Please I really need advice. Any obstetricians/midwives at all? just anyone. Shitting myself. Had 20 week scan today.

[ScottyDoc]

Scan was today, all was going well until sonographer spotted my placenta was low lying. He said its not necessarily a problem but they'll keep an eye out etc etc.

Then he said they will offer me a vaginal scan to detect where it is at around 34 weeks. This is the part where I really panicked. Due to certain events that happened when I was young, I cannot handle internal examinations, let alone a vaginal probe. I don't want to go into what happened to me but I'm absolutely petrified they will try to pressure me into having this done. Having G&A and things to cope is not an option either.

Sonographer said the ultrasound most likely wont give a greatly accurate location of the placenta, but a vaginal will. I can't and will not consider having this done. Foes anyone know what this means for my baby and my birth? Does anyone have experience of this happening? Do I ask for a C section if they can't find accurate positioning at the ultrasound?

So frightened. Please give me some advice. I know this sounds so minor and pathetic but it's a serious issue for me.

How low is it lying?

Mine was low - but borderline and they rescanned me later on but not vaginally.

Would you be able to speak to your MW about this? There might be other exams eg during labour so you should be talking to them now and working out how they can help you.

I know what it is like to have a severe phobia of internal exams. Does your own midwife know? If you give her a ring she may be able to offer reassurance.

hope you get some useful advice soon

It all depends whether the placenta is anterior/ posterior. If it's anterior i.e closer to your tummy then it should be easy to see with a normal scan. If it's posterior- on the back wall of the uterus then they can't always see it with a tummy scan because the babies head/bum gets in the way.

An internal ultrasound scan isn't half as bad as a smear test-just the tip of the probe goes in, there's no speculum or anything.

I think that most 'low' placentas aren't low at the end but you really don't want to go into labour with a low one because that can be dangerous.

Does your Midwife know how worried you are about internal exams? It'll be important for her to know especially when you're thinking about your care in labour.

I realise you have a phobia and I don't want to be nasty but a vaginal probe is shaped like a willy...it doesn't probe ..It goes in pic taken and then out again. It doesn't hurt at all. However your mw will be able to explain more to you . Also unless you are planning a c section then when you go to give birth it is likely you will have internal examinations... Its for the benefit of the wonderful bundle of joy you will be cuddling and it is all worth it...

Thankyou for all your replies. Much appreciated. I have actually had two dc's prior to this one, so I've had experiences with internals before. I have been traumatised by them and in my second labour, refused them altogether. Yes I should ring the midwife...just worried about what they will say. The ones I have been in contact with are very nice but not particularly understanding with regards to how bad my phobia is. I was hoping since this is my last ever pg, that I would just be able to get it over and done with without any internals. Sonographer didn't tell me if it was anterior or posterior, just said it was low lying. Just don't know how to cope with what could happen if they can't see placenta in ultrasound. I am very frightened of being pressured by them to do the vaginal when they don't know my history etc. not something I want to shout from the rooftops :(

Please don't worry, no one will force you to have any examinations you are not comfortable with. However you really do need to speak to your midwife about your fears as it will be impossible for you to be safely delivered without some level of vaginal examination during the birth. An elective caesarian might be a better option for you.

It will say on your ultrasound report whether it is anterior or posterior.

FWIW i had low lying placenta (posterior) at 20 weeks, also low on my 23 and 26 week scans. Just had a 32 week scan to check position and it's up and out of the way. 80-90% of them move. My scan was abdominal, despite head being engaged! First sonographer found it a bit tricky to be certain but called for second opinion from senior who was very sure straight away. Helpful to have a bit of wee in the bladder to help them make out your cervix. I got the impression that moving on to a vaginal scan was rare.

I do think it's maybe worth tackling the phobia though. What if you need ventouse/forceps? what about future smears? Maybe ask midwife if you could be referred for counselling or consider hypnotherapy?

Worcestershire- I don't think it's impossible to have a safe delivery without " some level of vaginal examination during the birth"- I've had three safe births without any VEs.

Scotty- this is obviously a distressing thing for you and your MW has more than likely come across other women with phobias, so please don't feel nervous about discussing it with them.

Fingers crossed it sorts itself out by itself, but if not, there are bound to be options. x

I'll add my experience: placenta was low at 20weeks so I was rescanned at 36 weeks, abdominallly. Was told all was well and placenta was back up. At 39 weeks had some bleeding, but a low placenta was not considered, was just told it was unexplained and was sent back home. One week later more bleeding, this time a lot worse, and ended up with emergency section. Placenta praevia was only diagnosed at that time.
So, if you're offered an internal scan really try to do it, it may well save you having several internal examinations, failed inductions and potentially dangerous bleeding.

When I've needed internal scans (early stages of fertility treatment) the sonographer has offered me the choice of inserting the probe myself. Don't know if this might help you feel more in control, or would be more acceptable?
Agree with those above though, talk to your MW about your concerns, and decline any VEs that you don't want. Once you get one who seems to understand, ask her if she can add a page to your notes explaining your wishes, and then if anyone pressures or challenges you later on, you can say "please look at my notes" rather than having to go into it if you feel vulnerable. Or you could add such a page yourself.

How can you possibly give birth without someone looking between your legs and touching you 'down there'? What if you need stitches? If it can be done I'm amazed. It is possible to say no to internals to check dilation, but a midwife can't assist without looking to see when the baby is crowning, and if there are problems forceps/ventouse may be needed.

I would just present it as a fait accompli, i.e. 'I'm sorry but due to a bad experience in my past I don't feel able to have a vaginal scan. What do you suggest?'. See what they say.

