Complete “Placenta previa” can be a scary diagnosis. As someone who has gone through it, let me share what to expect with complete placenta previa.
My diagnosis
Most pregnant women with placenta previa have likely been told that the placenta will move up and out of the way by the time they deliver. Depending on the guideline you refer to, somewhere between 90-98% of placenta previas will resolve by the time you give birth.
When I was pregnant with my first baby, my medical team informed me that I had placenta previa during my 24-week scan. They then told me not to worry too much as most cases of placenta previa resolve by the third trimester. Since I did not have any complications, such as pain or bleeding, we were going to check the placenta position again around the 32-week mark to ensure it had moved.
After diagnosis
Back home, I made the horrible mistake to google placenta previa and found countless accounts highlighting the danger of pre-term labour, bleeding during pregnancy and birth and even possible death of mother and baby during birth.
I was terrified and felt the slightest bit of guilt. Did I cause this? And if yes, how can I get rid of it?
If you have been down the placenta previa rabbit-hole, you know that there is no known cause for it. There is also no known way to move the placenta (trust me, I have tried!). The placenta will either move up on its own as the uterus grows – or it will not.
Roughly 1 out of 200 pregnancies will have placenta previa at birth. Even though this meant a less than 1% likelihood, I wanted to prepare for the event that the placenta would, in fact, not move. Would I still be able to deliver vaginally, like I intended?
Some facts about previas
I went on to find out whatever I could about placenta previa. Along the way, I found numerous statistics about the likelihood of placenta previa resolving. Consensus is that placenta previa is most likely to resolve by 32-ish weeks, as this is the time the uterus sees the most growth.
As the uterus expands, much like a balloon, the placenta is being pulled up and away from the cervix. After 32 weeks, the growth of the uterus slows and so the likelihood of the placenta moving further up diminishes.
I also found evidence that partial or low-lying placenta previas (where the placenta only covers part of the cervix or is very close to the cervical opening) are much more likely to resolve than complete previas, where the placenta is pretty much centered over the cervical opening.
Whether the placenta is located in the front, back or on the side of the cervical opening, can also play a role – with posterior placenta previa being the slowest to move and the least likely to resolve.
Can you still have a vaginal birth with placenta previa?
As fate wanted it, I had a complete posterior placenta previa. Chances were low that it would resolve, especially in the third trimester. Yet, I remained hopeful and continued my daily activities, as I had not experienced any complications.
When I went for my 32-week scan, and found that the placenta had basically not moved, I was devastated. My OB went on to tell me that there is no way I could give birth vaginally and that we had to schedule a c-section as early as 36 weeks. We scheduled another ultrasound for 36 weeks to check the placenta position again. At that point I had already given up hope. Given the studies that I had read, it would have been miracle if the placenta – which at that point was still a complete previa – would move by 36 weeks.
Scheduling a gentle c-section
Much to my surprise, at 36 weeks the placenta had in fact moved dramatically! It had moved on to being a partial previa, slightly covering the cervix. Hope reignited, I discussed the timing of delivery with my OB. As someone who very much favours natural birth with minimal intervention, I wanted to give my body and my baby as much time as possible to develop naturally.
Luckily, I had a very understanding high-risk OB who was comfortable taking the chance to wait. While most moms with placenta previa who are symptomatic will have a scheduled cesarean around 36-37 weeks, I was able to wait until 39 weeks. Waiting longer than that may have risked me going into labour and hemorrhaging as a result of it.
Even though a cesarean was not my preferred choice of delivery, there was nothing I could do about it. I have accepted that birth does not always go as planned and had a positive, gentle cesarean birth story.
If you are currently weighing your options, below are my top tips to figure out birth with placenta previa.
What to do if diagnosed with placenta previa?
- Find out what type of previa you have (complete/partial/low-lying) and where the placenta is located. You can ask your ultrasound technician or OB.
- Find out how close the placenta is to the cervical opening. Ask your OB how far the placenta needs to be for you to attempt vaginal delivery. Depending on the comfort level of your medical professional, this could be somewhere between 2-3 cm from the cervical os.
- Ensure you do not have any complications, such as bleeding. You also want to make sure baby is fine. This will allow you to wait as long as possible to see whether the placenta moves far enough to attempt a vaginal delivery. If it does not move, you can still schedule a c-section for a later point in time.
- You may need to consider pelvic rest, even if you do not have any symptoms. Pelvic rest means nothing goes inside your vagina and no strenuous exercise. Otherwise, you could start bleeding (even though I never did!).
- Take it easy! The potential risks of a previa can be detrimental to your mental and physical health, so rest as much as you can. If you are currently employed, try to get time off of work.
Stay positive
Even though placenta previa can be a scary condition and can make you feel helpless, nowadays the risks are very manageable. Especially if your previa is noticed early on in pregnancy and you live somewhere with decent medical care, there is little to worry about. Trust that, in the event you start bleeding or going into labour prematurely, your medical team will be able to intervene.
Even though the placenta previa diagnosis meant I had to give birth via cesarean, I had a positive, gentle cesarean! Read my story here.
Further reading:
This page does not provide medical advice. It is intended for informational purposes only. It is not a substitute for professional medical advice, diagnosis or treatment. Never ignore professional medical advice in seeking treatment because of something you have read on the internet. If you think you may have a medical emergency, immediately call your doctor or dial 911.