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20 Most Common Questions about Placenta Previa

So, after my first big scare (which was also my biggest bleed at 6 weeks) I didn’t know what to do. I didn’t know what placenta previa was or what to think about it. The first thing the doctor told me in the ER was “…don’t worry about it. These things usually clear up on their own, it will be fine. Just give it sometime.” Needless to say, mine did not clear and I did not enjoy my second pregnancy at all. I was mortified thinking that for so many crazy reasons, I was not going to make it (meaning I didn’t think my baby was going to make it). There are cases where mom, baby or both don’t make it, but it is a very small “small” percentage. Mind you, I’m a very healthy person, super positive, and totally open-minded. I AM so glad I was completely wrong for having those thoughts. On March 8th, 2019 Elena Rose was born Via C-section (vertical incision). I will share more about our journey as the months unfold. For now, if you have concerns, I have compiled the 20 Most common questions about placenta previa from expectant mothers. Many of these questions are things many of us didn’t think to ask until after the fact. Please be aware, many of these questions will not apply to everyone! Everyone has a different health background and different struggles. These questions are not in any particular order or level of importance. Several of these questions would have been helpful to me as I was going through my own p.p. journey. Another word of advice, is whomever your doctor is, please make sure that you feel 100% comfortable with them as they are an important part of your journey. I would encourage you to find out how many cases of previa he’s had or simply see how comfortable he is with your pregnancy. Seems pretty silly to ask, but one of my motto’s in life is “It doesn’t hurt to ask.” Talk to other nurses or get second opinions if you feel it’s necessary. As I have mentioned before, I was so lucky to have had the best doctors in my county. I remember all the people mentioning how great these doctors were and it all gave me a piece of mind. Overall, my pregnancy gave me anxiety, pain, and to be honest I was frightened. Not all cases have happy endings as I saw during my pregnancy. I will forever be grateful for my experience and my healthy baby, but I don’t ever want to go through a placenta previa pregnancy again.

  1. How serious is placenta previa?  
  2. Will I need to see a specialist? 
  3. What are the different outcomes? 
  4. What symptoms can I expect besides unexpected bleeds? 
  5. Will I have to have a C-section and will it be different than a regular C-section?  
  6. Will I have to deliver early? (Why? What are the risks if I do not deliver early?) 
  7. What are the chances of having previa again in subsequent pregnancies?  
  8. Will you work at helping me keep my uterus, if possible?  
  9. What is posterior or anterior placenta previa? (low lying/marginal/completely) 
  10. Will I have any Travel, exercise, restrictions etc.? 
  11. Is the risk of Postpartum depression higher in those with P.P? 
  12. Am I at risk for Accreta? Or a Hysterectomy? 
  13. How often will I need to get ultrasounds for progress (if any)? 
  14. No bleeding this far, what does that mean? 
  15. What are the chances of the placenta moving? (If cleared, can it come back?) 
  16. What are the risks of premature labor, if any? (What can I expect after delivery?)
  17. What is my Cervical length?  
  18. Why is bleeding caused? 
  19. Are orgasms okay without penetration? 
  20. Do you have a support group or is there a platform for expectant mothers? 

My husband, family, eh some mommy friends, and this incredible Facebook group that I’m a part of helped me out so much! I reached out to this Facebook group as often as I needed. I asked so many questions and did some research. Something that aggravated me the most, which I did mention to both of my doctors was that I’d noticed the lack of information, support or knowledge on the topic. They explained that it just simply wasn’t that common. Well! I was tired of the anecdata. I didn’t want to know old statistics or information from Google. I wanted to know facts! Recent facts! When you’re diagnosed with “possible accreta” causing you to “possibly have a hysterectomy”, not knowing these outcomes can be very concerning. Am I right?

***What should I do if I have bleeding? Please refer with a medical professional or your doctor right away!

What is Placenta Previa?

The condition Placenta Previa is when your baby’s placenta is “partially covering” or “completely covering” your cervix. (Yes, there are different levels of Previa). When women have to deal with Placenta Previa, this isn’t all they’re going to deal with when they’re going through with their pregnancy. The placenta covering the cervix is only the physical part. In my experience, along with many others, this is a devastating condition (mentally, as well). Not for all, but for most. Okay, here is a trigger warning so in case you have suffered dearly from this condition be aware there are some things mentioned that may be a trigger. Beware.

Not to alarm you with what you’re about to read, but it’s the truth: some women, depending on their placental grade and their own health condition; some women have to have a hysterectomy, organ repairs, loss of their baby, there’s a chance of losing too much blood and well, there could be many outcomes. We all want a positive outcome after any pregnancy, of course. Then, there are those individuals where the placenta clears and they can have a perfect delivery (what is a perfect delivery anyway?). Placenta previa, according to the doctors, can be a very common diagnosis (not cool though, right?). Well, for any expectant mother, this is definitely something you never want to hear.  

