A low lying placenta is not uncommon – and not often a problem.
After conception, your baby’s placenta will implant itself somewhere in your uterus, in no specific position.
The placenta might choose to implant low, high, posterior (back) or anterior (front).
After an ultrasound – usually the 20 week scan – you might be told you have a low lying placenta.
Low Lying Placenta – What Does It Mean?
This means the placenta has implanted low down in your uterus, close to your cervix.
A low lying placenta occurs in approximately 5% of pregnancies.
There is absolutely no need to worry if you are among this 5% – you can continue your normal daily activities, unless you have been advised otherwise.
Restrictions – such as no sex, or lifting things – are usually prescribed only for women who have placenta previa (where the placenta is covering the cervix) or those who experience blood loss due to a low lying placenta.
Don’t worry; there’s a very high chance that a low lying placenta will no longer be a problem when you have your third trimester scan.
“My placenta was low lying (15mm or 1.5cms) at 20 weeks. A repeat scan at 27 weeks showed that it had moved to 40mm (4cms), and at the birth it became a retained placenta (wouldn’t come out). I had to have it manually removed under a general anaesthetic. It had moved all the way up and became stuck at the top of my uterus!” — Amy, BB Member
Why A Low Lying Placenta Isn’t Usually A Problem
The lower part of your uterus does most of its growing and stretching in the third trimester (until around 36 weeks), and it takes the placenta with it.
The placenta doesn’t ‘migrate’ upwards; because it is attached to the uterine wall, it is carried upwards with the uterus.
In 0.5% of cases, however, the placenta doesn’t move up with the uterus.
That means there’s a 99.5% chance that your placenta will not be close to your cervix when it’s time to give birth.
A low lying placenta at or before 18-20 weeks of pregnancy does not mean you need a c-section.
The placenta will most likely be further away from the cervix at the end of your pregnancy.
During the first and second trimesters, the uterus still has a lot of growing to do.
An ultrasound late in the third trimester (after the uterus has finished growing) will give you and your healthcare provider a better picture of what’s really going on, and whether there’s any cause for concern.
How Close To The Cervix Can My Placenta Be?
Doctors have different opinions as to how low the placenta can be before they tell you you shouldn’t have a vaginal birth.
If you want to avoid a c-section, it is useful to have a second or third opinion.
Some doctors will be happy if the placenta is 2cms (20mm) from the os (cervix); some prefer 3cms (30mm).
Given the variation in measurements, if you want to have a vaginal birth, you should definitely be given the opportunity.
The exceptions are when the cervix is covered by the placenta, and/or when there are concerns due to bleeding. In these cases you should seek medical advice immediately.
What Should I Do If I’m Told My Placenta Is Low?
One of my clients was booked into a large public hospital, and told she had a low lying placenta.
She saw a number of obstetricians during her various check-up appointments.
Some were happy for her to have a vaginal birth; some were not. They had differing opinions about what was safe.
This is no way you can enjoy your pregnancy, if you are worrying about which doctor you’ll have during labour, and whether or not your doctor will trust your body to give labour a go.
If you are told your placenta is low, first find out the distance between the placenta and the cervix.
Then, ask whether your healthcare provider would be willing to support your wishes for a vaginal birth (if the placenta does not move).
Also, find out what measurement the provider would be happy with, in order to support a vaginal birth.
If you don’t find the support you need, you might decide to seek a second opinion, and possibly change care providers.
Giving Birth After Previous Low Lying Placenta
If you’ve had a low lying placenta in previous pregnancies, it doesn’t mean it will happen again.
The placenta simply attaches itself where it pleases; in some cases it’s just bad luck.
“I had a low lying placenta with my first baby. But my second, third, fourth and fifth have been fine – PHEW!” — Linda, BB Member
Low Lying Placentas Resulting In Intervention
Here are some members’ stories about cases of low lying placenta that needed medical assistance.
Remember: If you experience vaginal bleeding at any point in your pregnancy – especially if you have a diagnosed low lying placenta or placenta previa – you should seek medical advice immediately.
Kitty’s Low Lying Placenta Story
“At 20 weeks, I was told the placenta was adjacent to my cervix and not to worry, as 99% of cases sort themselves out. At 28 weeks I had bleeding. A scan at hospital revealed the placenta was partially covering the cervix – not sure how much though. I was given two steroid shots, and sent home after a week in hospital on bed rest. I was told: no sex, no being more than 30 mins from hospital in case of haemorrhaging, no picking up anything heavier than what I could pick up in one hand, no walking long distances, and no going anywhere by myself, just in case.
