you wouldn't know beforehand, if you had no prenatal care incl. no U/S. So what would the procedure be then? How would you recognize complete previa (or any previa, for that matter) during labor? Are there any risk factors for previa?
Thanks mamas!

Serious bleeding in labor. And that is a sign to transfer.

-Angela
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#16 of 58 Old 01-17-2008, 01:55 PM
 
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Originally Posted by alegna View Post
Serious bleeding in labor. And that is a sign to transfer.

-Angela
I know someone who had complete previa, no u/s during pregnancy. Mw dx'd it at homebirth (I think due to severe bleeding), she transferred, had a c-section and baby and mother were fine, aside from trauma of c-section, etc. So I've always thought, as Alegna posted, that you'd be getting some pretty clear signs of something wrong, even with no mw there to evaluate it.
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#17 of 58 Old 01-17-2008, 10:00 PM
 
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#18 of 58 Old 01-17-2008, 10:11 PM
 
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depends on degree of previa- complete not very likely that the baby will survive- there probably is some rare % that do and have but not a big percentage also risk to mom is greater because blood is being lost directly from the placental site-- a low lying placenta that would be 3 cm from the cervical opening when it is completely closed probably going to be fine- trans-vaginal ultrasound would be a way to have a look-see

take care
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#19 of 58 Old 01-17-2008, 11:12 PM
 
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It has been done-- I believe I read about it on unassistedliving.com , but it's one of those things that I think even 99% of potential UC'ers would go for a c-section for.

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#20 of 58 Old 01-18-2008, 02:39 AM
 
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Originally Posted by arcingpath View Post
To the pp wondering how UPer's would have early diagnosis:

I'm UPing, it's my first pg, and so I had this same question. If you search the forum for "placenta previa" you can find some earlier threads that tell you how to look and listen and feel for the placenta without having to get an ultrasound. Then you would only need the ultrasound if you couldn't find it or suspected it was covering the cervix.
Many thanks!
And thanks for the links and other great info, too!
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#21 of 58 Old 01-18-2008, 09:33 PM
 
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I'm like most pp. A previa is a big reason to transfer and get a c/s. Like I tell my children, if something is blocking the door, the baby can't get out. If it is complete, it covers the entire opening, and to have it torn or detach on one side would almost certainly have the baby suffocate before birth or mom bleed to death. Though like stated, there are rare chances where perhaps that did not happen. But those risks are more than I am generally willing to take. A partial is another story.

That is why I always get a 20 wk u/s. I believe the risks of u/s are out weighted by the benefits (that is one u/s at 20 wks for placenta check and basic baby check, not necessarily many u/s).

Any misspellings or grammatical errors in the above statement are intentional;
they are placed there for the amusement of those who like to point them out.
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#22 of 58 Old 01-18-2008, 10:21 PM
 
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That is why I always get a 20 wk u/s. I believe the risks of u/s are out weighted by the benefits (that is one u/s at 20 wks for placenta check and basic baby check, not necessarily many u/s).
And see, IMO a 20 wk u/s is next to useless to diagnose previa. It can *eliminate* it as a possibility, but if they see previa at 20 weeks it's pretty much meaningless.

-Angela
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#23 of 58 Old 01-18-2008, 10:22 PM
 
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And see, IMO a 20 wk u/s is next to useless to diagnose previa. It can *eliminate* it as a possibility, but if they see previa at 20 weeks it's pretty much meaningless.

-Angela
Why not eliminate it as a possibility? Many women choose to have an US for anatomy anyway.

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#24 of 58 Old 01-18-2008, 10:29 PM
 
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Why not eliminate it as a possibility? Many women choose to have an US for anatomy anyway.
Because if it's NOT eliminated then you've basically just signed up for a bunch more u/s.

I choose not to do any u/s without medical reason.

I have yet to read of a case of placenta previa that presented with NO bleeding by labor.

-Angela
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#25 of 58 Old 01-18-2008, 10:38 PM
 
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Because if it's NOT eliminated then you've basically just signed up for a bunch more u/s.

I choose not to do any u/s without medical reason.

I have yet to read of a case of placenta previa that presented with NO bleeding by labor.

-Angela
And there are those who do consider screening to be a medical reason. Do you have your midwife use a fetoscope for prenatals? Dopplers are much higher-energy US than a standard scan.

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#26 of 58 Old 01-18-2008, 10:41 PM
 
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And there are those who do consider screening to be a medical reason. Do you have your midwife use a fetoscope for prenatals? Dopplers are much higher-energy US than a standard scan.
Absolutely. No doppler without medical reason either.

-Angela
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#27 of 58 Old 01-18-2008, 11:40 PM
 
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Because if it's NOT eliminated then you've basically just signed up for a bunch more u/s.
This is true. We had a UC/ (mainly) UP and because of some symptoms I was having AND to rule out DP little doubts about the plan I agreed to a 20weeks US.

