placenta praevia at 36 +2 wks and home birth

[Helley]

Hi everyone,

I don't want to get too technical but I'll try and explain as best I can what my situation is at the mo.

Had scan at 20 wks which found I had placenta praevia, went back on Monday for my 36wks check up and the placenta has moved out of the way(approx 5.6cm from my cervix), great, I thought. However, the midwife who saw me after my scan was keen for me to come back and see a Consultant, as she said because I'm planning at Home Birth there could still be a possibility of a bleed.
So, saw a consultant today who said that unless it was right out of the way..whatever that means!! I would need to come into hospital 'in case' I bleed after delivery. Not happy with his response and generalisation, I've requested an internal scan which will happen on friday to determine exactly how far the placenta is away from my cervix because I'm desparate for my home birth.

Having done some reading on the trusty internet, I've found that if the placenta is 5cm or less from the cervix, it is cast at a Type 1 PP and 'could' cause some bleeding.

Dependent on how things go on Friday, I just want to get peoples opinion on whether I should risk still having a home birth and what action the hospital could take if I decide to go through with a Home birth even though they're not keen.....

My feeling is that even though the placenta could be further than 5cm away, they'll try and make me come into Hospital.

xxx

[dan39]

Whats the general approach to HB in your area? Are they generally supportive? Do you feel that they are definitely concerned for you and babe or just wanting to get you in? Do you know much about the hosp approach to home style birth - active birth stuff? Also do they support a 6 hour discharge? Hospital births CAN be positive, maybe you won't get the birth you planned but it could still be nice. But see what they say...

I would ask lots of questions in your position too - at the end of the day you want it to be safe, I guess?

Good luck with it and i hope you get some responses from people who might have been thru it - I haven't, I am just opinionated!!

[pollyblue]

Hi,
I had placenta previa with dd1 (was just touching cervix so had section) and until about 28 weeks this time around (now pg with twins) had one placenta very low again. This has now moved to 3.6cm away from cervix and my consultant has given me the impression that that is considered perfectly ok, although because of previous section am having another one this time, so won't be trying for vb. But it has meant he's now scheduled me for delivery at 38 weeks, rather than 37, as he's less concerned about bleeding if i do go into labour, and he's very much an 'err on the side of caution' consultant.

How supportive of home birth is your midwife? If you did start to bleed at home, the midwife would phone ahead and the hospital would be ready for you as soon as you arrived, i think the general rule of thumb is you should be able to get to hospital within 20 minutes. Ask on friday what their actual experience of this is - how many women do actually bleed and how serious is that bleeding likely to be, they should be able to give you some statistics and hard facts rather than just "could"s and "possibility"s...good luck

[Helley]

Thank you for your responses.....to be honest, I've not spoken to anyone about a hospital birth because I was pretty sure that I would have a home birth. Bit stupid, I know. But now I'm armed with some questions, I'll certainly be probing tomorrow.

My next door neighbour had her baby a couple of weeks ago at the hospital I'd need to go to and she said it was pretty rubbish, so that's not exactly filled me with confidence. There is another hospital I could be transfered to which is another option.

I guess I should wait until tomorrow and then speak to my community midwife on Monday to see if she is confident in me still having a homebirth.

[Isaidno]

I only had the all clear and permission for my home birth from placenta previa at 36 weeks. My placenta was still close to the os (can't remember how close.)

I would request scan as late as poss to assess situation.

I had no probs with a vb after panicking about possible c section etc. (Although had to had a hospital birth in the end because my waters broke and I didn't go into labour within the allotted 18 hours.)

[Helley]

If the internal scan tomorrow shows the placenta is a bit too close for comfort to the cervix, say less than the 5cm that I keep reading about, then I'll request another scan in a week or so to see if the distance changes.

My one concern is that if the distance is over 5cm but the hospital are still adamant that I should come in just in case, how much right do I have to ignore their advice and still be able to birth at home??

[Tangle]

Have you joined the homebirthUK mailgroup? There are a lot of women on there that have had a lot of babies at home, and a fair few IMs that are very supportive and experienced of home birth as well. They may be able to give you an educated view on the risks of placenta previa (or near PP) and homebirth that won't be tainted with anti-homebirth sentiments.

My experience when planning a homebirth or birthing centre birth was that, whilst you can choose to go to a given hospital if you're driving the car, once you're in labour and under the care of the MWs the options get much fewer and there will most likely be only one transfer route that all women under the CMW team's care will go to if they're in labour - but check that's the way things are in your area.

Just remember that at the end of the day the consultant cannot deny you a homebirth, only recommend against it. I'm not saying you should go against all medical advice, but if YOU are happy with the risks then YOU can choose where you have your baby.

[PrimulaVeris]

Hello Helley

I've had a placenta praevia - an anterior one actually which was only picked up by the consultant when I went in have a cehck-up when at almost 42 wks. I had no bleeding or any other symptoms. I had an elective caesarian 2 days later which had to be done under general anaes because it was that bad, basically.

If the consultant wants you to go in, quite honestly I'd say go in. Your life and your baby's life could be at risk.

[Helley]

No, I'm not a member of that mailgroup, but I'll definitely get myself on there, thank you!

When I saw the consultant, I did say to him that I'm not stupid and the last thing I want is to risk mine and my baby's health, but at the same time I need a persecptive on the risk. People are at risk every day, just from living so I want them to give me facts and figures to help with my decision.

If I go to my midwife on Monday and the hospital have put on my notes that they think I should come in because of the PP, can she say that she's not comfortable proceeding with organising the home birth for me?

[Tangle]

She can say that. But they cannot tell you you cannot have a homebirth (well actually they can, but they'd be lying). If you feel happier with the risks of a homebirth than you do with the risks of a CS and feel the MWs are becomming unsupportive you might want to talk to AIMS, who are very good on helping women deal with these issues. Many women have been told they "can't" have a homebirth, have put their foot down and gone on to have the birth they'd planned with full support from the MWs - but the mailgroup and AIMS would be better placed to advise you on that.

My DD was breech, and I found the hardest thing was trying to define what the risks for each course of action actually were so that I could make an informed choice. In the end we used IMs, they were wonderful and the only thing I regret is not signing them up sooner (I was 36 weeks when we did). It wasn't a cheap option but it was much better for my stress levels!