Here is one example: You and your husband (partner), want to have a baby. You get pregnant. You’re ecstatic. You tell everyone the amazing news. You can’t wait to celebrate and enjoy all the wonderful things pregnancy and motherhood have to offer (Right?). Let me just insert here the many different other cases of parents not mentioned trying to get pregnant or dealing with many other different factors. Anyway, it took my husband and me roughly five months to conceive. My first anxious moment happened as early, at 6 weeks. At such an early time in my pregnancy, everything was a whirlwind. I had what was called a subchorionic hemorrhage. I think it’s also known as “Chorionic hematoma”. And then, what? Well, the incredible “Birth Plan” you think you had has “potentially” gone out the window. Many expectant mothers want to deliver naturally, (eh, maybe not all), but now, that pregnancy’s going to have to be monitored, very closely. (Just Great!) 

Anyhow, back to Placenta Previa. There are several different levels or grades of Previa. Depending on your placental abruption, as your pregnancy progresses, your doctor will keep you up to date on how and when to deliver. I’m not going to get into all those details since I’m not a doctor. The knowledge I have and what I know is all from my personal experience. I do not want to scare you away from this situation as I know what it’s like.

Unfortunately, at this time there is no treatment on how to stop or prevent this condition. (Hey, and if there is, and I don’t know about it, please reach out to me and let me know). In case you don’t know, with placenta previa in a large number of cases, a cesarean is needed to safely deliver the baby. A C-section is needed, because of the placenta being so close or even covering part of your cervix, it’s a problem, because that’s where the baby makes its exit. The cervix is the opening to the birth canal. So, yaaaay! Now you know a little bit about Placenta Previa.  

Note from a wise Doctor

I had the pleasure of having an incredible Maternal-Fetal Medicine doctor right in my city. Before getting into all the questions and concerns, first, I want to share a few words from my doctor, Dr. P (as you’re reading this, yes, it’s a Bosnian accent) 😀

“When you are told that you potentially have placenta previa on a routine sonogram <20 weeks gestation, first thing is NOT to panic. It is a common diagnosis so early in pregnancy because the lower uterine segment where pregnancy is housed is not yet developed, so many times the placenta ONLY appears as previa or low lying placenta. More than 90% of the time, later in pregnancy around 28-30 weeks of gestation, a sonogram will confirm true placental location that will be sufficiently away from the neck of the womb and represents normal findings…

If placenta is truly previa and completely covers neck of the womb (confirmed by the sonogram latter in pregnancy), be aware that vaginal blood spotting or even light bleeding episodes are common. No panic again, as it is self limiting and will resolve over few days to weeks. 

Start to prepare yourself and your family that delivery (once placental previa is confirmed by later sonogram) will be earlier than planned – 2 to 4 weeks earlier than due date because your doctor will desire to deliver your baby before term-labor starts as regular uterine contractions may cause serious vaginal bleeding (by shearing forces of uterine wall contraction movements against placental tissue that does not contract so bleeding occurs at the line of placenta to uterine wall separation) that would necessitates emergency delivery for maternal and fetal sake. 

Many doctors will follow current guidelines created by ACOG (American College of Obstetrics and Gynecology) that advise for earlier delivery, as early as 36 weeks (whole month earlier than due date) to avoid significant bleeding from previa if labor develops. 

Please, do not preoccupy yourself too much about this earlier delivery, as your baby will be sufficiently mature and risk of respiratory complications at and beyond of 36 weeks gestation are small. However, this risk is lesser than risk of significant and serious vaginal bleeding from previa if delivery is postponed and you are in labor. 

Now, once you have diagnosis of placenta previa, many things will be ‘forbidden’ to you and your spouse… You will have to practice ‘pelvic rest’, that is, no sexual intercourse, no vaginal douching or washing, to avoid constipation, to avoid heavy physical exercise or activity – in other words, anything that may potentially increase uterine activity (that is always present at some mild level) and cause vaginal bleeding from placenta previa. Idea behind this is not to make your life miserable, but to reduce or even prevent fearful life episodes (and frequent visits to emergency room or your physician office) associated with vaginal bleeding. 

And finally, everyone will ask themselves, where will be safe to have delivery? 

In many patients with placental previa but no morbidly adherent placenta (also called accreta) suspected, delivery can be managed at your hospital. Though, it also depends on level of your physician self-confidence, and ability of hospital to provide support and ancillary services, almost all hospitals can accommodate delivery of patient with placental previa at and beyond 36 weeks of gestation. 

In rare circumstances, like when placenta previa with accreta is suspected, it would be beneficial to plan delivery at tertiary care center – that is, hospital that have all ancillary services and multitude of doctors of different specialties that could be required during the surgery (e.g. if additional surgical help is needed to repair adjacent organs or special radiological procedures required prior surgery itself).”

Mladen Predanic, MD, MSc, FACOG/ Texas