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Placenta Previa....

Last post 05-21-2012 9:29 PM by Aubre. 4 replies.
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  • 05-18-2012 5:54 PM

    • Aubre
    • Top 25 Contributor
    • Joined on 02-14-2009
    • Posts 75

    Placenta Previa....

    Just in need of a virtual hug......

    Had a lovely fourth time Mama come into our birth center, very early in the morning. She was clearly very close to birth.  She felt very strongly about  wanting to have her cervix checked, so I did. (I find that some ladies, despite empowering education and support during the pregnancy, really need the "validation" of cervical exams.....thoughts?) Anyway, I had been sleeping at the center and was the only one there. I can and have done births by myself, as I am sure all of you have.  At our center ultrasounds are optional and this Mama had opted not to get any.  I checked her cervix to discover that she was C/0......and had a partial placenta Previa!  In a split second, I decided that since she was a multiple, it would be quicker for her to have the baby than to try and transfer her.  There was a moderate amount of bleeding after the cervical exam( which was the first she had during the entire pregnancy) but after the first push, the bleeding stopped.  I believe that the descent of the babes head tamponaded the bleeding.  Babe needed some extra support, some strong stimulation and PPV breaths, but came around great, apgars 3/9.  So Mama and baby were well....the midwife was quite frazzled!  So, besides the virtual hugs....has anyone else had a case of partial Previa with zero antepartum bleeding?  I must also be honest and say that immediately after this happened, I was convinced that we should change our policy and require a 20 week ultrasound.  I have since calmed down and now feel that our original policy is correct....no required ultrasounds.

    Has anyone else ever had such a situation?

    Aubre Tompkins, CNM
    Wishing you Shade and Sweetwater
    http://www.midwifeyearone.blogspot.com
  • 05-18-2012 6:43 PM In reply to

    • midwifea
    • Top 10 Contributor
    • Joined on 02-12-2009
    • Kailua Kona, HI
    • Posts 475

    Re: Placenta Previa....

    Big hugs Aubre, big hugs!! Never had that exact scenario and sounds like you acted accordingly and wisely.  I once had a primip who bled a little too much, always just boderline of transport, and although I never felt any previa, I suspected one.  Same thing, once pushing commenced head tamponaded bleed and this babe was fine.  Good bleed in 3rd stage though and placenta came out dirty duncan so think it was on edge of cervix.

    Blessings,
    April
    moderator

    "The Voice

    There is a voice inside of you
    That whispers all day long,
    "I feel this is right for me,
    I know that this is wrong."
    No teacher, preacher, parent, friend
    Or wise man can decide
    What's right for you--just listen to
    The voice that speaks inside."
    — Shel Silverstein
  • 05-19-2012 1:01 PM In reply to

    • Aubre
    • Top 25 Contributor
    • Joined on 02-14-2009
    • Posts 75

    Re: Placenta Previa....

    Thanks April, the virtual hugs feel good! This placenta also came out Duncan....which makes sense.

     

    Aubre Tompkins, CNM
    Wishing you Shade and Sweetwater
    http://www.midwifeyearone.blogspot.com
  • 05-20-2012 3:03 PM In reply to

    Re: Placenta Previa....

    On the topic off assured mama's who need a cervical check...

    With DD1 i didn't want one but my mw sort of insisted.  I lay down resentfully but since DD1's head was crowned (i had no idea what was going on, active stage was written up as 1hr24mins which was their arrival to that VE, and honestly i just felt pressure and discomfort and believed them that i wasn't in "real" labour yet) there was no V to E.

    With DD2 i tried to feel myself right after my waters broke, but all i could feel was impossibly wide anterior vaginal wall and nothing else (i was hoping for top-of-head!).  My mw was behind me (i was on all fours) and asked me what i felt, i told her and asked her to feel.  I NEEDED to know, i just felt it.  It had gone from a very distant irrelevant detail to the only fact in the world which mattered in a few moments.  She did a VE (James Herriot style as she put it! :D) and told me i was fully, the head was at spines, and i could push whenever i wanted to.

    I pushed HARD, through the next contraction, and the gap (the urge never stopped, and i could feel the baby's feel stepping and bracing against the fundus inside), and the next contraction and then i panted (on autopilot, i wasn't told to and didn't think to, i just noticed i was) for a few seconds before giving another huge shoving push.  DD was born with a true knot in her cord.  I believe she asked me to have the VE because she wanted me to be able to push without reserve until she was born.  She was tachy in the only doppler listening the MW managed (labour was 55mins, plus 6 of pushing, mw was there for the last 30 or so mins and i simply couldn't keep still for her to listen but once - she was concerned but it was 7mins before the baby was born, right after the VE, and she could tell by the look of me that it was too late to think of transfer or anything) and i think she knew descent was going to be either very fast or very dangerous for her.  She took her first breath and began to scream when her (anterior!) shoulders were still inside me, her apgars were 10 and 10.  She screamed breathlessly until she was 20mins old, the placenta came and we cut the cord.  The second the knot was cut away she fell silent, looked at me for a moment, then began to nurse.

    Maybe the motherbabe you were helping needed you to know about the previa, nothing went badly, you did a great job, but maybe they just needed you to be prepared, just in case?

    Me 32, DH 41, DD 2006, DD 2010, DS 2013
  • 05-21-2012 9:29 PM In reply to

    • Aubre
    • Top 25 Contributor
    • Joined on 02-14-2009
    • Posts 75

    Re: Placenta Previa....

    That is an excellent point....that sometimes the MotherBaby will need to do certain things in order to be prepared. Thanks!

    Aubre Tompkins, CNM
    Wishing you Shade and Sweetwater
    http://www.midwifeyearone.blogspot.com
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