Placenta previa

Kelly writes:

"I just found out that my 28 year old cousin has placenta previa. She is about 5 months along, and she has a 2.5 year old. I was wondering if you could ask the community if anyone has experienced this, what happened to them, and any advice they may have? She's very concerned (not only because of the medical risks) but also about the possible bed rest requirement. Her husband works 60-70 hour weeks, they don't have much in the way of friends/family in the immediate vicinity of where they live, AND she has a 2.5 year old who has a lot of energy and some health problems. OY. Any help/advice/commiseration for her would be greatly appreciated."

I have no experience with placenta previa but know some of our readers do, and I'm hoping a bunch of people jump in to talk about how they dealt with it and how it all turned out.

I also have no experience with bedrest, but know tons and tons of readers do, and know they'll give advice.

I do have experience with not having help and being isolated, and it sucks. I'm hoping that they can build a support network they can count on. Is she part of any mothers' groups? Do they go to a church or temple?Do they hang out at any playgrounds regularly?

Even if she doesn't have to go on bedrest and the delivery is easy she'll still need friends to help her through having a toddler and a baby. It's tough work, especially since her husband works long hours. Can they afford any paid help to give her a break?

Readers, what have you got for Kelly's cousin? And how can Kelly help them?

Comments

[Elita @ Blacktating]

The AMAZING Ann at Dou-la-la wrote a 4-part piece about her experience with placenta previa (spoiler: she went on to have a normal pregnancy and a home birth).
http://dou-la-la.blogspot.com/2011/03/parallel-paradox-my-experience-with.html
That's part 1
http://dou-la-la.blogspot.com/2011/04/parallel-paradox-part-2-diagnosis-of.html That's part 2
Part 3- http://dou-la-la.blogspot.com/2011/04/parallel-paradox-part-3-dealing-with.html
Part 4-http://dou-la-la.blogspot.com/2011/05/parallel-paradox-part-4-placenta-previa.html

My favorite resource for bed rest is the website Mamas on Bedrest http://www.mamasonbedrest.com/tag/placenta-previa/
Darline is awesome and she's on Twitter/Facebook and would for sure be happy to point her to some resources. She offers coaching for moms on bedrest, but that's her business and I am not sure if this young mom has the option of paying for a service like that. http://www.mamasonbedrest.com/coaching/ But she does tackle some of the questions this mom has, like how to care for other kids while on bedrest. Hope this is helpful!

[Catherine]

my immediate thought was, if there is no obvious support network but funds, to check out post-partum doulas in the area. While you're not post partum, a lot of the work they usually do they might be able to put to good use during this stage, and they'll be used to dealing with siblings. If money is an issue, contact a doula group anyway, and see if there are some doulas in training, maybe, who would help at a discount?

[Laura]

If your cousin doesn't have any bleeding, she probably won't need to go on bedrest.
I had placenta previa and had to go on bed rest at home for 4 weeks after a scary episode of bleeding at 29 weeks. Placenta previa can (and usually does) resolve in the 3rd trimester as the uterus stretches. In my case, the placenta moved enough that I was able to have a vaginal delivery of a beautiful, healthy boy at 41 weeks. The bedrest part was not fun (though I didn't have a toddler at home). I was able to get up and move around the house, but no lifting, no physical exertion, and no sex. It was especially frustrating because I didn't feel ill at all. We were in a similar situation as your cousin with few family members/friends in the city that we lived. My dad and MIL came up and stayed with us at various points to help out and to be on call in case I needed to return to the hospital quickly. I was also very grateful for the daily phone calls from my sister and for the local friends that dropped by to visit.

[SarcastiCarrie]

Warning: GRAPHIC
I had placenta previa with my second pregancy (of 3). I had a c-section with the first, so it was certainly something they checked for in my second. It was found at the regular mid-pregnancy ultrasound. They did monthly ultrasounds after that to keep an eye on it. I was also on, ahem, pelvic rest for the duration (however, FYI, orgasms were deemed acceptable...just not penetrating intercourse). No other restrictions were put on me as I was not bleeding.

Mine did not resolve so a scheduled c-section was planned. If you merely have a low-lying placenta, you can probably deliver vaginally though presentation may be affected, but with regular placenta previa, you're a c-section. It's too risky. If your cousin did not have a c-section the first time around, she should probably read up on that (and figure out a nursing plan for post-section should she want to do that).

