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Marginal placenta previa and vaginal birth


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#1 Deiva

Posted 27 June 2018 - 04:24 AM

Hi all,
Did you have a similar experience?

At my 20 week morphology scan I was told that my placenta is only 14mm away from the cervix, so I will need a re-scan around 34 weeks. My OB didn't make a fuss about it then as apparently in 90% of cases the placenta moves away from the cervix as the uterus grows.

Well, I'm now 35+2 weeks and had a second scan at almost 34 weeks. The technician (who also happenned to be an OB) said that one edge of my placenta is still only at 15mm and mentioned it will be up to my OB to decide whether it's a reason for a caesarean. She said it's a grey area, so it could go either way. The report my OB got had 14mm written on it as the scans were rechecked by another, apparently more conservative, doctor.

In OB's opinion it is very likely that I will need a c-section at 39 weeks. Because I've read extensively about the diagnosis (scientific journal articles and recommended management plans), I know I should be allowed to have at least a trial labour and then a c-section if any bleeds occur during labour. My OB said that for that I would have to give birth at the public hospital and not the private one that I signed up for. At least I've been given the option, so I know he is doing the right thing.

We agreed that I have another scan at 37 weeks to see if a miracle happened and my placenta moved further away :pray: ..not getting my hopes up though and I will have to make a decision about what to do.

This is my first baby and I spent so much time to prepare myself for a vaginal birth, I even hired a doula...I am so dissappointed with my body letting me down (again).  It's been only a couple of days since I had a chat with my OB so I'm still processing it all and I'm pretty upset...

Did you have a similar experience? Would you consider changing to a public hospital at this stage so you can have a vaginal birth?
At this stage, I guess I'm not seeing the big picture yet...waking up at 2.30am and not being able to go  back to sleep doesnt help the issue either :down:

#2 Daffy2016

Posted 27 June 2018 - 08:42 AM

Hi OP

I didn’t share your experience but couldn’t not reply. It’s so hard when there’s a lot of pressure from the world, other people and ourselves to do things the ‘right’ way.

Can you maybe think a little bit about why a vaginal birth is so important to you? Are there ways you could achieve what you want with a cs? Another poster was asking about gentle cs before - maybe something like that could help.

Also, could you think about reframing this? Maybe think of it as your body isn’t letting you down, it’s doing the best it can, and you have doctors and medical staff who can help you get the best outcome. Can you think of ways you can work with your body to get a good experience, even with a cs?

I hope I’m not stepping out of bounds or sounding harsh, but I hope you can find a way to be a bit more gentle with yourself and become more flexible with your thinking.

All the best!

#3 Moo point

Posted 27 June 2018 - 09:52 AM

I was all set to have a drug free water birth except DS was still stuck after 2 hours of pushing. I had an epidural, episiotomy, forceps, catheter and now have a minor prolapse. I came very, very close to an emergency CS, and in some ways that may have been preferable. At the time I was disappointed and thought I'd failed at first, but in hindsight I was in great hands, it was out of my control and DS was born healthy.

The reason you would need to go to the public hospital to attempt a vaginal delivery, if the placenta hasn't moved, is to ensure you have a consultant OB and other specialists on standby in the case of haemorrhage or other issues. Your current OB is following best procedure.

Your body hasn't failed you, and neither did mine. So much of conception, pregnancy, labour and delivery is out of our control, and we are so fortunate to have access to modern technology that enables diagnosis of potentially dangerous conditions during pregnancy and birth. Please don't be too hard on yourself.

#4 Chief Pancake Make

Posted 27 June 2018 - 10:08 AM

You get a lot bigger between 32 and 39 weeks. Your uterus is like a giant balloon. The bigger it gets the further away from your cervix the placenta will get so there is still hope.

#5 IamtheMumma

Posted 27 June 2018 - 10:23 AM

I would call your local public hospital and ask what their criteria is for vaginal birthing with a low lying placenta. Use that information to help you form your decision.

#6 zeldazonk

Posted 27 June 2018 - 10:25 AM

I had a very similar experience - marginal placenta previa with baby #1 that led to a c-section even though I had been desperately hoping for a natural birth.

I just wanted to reassure you that a c-section (especially a planned c-section) can be a very calm and happy birth too. The atmosphere in the delivery room was full of joy. We had time to plan what we wanted and discuss it with the OB. My baby and husband came with me to recovery for skin to skin contact, breastfeeding and photos.

