Worried About Placenta Previa

QUESTION

Dear Midwife,
My doctor keeps trying to act like it's not a big deal about my complete placenta previa. I want the truth. I am 27 weeks and I just found out that I have complete placenta previa. I have had two spotting episodes.

Two days ago, I was having contractions in my lower abdomen all day. Later that night they were a regular ten minutes apart. My back hurt and I felt like I had to go to the bathroom but nothing was happening. I remember what my doctor's nurse told me about lying down the last time. After two hours of rest they became irregular and slowly went away. I think I may have been in labor.

About a week before that I had irregular contractions. I've birthed a son and know what labor pains feel like. Do you think I may have been in labor? Should I have gone to the hospital? Can you have premature labor with placenta previa?

My doctor doesn't tell me much. It seems like he is always trying to sugar coat things.

I want to be sure that he won't be born too early. I want him healthy but I really want the truth about what is happening to me.

Please help!

ANSWER

A complete previa is serious. Any episode of bleeding should be reported to your provider right away.

A second baby usually produces stronger Braxton-Hicks contractions, and many women feel like they are going into labor early, when they really aren't. In your case, if your cervix were really dilating (which it has to for it to be labor), you would undoubtedly be bleeding.

If you're not bleeding, the cramps are probably not labor. The fact that they quit when you laid down is another indication that the cramps were not "real" labor, the kind that make your baby come.

Your placenta would have to move out of the way or you will need a cesarean to deliver safely. I realize that may be no big deal to your doctor, but I'm sure it is to you.

If you do not feel that you are communicating well with your provider, you might consider interviewing others to find one that will care for you from here on out. You are far enough along so that in many communities, finding a space in another practice may be difficult, especially with the previa. But it may be worth a check!

Good luck, and I'll be thinking about you and your baby.
-- Cynthia, CNM

Cynthia Flynn

Cynthia Flynn, CNM. PhD, is the General Director of the Family Health and Birth Center which provides prenatal, birth, postnatal, gynecological and primary health care to underserved women and their families in Washington, D.C. Recently Cynthia served as Associate Professor of Nursing at Seattle University. There she not only taught, but remained in full scope clinical midwifery practice at Valley Medical Center where she cared for pregnant and birthing women, and practices well-woman gynecology, family planning, and treatment of sexually transmitted diseases.

Cynthia founded Columbia Women's Clinic and Birth Center, where she took care of pregnant women and infants up to two weeks of age and attended both birth center and hospital births. Before Cynthia earned her CNM, she worked as a registered nurse in labor and delivery and postpartum and is a certified Doula and Doula trainer.