Hi ScottyDoc my advice is that you go to the appointment at 34 weeks and tell the sonographer that you are not able to have an internal scan or ask your midwife to ring up before your appointment and them aware of the situation. Fingers crossed they might be able to assess the placenta without doing internal scan. If not, then they will most probably refer to see an obstetrician to discuss options.

As puddock the other option is that you put the probe in yourself but the sonographer would still have to guide the probe to do the scan so I don't know if that would make it any better for your or not. Of course you can request a female sonographer if that would help also, but no one should pressure you to have internal scan if you don't want it.

I also have issues with VEs. But actually a vaginal ultrasound is really not bad - much much less difficult/painful/traumatising for me than a VE or a smear or anything like that. The probe is not very wide, they lubricate it really well and the only insert it a little; it's also quite dignified in that the operator sits to the side, you stay partially covered up and you don't have to part your legs that far. I had to have one at the very beginning of my pregnancy (five weeks) to check for twins and it was so much less awful than I expected.

I had a low placenta at 20 weeks with my first DC. I was re-scanned at 34 weeks abdominally which confirmed it was out of the way.

I have also had 3 DC and only had one vaginal examination - a sweep with DC2, so it is perfectly possible. If your placenta moves and you are low risk you could consider a waterbirth. Much more private, shielded and hands off in my experience.

You need to know if the placenta is still in the way of the cervix later on as it has serious implications for mother and baby if you go into labour with a low placenta or. Placenta Previa. But remember too that whilst it is relatively 'common' to have a low placenta at 20 weeks the vast majority of those will not be low later on. The statistics are on your side that all will be well.

Best of luck OP

Ive had a low lying placenta 3 times and they've never done a vaginal scan for the rescan. And all three times it had moved just fine. I wouldn't sorry, the vaginal scan thing sounds like an excessive precaution.

How are you going to manage during birth though?

Hi Scotty, I'm assuming that you were abused in the past (I don't expect you to say). I would speak to your midwife, you don't need to give any details just that you were abused and can not imagine being able to consent to any vaginal scans or internals. You don't have a "phobia" (word always has negative connotations to me).

I think that you need to think about what you can and can't consent to, in various scenarios and discuss what is safest for you and your baby with your midwife/consultant. Wishing you and your baby all the best.

Thank you to all who have replied. I'm going phone the midwife and have a proper chat about it all and book an app with them. I'm going to see how it all goes and just hope it moves. SummerRain - in terms of labour I've been through it twice before (very long ones) and have had two natural births, so managing is ok. I don't like pain relief either so I don't have it and I think this is again related to past issues, i.e me feeling out of control of my body/hating anything invasive etc. I would enjoy labour and birth a lot more if I knew the midwives wouldn't pressure me to have internals.

Thankyou mrssmaretto, I hope they take it seriously if I tell them the cold hard truth :( "phobia" always seems to be dismissed easily

Good luck Scotty

Scotty, I hope your labour goes smoothly again this time but I would strongly urge you to discuss with your mw some situations in which an internal is impossible to avoid and make a birth plan based on how you want to proceed in those events.

Dds life was in danger during her birth and I had some very intrusive internals which could not be avoided. After her birth I had a pph and needed stitches and the mws had to do some even more intrusive things to my nethers. I sincerely hope nothing of the sort happens to you but I think for your own wellbeing you need to have a plan in place if the worst happens.

Summer that's a very valid point . I think definitely if baby's life was at risk I would force myself to go through whatever was needed, so I'll be discussing that with the midwife. Thankyou Guntie :) I'm hoping for the best this last time.

Scotty, by far the worst internal I've ever had carried out was done by a male police surgeon and it was an extremely distressing experience. It was the first internal I had ever had. So, for my first birth, I requested that I only had internals by a female and only if necessary. All this went out the window when I went into prem labour and was expected to just go along with whatever was convenient for my care. I was upset that I had a male obstetrician looking after me but the midwife ordered him out when he wasn't needed. Interestingly, I had to have a vaginal probe for early pregnancy scans following bleeding. Because they use loads of KY Jelly to get good pictures and the probe is quite slim, I didn't find that at all distressing. I felt less violated having a vaginal scan than any sort of internal. They also keep you covered up with a 'modesty sheet' as much as possible.

I don't know if that helps at all. I know that how I felt maybe very different to how you feel. I hope that you manage to work it out in a way that you are comfortable with.

Hi Scottie - I'm v sorry to hear about your previous bad experiences. I'm not seeking to dismiss your concerns however I did want to echo what someone else said up thread in case knowing the details enables you to go ahead with it. Totally understand if it makes not a jot of difference!

A transvaginal scan is very different to other internal examinations. What happens is that you undress (lower part only) cover yourself completely in a voluminous sheet and lie on the examination couch. The dr then inserts an extremely narrow probe. I swear on my life that they do this whilst looking you in the eye and looking no where else. In fact i had my partner with me for one and he was agog at how the nurse got it in without even looking south. Their hand will not touch your genital area - the most contact I have ever had is the consultants cold cuff links brushing my thigh. I am pretty sure that you could ask to insert it yourself and also take your partner or a friend with you.

I've had 13 rounds of fertility treatment done so have had umpteen if these flippin things. I would rate a smear as a 6 in terms of discomfort/ loss of dignity. I would rate this as barely a 1 - perhaps a .5 if that. I totally get that it's the memories and anxiety that are key here for you but I'm just posting in case the detail helps you at all

Thanks so much for both of those experiences plus all the info. It does make me feel a bit better that if worst comes to worst, I could ask to insert it myself. I thought the probe thing would be like a speculum, that's another thing that was frightening me. I don't feel as horrendous and thanks to you ladies, feel like I know what happens rather than turning up at hospital without any idea at all. Very much appreciated xxx