We had no issues with bonding, feeding or recovery.

It was not what I had wanted or planned for, but it did mean that my baby and I were healthy and safe. Which I realised in the end was absolutely the most important thing.

Also, for me, the stay in the private hospital was also absolutely the best thing I could have done. DH got to stay with me in a double bed for all but the first nigh, I didn't have to share a room or bathroom, I had access to lactation consultants, the facilities and food were good, the midwives were not under resourced and could afford to give me lots of time. I would definitely not got public over private if I had the choice.

And a planned c-section is definitely less risk and stress than an emergency one if something goes wrong.

Edited by zeldazonk, 27 June 2018 - 10:26 AM.


#7 onyxmoon

Posted 27 June 2018 - 12:42 PM

I would pick an elective c-section over an emergency one any day of the week. Much more calm for baby, mum and everyone. During daylight hours. Spending unrestricted time with my child (because you have an assigned midwife). Almost no risk of having a GA, not having to sit through epidurals while contracting. Not bleeding bucketloads and feeling like sh*t for weeks while your blood levels improve. Not having to recover from labour and major surgery. I loved my elective c-sec.

All of those reasons, and more, were why my elective c-sec was heaven compared to my emerg c-sec.

The reason your OB won't do it at a private hospital is you're now in a high risk group. and for a VB, a very high risk group of bleeding a large amount and needing emergency surgery like 'right this second, we don't have time to wait for the OB to arrive from home'.

Your body grew a baby, imagine all of the complex physiological processes happening in it right now. I'm always in awe of how many things it does get right!

Your call of course, but that's just my experience with those options.

#8 Deiva

Posted 28 June 2018 - 05:38 PM

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Edited by Deiva, 28 June 2018 - 09:26 PM.


#9 Deiva

Posted 28 June 2018 - 05:42 PM

 Daffy2016, on 27 June 2018 - 08:42 AM, said:

Hi OP

I didn’t share your experience but couldn’t not reply. It’s so hard when there’s a lot of pressure from the world, other people and ourselves to do things the ‘right’ way.

Can you maybe think a little bit about why a vaginal birth is so important to you? Are there ways you could achieve what you want with a cs? Another poster was asking about gentle cs before - maybe something like that could help.

Also, could you think about reframing this? Maybe think of it as your body isn’t letting you down, it’s doing the best it can, and you have doctors and medical staff who can help you get the best outcome. Can you think of ways you can work with your body to get a good experience, even with a cs?

I hope I’m not stepping out of bounds or sounding harsh, but I hope you can find a way to be a bit more gentle with yourself and become more flexible with your thinking.

All the best!

Hi Daffy2016,
Thanks for your insight, I appreciate it. The news were still relatively new for me when I wrote the original post (in the wee hours of a morning), and I'm still processing.. I don’t think I was being inflexible with my thinking (at least I hope :) ), just a bit shocked. Imagine preparing for something for months and months and then having that option completely taken away from you in a few seconds. This is an IVF baby, and I was so happy that most of my pregnancy was without any complication – my body was doing greatly and I loved the feeling.


It’s really not pressure that I'm feeling (from myself or others) - the vaginal birth was something I really wanted to give a go. I was always prepared for any scenario after that, I only wanted 'try' labour or at least experience a contraction. In the end there is no 'right way' to give birth, only a safe way. I was not kidding myself by trying to stay in control, as it was going to be out of my hands in the end anyway.

I'm feeling a little more at peace with me having a c-section now as I can still have some of the things I would have wanted with vaginal birth - skin to skin (although not immediate apparently), partner at my side, beautiful healthy baby.

Some negatives that I still need to reframe and come to terms with - not getting the vaginal microbiota to the baby, not having the hormonal cascade that occurs with birth, the experience in itself, putting in the effort and have the sweet reward (and the euphoric feeling of relief apparently) in the end, not having to have an epidural if I didn’t need it, and just seeing what it’s all about. I am aware that it may have not gone this way anyway, and that would have been fine too.

And also with my second baby (if it happens), it will be hard to achieve vaginal birth without complications after a caesarean. Will see about that though when it comes to it :yes:

#10 SeaPrincess

Posted 28 June 2018 - 06:08 PM

Personally, I wouldn’t take the chance, and I agree with what Daffy2016 said. At the end of the day, you and your baby being safe and well is the main goal.