It's an average of 3 weeks from the first bleeding episode until it's time to deliver (of course, an average is just that, some less, some more). I found that very encouraging as I made it to 30 weeks, I thought "On average, I'll go at least 33 weeks if I start bleeding....now!" And so on as each week passed.

I had my first bleeding episode at almost 39.5 weeks (but OMG, the blood, so much blood) the day before my scheduled c-section, so rather than wait for the next day, they delivered me then. But when I went to the hospital I was all "NO PELVIC EXAMS..PLACENTA PREVIA..STAY OUT." So, they just had to take my word for it on the bleeding (nothing is supposed to go in the vagina when you have placenta previa, so pelvic rest and no speculum/no exam, etc).

There is a risk of excessive bleeding after delivering a PP pregnancy because the uterine contractions that normally stop the bleeding after delivery are not as strong on the lower half of the uterus where the placenta has now detached. So, during my c-section, they had the blood bank on stand-by during the procedure (and my husband was prepared to donate had I needed a transfusion in the day or two after delivery if the bleeding didn't stop quickly). As it turned out, the bleeding resolved on its own and it was my lowest stress delivery of the 3. It was also my best pregnancy in terms of my energy and how I felt.

My post on it (and every post after it until I delivered): http://sarcasticarrie.blogspot.com/2008/07/well-it-never-is-thing-you-worry-about.html

[persephone]

Chiming in to say I had placenta previa with my twin pregnancy - and I was completely asymptomatic. Which meant the only consequence was a planned c-section.

Oh, and a whooooole lot of anxiety. I was very focused on the worst case scenario. Someone at the time commented on my blog to say, "I can't promise you the bad stuff you're envisioning won't happen, but I can tell you *I* had placenta previa, and I went to full term with no symptoms and a healthy birth. I just want you to know that it can turn out 100% fine, too." It helped...a little. So I'm saying it to you. :)

I was at a high risk practice with a ton of experience, and I think that made a big difference in terms of what it was like for me. They do not believe in home bed rest. They told me explicitly they would not give me any restrictions at all, unless I had a hemorrhage - and then it would be hospital bed rest, not at home. I had frequent ultrasounds, and I tried not to travel, so that if I did end up in a hospital, at least it would be the one close to home. But that's all I did.

I would urge you to transfer to a high risk OB, if you're not already seeing one - and then try to trust that your medical care is in the best hands possible.

Apart from that, if you are trying to make a contingency plan in case you do end up on bed rest, it's worth clarifying with your doctor whether you would be at a hospital or at home. It will make a big difference in how much childcare help you need with your toddler.

Good luck!!

[J]

I had full placenta previa with my first (and thus far, only) kid. Five bleeds total, with the first at around 24 weeks. Went on bed rest and continued pelvic rest (started with u/s at week 20). Usually my perinatologist's (which I started seeing for a whole other chronic health condition/potential complication) clinic had a 'three bleeds and you're in the hospital' approach. Since I had a lot of support at home, I convinced them I should be able to continue bed rest there. Maybe they humored me.

After bleed four, I was admitted to the hospital to hang in out antepartum until my planned c-section at ~37 weeks. I made it to 34 weeks 2 days before the fifth bleed and emergency c-section. To protect my kid I was given steroid shots to mature the lungs (after the first bleed) and had NSTs twice daily. I'd already met with the NICU doctor and anesthesiologist to prep for an early birth, which was comforting to me since I could ask questions and get a sense of what to expect if my placenta made things tricky.

My c-section was really easy and I healed so quickly. My chances of havinn placenta previa in n subsequent pregnancies is increased. My son was in NICU for 13 days; a good size at nearly 6 lbs and 34w2d but he had an uncoordinated suck. So he needed to learn how to feed. He was also treated for jaundice. I started pumping right after surgery recovery to get breast feeding going and along with meeting with lactation nurses it was pretty successful at in bringing my milk in.

My understanding (from knowing 2.5 year olds and talking to a physician friend) is that bed rest with a small child at home will be nearly impossible. Bed rest isn't a guarantee of no bleeding with previa - the uterus is also growing and changing shape in the third trimester, which can stretch and pull on the low-lying placenta - not anyone's fault.