This was my third pregnancy and I hadn't had ultrasounds before 30weeks with any of them.

I think I went in at 20 week and what do they find? "placenta previa" that wasn't. But now, we had to go back one more time to see that it had resolved...because I agree a previa is a reason for a c-section even if I would have prefeered a UC/homebirth.

at the 33 week u/s the previa had resolved, but now they see another "normal but maybe not" thing they need to check on again at a later US. (possible kidney refluxing, but they weren't certain)

I never went back and had my UC.

This is one of the risks of spying on the unborn, unfinshed forming fetuses. Since babies don't all develop at the same rate, and some placentas take longer to migrate to the top 1/3 of the unterus, you wind up with unecessary serial ultrasounds, extra costs to your insurance company and alot of stress.

I now think that if you want to check on your pre-born (and we like to, I think it's a great diagnostic tool when used properly) do it as late as possible.

with my next pregnancy, I planned the 20week one then kept rescheduling until I thought it was late enough, that I wold not have to repeat it. I think I was like 30 odd weeks.

Carrie, The Birthteacher CCE and Doula, real mom to five; and womb-mom to G. born at 23w by emergency C. 12/09
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#28 of 58 Old 01-18-2008, 11:43 PM
 
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You know how sometimes you read a historical novel, and a woman dies in childbirth and the midwives all wring their hands and say "there was too much blood." That's basically the situation. If you try to deliver vaginally, the placenta is in the way and comes out first during labour, then the mother hemmorhages and the baby suffocates because of still being in there with no oxygen supply. There are stories of emergencies where the placenta is successfully cut to allow the baby through, but in my limited knowledge, I believe these would probably have been the fastest, easiest labours had the previa not been present.

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I have yet to read of a case of placenta previa that presented with NO bleeding by labor.
I had complete placenta previa with my first pregnancy, and I never bled at all. I had the cesaerean at 38 weeks, so I'm not sure what would have happened had I gone to term. My doctors all told me to rush to hospital if I bled, or felt any signs of labour, but everything was perfectly normal. Had I been avoiding ultrasounds for whatever personal reasons, the previa would not have been caught, and I and my son would have been tragic characters out of a novel.

Now I'm pregnant again, just had an ultrasound at 18 weeks, and guess what. Previous previa and prior cesaereans are both risk factors.
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#29 of 58 Old 01-18-2008, 11:57 PM
 
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I've got a complete previa, and am having a c-section in just over a week for it. I wanted to have a home birth, but DH wasn't comfortable with that, and we compromised with a water birth at a nearby birth center with midwives. Then, a previa was discovered at my 20 week U/S, which I nearly refused, and I'm glad at this point that I didn't. I had another U/S at 29 weeks, and another at 35 weeks (just looking at the placenta, no baby measurements). The placenta hadn't moved at all in either case, so I think the benefits of a section are undeniable at this point.

I'm sure that it could happen, but I think that a vaginal birth, especially with a complete previa is an almost guaranteed death sentence for mom and baby without proper care. If the placenta is supplying oxygen to baby, and the placenta detatches or is broken, unless baby is very close to coming out, baby is going to die (or be seriously brain damaged) without oxygen. With my first child, I pushed for over three hours, so there is no guarantee that even if you're at the pushing stage, birth will be over quickly enough to make sure baby survives.

Also with a complete previa, as mom dilates, there is a risk of the placenta detaching, as there is a larger and larger hole behind where the placenta is attached. That detachment can not only lead to the issues I just mentioned with the baby, but also to mom hemorrhaging. And that hemorrhaging can happen incredibly quickly.

As I said before, I'm glad that I've had the U/S studies, because I haven't had any symptoms. I'm 36 ish weeks pregnant, and I am still working, haven't had any spotting or bleeding. Without the U/S, I could be heading for a disaster that I didn't even know was coming.
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#30 of 58 Old 01-19-2008, 12:01 AM
 
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I had complete placenta previa with my first pregnancy, and I never bled at all. I had the cesaerean at 38 weeks, so I'm not sure what would have happened had I gone to term. My doctors all told me to rush to hospital if I bled, or felt any signs of labour, but everything was perfectly normal. Had I been avoiding ultrasounds for whatever personal reasons, the previa would not have been caught, and I and my son would have been tragic characters out of a novel.

Now I'm pregnant again, just had an ultrasound at 18 weeks, and guess what. Previous previa and prior cesaereans are both risk factors.
I can not imagine that you wouldn't have had bleeding at the beginning of labor- telling you that you needed further care. You then would have had time to go to a hospital in all likely hood.

-Angela
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