I had a low-lying placenta during my second pregnancy, but was given the ok for a VB. As it turned out, I went into labour at 36w5d, and delivered in less than 3 hours, so it was lucky really that I was cleared. However, I had a significant bleed after the delivery, enough that I felt the blood puddling around my feet on the bed before anyone else noticed - they were all off giving the baby oxygen because the cord was around his neck. I had dizzy spells for several days afterwards as well. I would prefer to err on the side of caution.

#11 Chief Pancake Make

Posted 28 June 2018 - 06:08 PM

experience in itself, putting in the effort and have the sweet reward (and the euphoric feeling of relief apparently) in the end, not having to have an epidural if I didn’t need it, and


It ain't that great :-). You get a baby either way that's the only reward.

#12 Ellie bean

Posted 28 June 2018 - 06:46 PM

Wishing you all the best. From someone who’s had 2 VBs, literally the only good thing was when they ended- I didn’t feel like an empowered earth mother or anything, it just bloody hurt- in no way is a Cs “lesser”
I hope you get the birth you want

#13 22Fruitmincepies

Posted 28 June 2018 - 07:00 PM

I’ve had two c-sections, first emergency, second by choice. They were both wonderful, beautiful births. In recovery baby and I had skin to skin, and the midwife encouraged me to let baby find his way to the nipple both times. Both babies I’ve had a great breastfeeding relationship, first until almost 2yo, second going strong (apart from some nipple biting) at 7mo.

#14 Lallalla

Posted 28 June 2018 - 07:08 PM

I haven’t had the same experience as my placenta did move. But I have had both an emergency c-section, which is what yours would be if you laboured first and a planned c-section. The latter was so much better for so many reasons. I would only have gone for a vbac if I’d had a good chance of seeing through. But I had twins with one breach so nope.

Also please don’t see it as your body letting you down.
You grew that baby from a few cells, your body is amazing!!

Edited to add it was the recovery time that differed the most for me, and for every single person I have ever spoken to who has done both emergency and planned. After 20+ hours of labour the last thing your body wants to do is go through emergency surgery

Edited by Lallalla, 28 June 2018 - 07:10 PM.


#15 Blue Shoe

Posted 28 June 2018 - 07:12 PM

I had a very similar situation with my first pregnancy, OP, and went with my OB’s recommendation of an elective CS. I wanted to try for a VBAC for #2 but the previous CS ruled that out (he was overdue etc). To be honest, between the two births there were a lot of ‘what if?’ feelings, as if I’d missed out on the authentic birth experience the first time around and needed to make up for it. But now, a few years on, I wouldn’t have done it any other way. My kids were both born safely (both had ended up with the cord around their necks which could have been serious problems) and calmly and basically pain-free. I have more than earned my motherhood badges with sleepless nights and sore boobs and everything else - not having gone through the particular experience (and pain!) of a VB doesn’t take away from that.



#16 PhillipaCrawford

Posted 28 June 2018 - 07:15 PM

 Deiva, on 28 June 2018 - 05:38 PM, said:


Some negatives that I still need to reframe and come to terms with - not getting the vaginal microbiota to the baby, not having the hormonal cascade that occurs with birth, the experience in itself, putting in the effort and have the sweet reward (and the euphoric feeling of relief apparently) in the end, not having to have an epidural if I didn’t need it, and just seeing what it’s all about. I am aware that it may have not gone this way anyway, and that would have been fine too.


I am sorry things aren't going the way you hoped.
It maybe worth investigating a swab for micrbiota, I am sure I read of that happening.

In terms of expectations being different from reality , unfortunately that is the nature of parenthood. Not necessarily better or worse but certainly different.
Good luck. However it happens, it will be special and euphoric just to finally hold the little person you have made.

#17 Deiva

Posted 28 June 2018 - 07:22 PM

 Moo point, on 27 June 2018 - 09:52 AM, said:

I was all set to have a drug free water birth except DS was still stuck after 2 hours of pushing. I had an epidural, episiotomy, forceps, catheter and now have a minor prolapse. I came very, very close to an emergency CS, and in some ways that may have been preferable. At the time I was disappointed and thought I'd failed at first, but in hindsight I was in great hands, it was out of my control and DS was born healthy.

The reason you would need to go to the public hospital to attempt a vaginal delivery, if the placenta hasn't moved, is to ensure you have a consultant OB and other specialists on standby in the case of haemorrhage or other issues. Your current OB is following best procedure.