If it were my friend, I'd recommend a plan-for-the-worst-hope-for-the-best approach. This probably means some outside help to watch the 2.5 year old so she can go on a modified bed rest at home.

[Celeste]

www.sidelines.org ...great website for bedrest support. It has tips for those who want to help as well as resources for moms on rest to find someone to talk to. I never used it, but the moms I know who have thought it was a good resource.

[dandg]

I had a partial placenta previa with my 2nd pregnancy. They first discovered it at the 20-week ultrasound and by 30 weeks it was totally gone. I went on to have a totally normal labor and home birth. Hope hers resolves itself!

[CoCo]

Celeste I forgot all about www.sidelines.org that was a great help that site is.

I was on bedrest but not for Placentia Previa. Try the library, mine had a home bound program that would mail books. The might keep the 2.5 busy some. See if your market has a delivery service. A friend of mine would give her kid piggy backs instead of lifting them up.

Don't forget to throw a lot of things out the window that you might normally do. Eat frozen food or cereal for dinner. Eat on paper plates so you don't have to stand for dishes. Don't stress about XYZ being extra messy.

Get Netflix...if you end up on bedrest. Netflix will be your best friend. I think they have a 2 week trial if you don't already have it.

Good luck to your cousin. Nothing more stressful than something wackie during pregnancy.

[Elizabeth]

I had placenta previa and was hospitalized for the last, um, I think it was seven weeks of my pregnancy. I had a four-year-old at the time. My husband's parents came and set up their RV in our driveway - otherwise, I don't know how we would have gotten through.

Her husband needs to be prepared to take FMLA leave if she is put on bedrest. No more 60-70 hour weeks. He shouldn't lose his job over that, but they need to be prepared for the possibliity.

[Chantelle]

If I was in this situation with my toddler I would create a toddler proof funtimes area in my bedroom and hole us up in there! TV is not ideal , but in this situation I would be using that to get an hours rest in.I would be explaining to my girl that mama is unwell , and even though I have to be in bed , thats OK coz we have the funtimes cave room to play in! Playing doctors and nurses would be ideal in this situation. You got to do what you got to do at the end of the day.
And if money isn't an issue a in home nanny for non nap times!

[Chantelle]

I second the comment above about the husband taking leave also. Again , you just got to do what you got to do. Family first!

[Anonymous]

Lurker turned commenter to chime in and share another positive story. I had a complete placental previa with my first pregnancy that stayed put and never moved. I felt very much like a ticking timebomb the whole time - waiting to bleed and go on bedrest. I was on pelvic rest and didn't travel. I prepared for bedrest and even bought supplies to sew a quilt expecting to have some time on my hands! I never bled a drop and worked up to the day before my scheduled C-section at 37 weeks. Everything went very well and my daughter is now a healthy happy 8 year old! I went on to have 2 vaginal deliveries with no previa concerns. Oh and that quilt still hasn't been made!

[Schwa de Vivre]

No placenta previa or pregnancy bedrest experience, but my son was almost 2 for my first back surgery and 2.5 for the second -- all told about a year of on-and-off bedrest, surgeries, recovery, etc. I don't think I would have managed without daycare, and I think my husband, a couple of years out, is still exhausted from doing most of the work. (We don't have family in the area, and didn't have much in the way of help.) Mostly I wanted to chime in to second Chantelle's ideas about being creative about being with your child -- finding things to do in bed, ways to bond, etc. I think I did story time all the way through the bed rest (honestly, I was on a lot of drugs, so that might not be accurate). I know I breastfed through the first back surgery and up until the second, because at that point it was a way to bond and something I could do just lying there (and I could delay the drugs until after the daily feeding).

But really, some kind of nursery school or regular care might be a very good idea. In this area (Georgia), Mommy's morning out programs can be a good somewhat temporary fix. I've also learned that here, if you want anything community-like, you've got to check with the churches.

[Anon for this]

I had placenta previa with my first. There were no complications. The worst part was being taken into the crying room after my 20-week ultrasound. We were relieved to learn it was only placenta previa.

I was put on "pelvic rest" until birth -- no heavy lifting, or exercise, or sex. I suspect that will be hard with a toddler around, so making sure that Dad or a friend or family member can help out more with baths and diaper changes and getting in and out of the high chair would be useful.

My placenta did move off slightly off my cervix by the time I was at term, but not enough for my or my doctor's comfort. I had an uneventful C-section and a healthy baby. For my second, I had no previa and a VBAC.