Then, at 32 weeks, I was bleeding again. I had a scan at hospital, but I wasn’t told whether it was worse than the 28 week scan. After being given another steroid shot, I was told to have another scan 36 weeks, to check where placenta was, before making a decision on the birth plan. I was sent home after about 4-5 days in hospital, again on bed rest. Unfortunately I was still bleeding slightly over the weekend, so I went back to hospital on the Monday at 33+6 weeks. They did a vaginal examination and I was kept in hospital for monitoring.
I was 34 weeks on the Tuesday and had a large bleed with a clot about the size of a peach, resulting in an emergency caesarean section”.
Jennifer13’s Low Lying Placenta Story
“My low lying placenta was picked up at both the 12 and 18 week scans, but it was never over the cervix, just close. I had no bleeding and didn’t need to take any precautions. The scan at 37 weeks showed that the placenta was still low, but not over. It was about 1.7cm from cervix when the obstetrician wanted it to be 2cms away. Therefore, I was advised to have an elective caesarean at 39 weeks. I tried to research outcomes for labour with that proximity to cervix, with not much luck, and my obstetrician was a bit dismissive of my efforts to look into it further. So I had the caesarean at 39 weeks.
“BUT, in hindsight and after much research, I think I should have sought a second opinion.
“With no bleeding and a baby that had engaged, I believe I would have been fine for a vaginal birth. At the very least, even my obstetrician acknowledged I would have been okay to go into labour and go from there. There would have only been the need to keep a close eye on how things progressed. Allowing labour to start naturally would have been beneficial for my tiny 2.5 kg baby too. She could have done with the extra week or so on the inside, plus the hormones that kickstart birth.
I had no complications at all, and I think they gave me overly cautious advice and a probably an unnecessary caesarean. I have since found very similar cases online [where women] did manage to have vaginal births without undue complications (some extra blood loss seemed to be the extent). Mine was not a previa and should not have been treated as such. Plus, that extra 3mm was not that unlikely, if I’d stayed pregnant until 40 weeks. I had a very small baby and uterus and I think this impacted the growth/movement”.
Low Lying Placentas Requiring No Intervention
In the vast majority of cases, low lying placenta resolves itself and is nothing to worry about. Here are some members’ stories about their low lying placentas that needed no further intervention.
Pholi’s Low Lying Placenta Story
“The 20 week scan picked up that the placenta was 2cm from cervix. They told me it was borderline, and that there was a 95% chance it would have ‘moved away’ by the time of my baby’s birth. Then they explained that the placenta doesn’t move but, as the uterus grows, the edge of the placenta becomes less close to the cervix, and I should still be hoping for a vaginal birth from that point of view. They booked me in for a re-scan at 34 weeks, when it was confirmed to be well out of the way of the cervix. They didn’t given a measurement, but just assured me it was completely fine. The obstetrician reiterated the position was no obstacle to my goal of a vaginal birth. I birthed my baby vaginally, with vacuum assistance, at 40+5. No complications to do with placental position”.
Taurean’s Low Lying Placenta Story
“I found out I had a low lying placenta at the 20 week scan, so they booked me in for another scan at 32 weeks. At 32 weeks the placenta had moved a lot – around 7cm, from memory. It continued to move. I went into spontaneous labour at 38+5, waters broke around 7.30am at home and my daughter was born at 3.10pm. I had no issues at all with my next birth”.
The Flying Butter’s Low Lying Placenta Story
“At the 18 week scan, my low lying placenta, was partially covering the cervix. They told me it would probably move and not to worry. No-one said anything at the 20 week scan, so I figured it had moved by then. No-one said anything at a 30 week scan either. The placenta did not affect birthing at all”.
Meg’s Low Lying Placenta Story
“In my 4th pregnancy, I had a scan at 13 weeks, due to bleeding. It showed I had a low lying placenta. Because of the bleeding, they told me to reduce heavy lifting. They confirmed at the 20 week scan that the placenta was 2cm from my cervix and told me it should most likely move out of the way. Had another scan at 28 weeks and the placenta was well out of way – I think 8cm. Birthed vaginally at 40 weeks, no complications”.
What If My Placenta Is Covering The Cervix?
Placenta previa – which means placenta first – is a rare condition that occurs in about 0.5% of pregnancies. Instead of implanting on the uterine wall, the placenta implants partly or wholly over the cervix.
Although it can happen, the chances are quite low.
For more information, check out our article on placenta previa.