In the months leading up to the anatomy scan during pregnancy, there are many emotions: excitement, nervousness, pure joy. While the anatomy scan is designed to check on a baby's growth and development, most moms-to-be also know it as the 20-week "gender reveal ultrasound." Like many expectant moms, I headed into my anatomy scan with one question in mind: Is it a boy or a girl? As a mom of two boys, you can imagine my happy tears when I learned that my future mani-pedi buddy was on the way. But my over-the-moon excitement was dampened quickly by a scary diagnosis: placenta previa.
Placenta previa is a dangerous condition in which the placenta essentially covers the cervix, preventing the baby from being able to be born vaginally. It's not ideal if baby's normal exit path is blocked, but there's always a C-section, right? Well, with placenta previa, there's more to worry about than a mandatory C-section. Any slight irritation (such as through intimacy) or dilation of the cervix can cause bleeding. And because the placenta has a rich blood supply, bleeding from the placenta can cause major blood loss in moms and/or cut off the blood supply to baby.
After finding out my diagnosis and being ushered upstairs to chat with my doctor, I left tear-stained and filled with worry. My doctor's words echoed in my head: placenta previa, risk of hemorrhage, pelvic rest, call 911 if you start bleeding a lot, scheduled C-section at 37 weeks, and the scariest words to hear from a doctor: "just pray."
That night, I spent a considerable amount of time researching this condition and all of the risks and outcomes associated with it. In that time, I found a wonderful support group online, and I learned that I was not alone. In fact, more and more women are being diagnosed with placenta previa than ever before, and it's starting to worry doctors.
What's so scary about placenta previa?
Experts estimate that about one in 200 women is affected by placenta previa during the third trimester, but many more women experience this condition during the first and second trimester. From 2001 to 2009, the rate of women diagnosed with placent previa increased by 26 percent, and instances of placenta accreta, the most severe form of placenta previa, increased from one in 2,510 pregnancies in the '80s to around one in 533 pregnancies by the early 2000s. Some women don't even realize they have placenta previa, while other women are alerted due to painless bleeding. Thankfully, a placenta previa detected in the first trimester has up to a 90 percent chance of moving on its own; as the uterus grows, the placenta can shift along with it. However, even though it can move, the situation is still very serious until it actually does move.
Complications from placenta previa include increased risk of hemorrhage, higher need for blood transfusions, increased risk of placental abruption (where the placenta starts to detach from the uterus too early), preterm delivery (since many women diagnosed with placenta previa end up being scheduled for C-sections around 35-36 weeks' gestation), and the increased risk of hysterectomy.
Because of this, most moms are placed almost immediately on pelvic rest and some form of bed rest. If ever there was a time to be cautious, this is it.
So, what gives? Why is it becoming more common?
Given the nature of this condition, most moms want to know if there's anything they can do to prevent it, but it's difficult for doctors to pin down exactly what's driving the rise in the number of diagnoses. Risk factors for placenta previa include having had previous children and having had a previous C-section or any surgery on the uterus. Dr. Cindy M.P. Duke, MD, PhD, a board-certified ob-gyn and fertility specialist and the medical director of the Nevada Fertility Institute in Las Vegas, also points to "women who have had fibroid removal surgery or those treated with IVF" as possible patients with increased risk.
Dr. Angela Jones, Astroglide's resident health adviser, also notes that "more procedures are being done on uteruses including myomectomies, dilations and curettage, C-sections, etc." All of these procedures contribute to scarring in the uterus, and a placenta embedded into a scar is never a good thing because it can burrow too deeply into scar tissue.
One mom from California, who asked to remain anonymous, says her doctor thinks her IUD may have contributed to her experience with placenta previa. "My doctor is convinced scarring from my Mirena caused my previa," she tells CafeMom. "I nearly bled out after a vaginal ultrasound irritated my cervix. I had to deliver immediately, and I had four units of blood during my surgery. I also had to have a hysterectomy. I'm only 22 and I won't be able to have any more children."
How to Cope With the Diagnosis
It's one thing to read about stats, risk factors, and causes, but it's a completely different thing when it happens to you. For many women, placenta previa comes as a total surprise, either during a routine ultrasound like it did for me, or during terrifying experiences later in pregnancy. When I asked real women to share their stories about having placenta previa, their answers were all over the map, and they only drove home why the condition is so worrisome.
Johnna, an internationally selling author and heath advocate, tells CafeMom she was able to carry her son well after her diagnosis. "I was put on moderate bed rest (no heavy lifting) in my first trimester. My son was born two weeks early via an emergency C-section because there was not enough fluid by the third trimester," she explains.
Irene, an actor, author, and model, says even her doctor was surprised that she had placenta previa, since she was diagnosed in her second pregnancy, and her first pregnancy had been complication-free. "At the time we lived in Pelham, part of New York's Westchester County," she tells CafeMom. "I was at the train station, waiting for the next Metro North to Manhattan. I went to the ladies' room, relieved myself … and saw that the toilet bowl was full of blood."
Susie, who is from Chicago, tells CafeMom her sister didn't know she had placenta previa until she was about to give birth. "My sister had no idea she even had the condition. She went into labor and was bleeding. When she got to the hospital, they rushed her back for an emergency C-section. Thank goodness she made it to the hospital in time!"
From your doctors' standpoint, there are many things that they (and you!) can do when facing placenta previa. The first and most important thing to do is follow any advice or restrictions that you are given.
Emotionally, however, moms may need extra support during this time. There are support groups for moms with placenta previa, either online or that you can find through talking with your care provider. You should also share your worries and thoughts with your partner, friends, and doctors. Of course, doctors don't want moms to worry, but it helps to educate yourself and learn about all warning signs of complications, as well as have an emergency plan in place — simply knowing what to do can ease your anxiety.
