Placenta Previa – What You Should Know

What did they just say?

You’re round and glowing, taking labor classes, doing prenatal yoga… And then your doctor says the words “placenta previa,” and suddenly, things look different. Pregnancy and birth are unpredictable, and a diagnosis of placenta previa might change many of your plans. Try not to panic. Placenta previa can be a serious concern. But your doula can help you understand your options, rethink your birth preferences, and will still be an important member of your birth team if a C-section is necessary.

What is placenta previa?

Placenta previa is a pregnancy issue where the placenta is located in a low position in the uterus and covers all or part of the cervix. Placenta previa can be “marginal,” close to the cervix; “partial,” covering part of the cervix; or “complete,” blocking the cervix entirely. Since the baby needs to enter the cervix during labor, this is not ideal for a vaginal delivery.

What causes it?

No one knows what causes placenta previa. It happens in about 1 in 200 pregnancies, and there is no way to prevent it. Like many pregnancy complications, there are factors that may increase your risk, including:

  • Previous pregnancies
  • Previous C-section
  • Scarring inside the uterus from surgery or dilation and curettage (D&C)
  • Being pregnant with multiples (twins, triplets etc.)
  • In vitro fertilization
  • Pregnancy at an older age
  • Smoking
  • Cocaine use

What are the symptoms?

Usually, placenta previa has no symptoms at all. But a small number of people may experience vaginal bleeding or pre-term contractions. Call your OB-GYN or midwife if you have either of these.

What are my birth options?

If you are in your 2nd trimester, the odds are in your favor. At that point, the placenta can still change position, and medical studies have shown that it can shift away from the cervix during the 3rd trimester as much as 90% of the time. So, if your 20-week anatomy scan shows that your placenta is low lying, do some of that deep yoga breathing and try not to stress too much. 

If your placenta stays near the cervix, but does not cover it, a “marginal” previa, you may still be able to have a vaginal delivery. Usually, if the placenta is located 2 cm or more from cervix, it is safe for labor to begin normally. If the placenta is closer, but does not cover the cervix, talk to your OB-GYN or midwife about the risks and benefits of trying for a vaginal delivery. 

If you are nearing the end of your pregnancy and the placenta is still in the way, unfortunately, your baby can’t exit through the birth canal, and laboring with placenta previa carries dangerous risks of severe bleeding. Your doctor will likely recommend that you have a scheduled C-section.

What if I need a C-section?

If you planned on having a vaginal birth, finding out that a C-section is necessary can be scary and disappointing. Give yourself time to work through those feelings, and remember that having the safest birth is most important for you and your baby. 

A C-section does not have to be impersonal or traumatic. You still have options for your birth experience, and your doula can help you create a new plan. You might be interested in a “gentle cesarean,” which incorporates a range of methods to create a more peaceful and empowered atmosphere. These include:

  • Wearing your own clothing, and having music or dimmed lights 
  • Watching your baby being born through a clear drape
  • Having your baby placed on your chest for immediate skin-to-skin contact and breastfeeding
  • Having monitors positioned to allow space and freedom of movement for holding and breastfeeding 
  • Requesting delayed cord clamping 
  • Requesting a vaginal swab to expose your baby to vaginal microbes that help create a healthy microbiome, though the evidence for this is not conclusive
  • Having any post-birth assessments or procedures delayed until you are ready

How your doula can help

If you are having a C-section, your doula can still provide crucial support, information, and advocacy to create a positive experience. Their knowledge and expertise can help you ask important questions and prepare for the surgery in advance. Depending on your hospital’s policies, your doula may also be able to stay with you in the operating room, along with your partner, to help you focus and relax. And after your baby is born, they can help with breastfeeding and support your recovery. 

Remember

With placenta previa, you can still take an active role in your baby’s birth. While the diagnosis is likely not what you were hoping for, respectful, evidence-based medical care can ensure that your birth experience is still empowering, beautiful, and memorable.
Interested in talking through your birth options with placenta previa? Visit MeetMae.com to create a profile and connect with an expert.