Your body hasn't failed you, and neither did mine. So much of conception, pregnancy, labour and delivery is out of our control, and we are so fortunate to have access to modern technology that enables diagnosis of potentially dangerous conditions during pregnancy and birth. Please don't be too hard on yourself.

Hi Moo point,
I’m so sorry about how it turned out for you – a very good example of how we can’t really control how it’s all gonna go. 2 hours of pushing, I can’t even imagine! I think it would be natural to first see all this in a negative way, then you process it all and realise that in the end you have a happy healthy son and all is good

Yeah, I figured the private hospital didn’t have all the equipment and staff handy in case I had a massive bleed during or post labor. Australian health care is overall pretty amazing. And my OB is too – he listens to me and I feel he wouldn’t do anything that is not absolutely necessary.

I’ve come around a bit now. Although it’s an IVF baby, my body did end up nurturing and growing it. For the first two trimesters my pregnancy was a breeze, didn’t vomit once!
I love my pregnancy body, just the shock and the lack of sleep got the better of me, which showed through mist first post.

Here is to a drug-free orgasmic water birth for your next one :yes:

#18 Deiva

Posted 28 June 2018 - 07:28 PM

 Chief Pancake Make, on 27 June 2018 - 10:08 AM, said:

You get a lot bigger between 32 and 39 weeks. Your uterus is like a giant balloon. The bigger it gets the further away from your cervix the placenta will get so there is still hope.
Very true! Fingers crossed – grow uterus, grow!!!

 IamtheMumma, on 27 June 2018 - 10:23 AM, said:

I would call your local public hospital and ask what their criteria is for vaginal birthing with a low lying placenta. Use that information to help you form your decision.
My OB delivers there too, so he knows and told me already. Still need 6mm to go (14 to 20!).

#19 Deiva

Posted 28 June 2018 - 09:36 PM

 zeldazonk, on 27 June 2018 - 10:25 AM, said:

I had a very similar experience - marginal placenta previa with baby #1 that led to a c-section even though I had been desperately hoping for a natural birth.

I just wanted to reassure you that a c-section (especially a planned c-section) can be a very calm and happy birth too. The atmosphere in the delivery room was full of joy. We had time to plan what we wanted and discuss it with the OB. My baby and husband came with me to recovery for skin to skin contact, breastfeeding and photos.

We had no issues with bonding, feeding or recovery.

It was not what I had wanted or planned for, but it did mean that my baby and I were healthy and safe. Which I realised in the end was absolutely the most important thing.

Also, for me, the stay in the private hospital was also absolutely the best thing I could have done. DH got to stay with me in a double bed for all but the first nigh, I didn't have to share a room or bathroom, I had access to lactation consultants, the facilities and food were good, the midwives were not under resourced and could afford to give me lots of time. I would definitely not got public over private if I had the choice.

And a planned c-section is definitely less risk and stress than an emergency one if something goes wrong.

Hi zeldazonk,
Thank you for your reassurance, I needed to hear something like this. I heard about gentle planned c-sections, where you can plan for a few things - skin to skin, delayed cord clamping etc. And you are so right, if I end up going down this route it's all going to be fine because in the end I will end up with the ultimate prize
:babyboy: or :babygirl:

I am reluctant to go to the public hospital (although their delivery room is great and it's only 3 years old!) as I already got to know a lot of the staff in the private one - they have been all very helpful and knowledgeable.

#20 Deiva

Posted 28 June 2018 - 09:42 PM

 onyxmoon, on 27 June 2018 - 12:42 PM, said:

I would pick an elective c-section over an emergency one any day of the week. Much more calm for baby, mum and everyone. During daylight hours. Spending unrestricted time with my child (because you have an assigned midwife). Almost no risk of having a GA, not having to sit through epidurals while contracting. Not bleeding bucketloads and feeling like sh*t for weeks while your blood levels improve. Not having to recover from labour and major surgery. I loved my elective c-sec.

All of those reasons, and more, were why my elective c-sec was heaven compared to my emerg c-sec.

The reason your OB won't do it at a private hospital is you're now in a high risk group. and for a VB, a very high risk group of bleeding a large amount and needing emergency surgery like 'right this second, we don't have time to wait for the OB to arrive from home'.

Your body grew a baby, imagine all of the complex physiological processes happening in it right now. I'm always in awe of how many things it does get right!

Your call of course, but that's just my experience with those options.

