Caesarean due to Placenta Praevia / Low Lying Placenta

I had my 34 week OB visit this morning and found out that my placenta is still not out of the way and the OB suggests a caesarean section is the safest way to go. I had really high hopes of my uterus stretching and the placenta moving up so to hear this news I was a bit crushed. My OB has given me some reading info and has booked me in for when I am 38 weeks 4 days. I've spent the day reading these threads and articles about caesareans and even though it's not my preferred option, I am coming to terms that a ceasarean is the best choice for me.

I was just wondering if anyone has had a caesarean due to placenta praevia and what your experience was?

Also, I haven't signed any consent forms yet as my OB has given me time to let things sink in and I go back in 2 weeks to chat again. So, what sort of things should I be asking my OB about the caesarean?

How can I prepare myself mentally and physically for the caesarean? I had my appendix out 4 months ago when I was 17-18 weeks pregnant and with that and the normal changes of pregnancy my body has gone through a lot!

And one last question, what things do I need to consider for my hospital stay? What to pack? etc etc. I had my labour bag organised but guess I won't need this.

Sorry for the long post, but I appreciate all your suggestions.

TIA

Hi Laranna,
I had my baby girl Caityln via c-section 3months ago due to grade three placenta previa. At first I was told that the c-section would have to be done under a general, however when the day came I was allowed to have a spinal block. My experience was wonderful I didnt feel a thing some people feel pulling and tugging but I didnt feel anything. Questions I would be asking are, will I be having a general, spinal block or epidural? Can my partner and baby come with me to recovery? Even though I had a spinal block I was in recovery for two and a half hours while my husband and daughter were up in my room waiting for me. As for advice I would keep up your pain relief, even if you dont feel any pain take what is offered to you for the first couple of days. Even though it does hurt get out of bed as soon as you are allowed once you are up moving about a little bit you will feel alot better. Make sure you buy some really stretchy granny underpants that will sit above your scar and wear comfy clothes for the first couple of days. I was very lucky and had a very positive c-section experience. It did take me a good 3 weeks to feel almost normal, just take it slow. Three months on the only complaint I have is an itchy scar and some numb spots on my stomach but no pain....... C-section is not the easy way out and although I didnt have a choice in the matter it was the only way my daughter could come into this would safely I look back on my birth experience as totally positive.

I wish you all the very best,enjoy every moment of motherhood it is such a wonderful experience.
If you have any questions please dont hesitate to ask me?

Coral

Do you know how far the placenta is from the os? My client has been told that as long as it's 2cms from os he will support her for a vaginal birth. I would find out exactly how high that placenta is and also ask for another scan at 37 weeks, as my client is too. There is always room for a second opinion when you are not happy with the prognosis! Don't feel bad - we get lots of opinions and quotes when we fix our car, how about having your baby!!! :) Don't think it's too hard / too late - the birth will be with you forever and it's worth the effort knowing.

I had a low lying placenta with #2... when I had my scan at 32 weeks to see if had moved it ws 3cm from my cervix. How far from your cervix is your placent a lying?

After my scan at 18 weeks my dr said that I had a very low placenta and I was so scared I would have to have a c-section!! Thankfully that didn't occur.

Tanya

Thanks for the info Coral. Did you have any bleeding before your daughter was born? I know that is one of the "signs" of praevia and I haven't had any bleeding yet.

Kelly/Tanya - I had a scan at 32 weeks and my placenta is 3cm away from internal os. For this scan I went to a specialist women's imaging where an obstetrician (not my own) and a sonographer performed a normal ultrasound and a transvaginal one. They said 3cm is very borderline and suggested I would need a c/s. But they also suggested I could have another scan at 37 weeks to check again. Tanya, did your placenta move away any more than 3cm after 32 weeks? And if not, did you experience a lot of bleeding/risks in labour?

After seeing my ob on Monday, she prefers the placenta to be 5cm away and is happy to send for more scans but believes a planned c/s is best due to the risks of haemorrhaging/cord prolapse etc. I do trust my ob and I know how pro-vaginal birth she is and wouldn't suggest it if it wasn't necessary but I just want to make sure I am making the right decision.

My client is at the women's in Melbourne. I will let you know how her scan goes @ 37 week - very soon.

I only ever had slight spotting at 7 weeks which never turned into bleeding. I was very lucky. My husband and I were told at 30 weeks that we could no longer do the deed and for me to be very careful which I was and I didnt end up bleeding. I did have a small bleed during the c-section, however that was expected and stoped almost instantly. I was lucky enough to have two obstetricians perform the c-section also.

Listen to your obstetrcian they know the best way to bring your baby into the world safely.

Hi Laranna,

As the others have said. Definately have another scan at 37 weeks. I will have my fingers crossed for you that that placenta of yours has moved out of the way.

If you end up needing a caesarean I strongly recommend you write out a birth plan. I never even considered writing a cs birth plan and I wish I had have as even caesareans can be unpredictable. some suggestions:

If it appeals to you,
* ask for the screen to be lowered so you can see bub being born
* ask for skin to skin contact while you are still in theatre
* if you are interrested, ask to see the placenta once it's delivered
* Ask for your DH and bub to be with you in recovery

This can all help to normalise the birth and make it a more positive experience.

Also. Just in case you do end up needing a general. Which by the way is very rare. Only about 1 in every 100 caesareans. I definately suggest having someone video bubs birth and also video DH's time spent with bub before you wake up. I was one of the unlucky ones who ended up needing a general. I didn't even really consider the possibility and I feel that if I had footage of my baby's entrance into the world - first cry etc. And footage of all the things she did while waiting to meet her mummy then it really would have helped me deal with the emotional side effects of missing my babys birth. Oh, and if you did have a general make it clear you want bub placed on your chest in recovery as soon as you wake up. I did have this at least.

Just one last thing. As soon as you can get up and walk around - do it! I found it really helped me heal quicky. I was up and walking around as soon as they took the catherer and IV out.

Laranna, my Dr was happy with the amount that it moved for me to have a vag birth :) I had no evidence of low lying placenta at all! I did have a bleed during 2nd stage and had a managed 3rd stage, however the bleed was not caused by the low placenta, I went on to have another bleed with #3 in the 3rd stage also (with a high placenta).

Thanks for all the advice ladies :)

The option would be much easier to deal with if my placenta was covering my cervix but since it is only very close to it, it makes it hard to decide whether I am doing the right thing by going with a c-sect. And as I said in my belly buddies group, I was very lucky to fall pregnant in the first place due to endo and blocked tubes so am I just being selfish in wanting a vaginal birth rather than taking the safer/controlled option of a c-sect to avoid risks to me and my baby....

Charlismumma - thanks for that info. My ob is pretty good with all those options.

If I end up having the c-sect, then I also just want to have a good recovery. This will be the 2nd lot of abdominal surgery in 5 months as I had my appendix out at 18 weeks pregnant via a big cut as they couldn't do it laparascopically due to the pregnancy. My body has gone through alot!