This may tread into TMI, but when my doctor gave me the 6-week all-clear for sex, it had been so long since we were intimate that my husband was over-eager while I was far from ready (recovering from surgery and post-partum depression). Not everyone will face that, obviously.

[anon]

How timely. This was posted on my daughter's, with whom I had placenta previa, birthday! Everything for me was fine until after she was born. My pregnancy was normal, no bleeding. No bedrest. I had to go in for a vaginal ultrasound later in my pregnancy. This was after it was determined I had pp but they wanted to see if the placenta moved up so that I could deliver without a C-Section. Regular labor but after my daughter was born I bled a lot. It was pretty scary. Fortunately, I didn't need a blood transfusion. Instead I was given a saline pitocin drip. Because of where the placenta was my uterus, despite clamping down, could not stop the bleeding as effectively as it would have if the placenta was higher. It was very scary at the time. I also think that it didn't help that the OB insisted on tugging on the cord v. letting the placenta come out naturally. Despite being told otherwise, I don't think this helped matters. I'm still pissed off about this six years later! If I could tell Kelly's cousin anything it would be to tell her OB not to pull on the cord and to please let her try and pass the placenta naturally. ALSO I would really talk to my Doctor and find out what the post birth plan is in case there is a lot of bleeding. I would make sure everyone heard it directly from me that I had PP. in the delivery room. Often you aren't even delivered by your regular OB. Of my three pregnancies this was the only one where I had PP. So just because you have it once it doesn't mean all your pregnancies will be like this. Good luck safe delivery happy pregnancy!

[Erin]

A good friend of mine had placenta previa as part of a high risk pregnancy (the result of fertility treatments following a devastating number of miscarriages). It was stressful, but she had no bleeding and the placenta eventually migrated (though technically, the placenta itself does not move, it's the uterus that grows and changes the location of the placenta) and she thought she could go full term, but then had a nasty bleeding episode, and she was close enough (37 weeks?) so they took her in for an emergency C, no problems with recovery. I would definitely recommend intense planning for the worst case scenario. I hope the OP never needs it, but it will bring great peace of mind to have a Plan. (I'm assuming that the OP's friend is a SAHM?)

I also babysat in grad school for a woman on best rest who had a toddler. She wasn't even allowed to sit up during the day, so she had a full-day babysitter and then hired me to come in the evening until her husband came home from work. Of course, that takes $$.

[Vacationland Mom]

I'm the OP; I just wanted to say thank you to everyone for commenting and to Moxie for posting my question. My cousin hasn't had any bleeding yet fortunately, and she's hoping for "migration". @Erin yes sorry I didn't mention she is a SAHM. And as for money it is very very tight for them, but finding a post-partum doula may be a good option. I will definitely mention it to her. The other part of the equation is that her son has hereditary spherocytosis and her unborn son has a 25% chance of having it too. I know I'm hijacking my own thread but if anyone out there has experience with HS please comment as well. Thanks again- this has been a huge help so far.

[Katie]

I had placenta previa with baby #2. I was on pelvic rest from week 18 on. Of note, no one explained what pelvic rest was, so I had to google it. I was fortunate that at my follow up ultrasound at 32 weeks my placenta had moved. I was able to have a vaginal birth.

I did not have bleeding during pregnancy, and other than pelvic rest had a pretty typical pregnancy.

[SarcastiCarrie]

I have no experience with the hereditary spherocytosis, but according to the quick NIH summary I read, prognosis is very good once the spleen is removed around age 5. It would still be very scary to have a child have a health crisis or condition regardless of prognosis (plus when your kid is 2, age 5 seems a long way away).

Even though I have no experience with HS, I can say that I have experience with wonky test results during pregnancy leading to uncertainty about whether something will be "wrong" with the baby after birth. It's nerve-wracking. I handled it by looking up everything I could about the tests, their accuracy, the conditions, prognosis, etc.

However, since your friend already has a child with the condition, she already knows what the situation would look like on the outside, so really, she just needs a way to cope with the uncertainty until the baby is born (in four gloriously long months...positive thinking). It's a shame wine therapy is contraindicated during pregnancy. Anyway, I would go with distraction and additional research (like is a sibling who is affected likely to have the same severity of condition, etc?).

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