Hi Onyxmoon,
I agree, an elective c-section would be much calmer than an emergency one.
I'd love to avoid both though if I could. Not that I'm scared of the surgery, it's just I want the experience of the vaginal birth.
As I mentioned in other replies, when I was writing my original post I was still in a bit of a shock, very tired and in not a very good frame of mind - in reality I don't hate my body. I think it's doing an amazing job growing a baby.
I even love the extra kilos I put on :grin: (I probs will change my mind about this later once I will try to loose them hehe)

#21 Deiva

Posted 28 June 2018 - 09:54 PM

 SeaPrincess, on 28 June 2018 - 06:08 PM, said:

Personally, I wouldn’t take the chance, and I agree with what Daffy2016 said. At the end of the day, you and your baby being safe and well is the main goal.

I had a low-lying placenta during my second pregnancy, but was given the ok for a VB. As it turned out, I went into labour at 36w5d, and delivered in less than 3 hours, so it was lucky really that I was cleared. However, I had a significant bleed after the delivery, enough that I felt the blood puddling around my feet on the bed before anyone else noticed - they were all off giving the baby oxygen because the cord was around his neck. I had dizzy spells for several days afterwards as well. I would prefer to err on the side of caution.

Gosh that doesn't sound good at all, - am glad you were both ok! If you don't mind sharing - how far away was the placenta from the cervix? Was it anterior or posterior?

My mum had an extremely short labour with me (am the eldest) - I was out 2 hours after she felt her first contraction, so I would probably be similar to her. Mind you she was 18 when she had me...I'm in my 30's and have a much creakier pelvis :grin:  My two brothers didn't even make it to the hospital...side of the road in an ambulance.

I will see how I go with the last scan at 37 weeks. At this stage I'm getting comfortable with a planned c-section at 39 weeks.

#22 SeaPrincess

Posted 28 June 2018 - 10:19 PM

 Deiva, on 28 June 2018 - 09:54 PM, said:

Gosh that doesn't sound good at all, - am glad you were both ok! If you don't mind sharing - how far away was the placenta from the cervix? Was it anterior or posterior?
At 19 weeks, it was anterior and completely occluding the internal os (cervix), so a complete previa. I had bleeding at 23 weeks and was in hospital for a week, then on light activity, no lifting my older child, etc. I was upset at the initial idea of a caesarean, but after the bleeding episode, I was ok with it. At 29 weeks, I was given the ok for a VB, but I don’t know how far it was from the cervix at that stage. Presumably it only got further away if it was moving in that direction.


#23 Hope28

Posted 28 June 2018 - 10:54 PM

I was in a very similar situation with DS1 - IVF pregnancy as well! In the end my placenta didn't move out of the way and I had a c section at 39 weeks. It was not what I wanted at all - I had very much wanted a vaginal delivery, no/few interventions, but that wasn't to be. There is literally nothing that can be done to prevent or "cure" placenta previa. That thought has brought me some comfort because it makes it harder for me to have regrets (something I am otherwise very prone to!).

Being a planned c section meant that it was very calm. DS1 stayed with me the whole time - he was on my chest within I think a minute or two of being born, we did skin to skin in recovery and he started breastfeeding there.

In my case, my OB would have been happy for me to have a VBAC with DS2, but I ended up with another c section after going overdue.

Wishing you all the best either way :smile:

Edited by Hope28, 28 June 2018 - 10:54 PM.


#24 sara030

Posted 29 June 2018 - 03:13 PM

Go easy on yourself, your body hasn't failed you. I know it's disappointing but from what I gather, 15mm is still very close. At 20 weeks mine was 18mm away and my ob who is pretty easygoing and very pro VB where safe said that was still a definite C-section at 18mm.
The most common minimum I've heard of for a VB is around 25mm...maybe less conservative obs might say 20mm...but I'd be worried myself about the risks involved with anything less than that. Give yourself some time to get used to the idea of a C-section, perhaps you're just in shock and upset about it at the moment but might be more open to the idea with time.

#25 Daffy2016

Posted 29 June 2018 - 03:32 PM

I hope my post didn’t come across badly, OP. I just feel like we often put so much pressure on ourselves for things that are out of our control!

Like a pp I had a vaginal birth, but very long, 2 hours of pushing, very nearly a cs (they had the theatre prepped) before DD made her appearance. It was horrible, so much pain and misery! I spent a lot of time thinking about how I ‘should have done better’, not helped by my sil having a textbook birth three months later. But even she feels there are things she would have done differently, so there you go!

Good luck and I hope you feel happy and content, however it turns out.




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