Higher risk pregnancy - feeling low

[sleepcrisis]

My first pg was so straightforward it was text book, as was the birth (home water birth)

Then I had a mc, and now this pregnancy is turning out to be not very low risk and its scaring me!

Firstly I had a bleed at around 14 weeks, which turned out to be membrane separation - which quickly healed and didn't really affect the outlook for the rest of the 9 months.

Then I had a suspected amniotic leak at 18-19 weeks, combined with a significant shortening of the cervix. Basically they described it as a threatened miscarriage, no idea why, but the cervix has since returned to a tight and healthy looking 3.5 cm.

Then my swabs came back as GBS positive which means I would choose to have the antibiotics and therefore not be able to have my homebirth :( I had planned to ask for a re swab at 34-36 weeks and make my decision then.

Now at my 20wk scan today I was told I have low lying placenta, abutting the cervix. I thought 9/10 low lying placentas move up, but the sonographer seemed pretty convinced it wouldn't move. No idea why he thinks that, he just told me to be prepared for c section and not have any expectations. Am being rescanned at 30 and 32/34 weeks.

He also implied that because of my 'history' the docs might like to induce/section a few weeks early. While my scares have definitely been terrifying, I haven't been led to believe that they have been particularly indicative of anything very sinister. I was even although obviously my body has been trying to tell me something.

Anywyay, up until today I still held out hope that I'd get my home birth (I'm terrified of hospitals)

What I'd like to know is a) will a subsequent pregnancy be high risk too or can you go on to have a perfectly normal pg? This might make my mind up one day whether to have a 3rd!
and b) has anyone had any similar experiences? what are your thoughts on what I've been told re induction etc?

thanks in advance.

I'm also a bit freaked out as I had a bad case of pnd with my first despite the wonderful build up and birth, and I'm terrified that its all going to happen again.

Hi sleepcrisis, I can sympathise with how overwhelming it can be.

I knew my pregnancy would be high risk due to some health conditions I had and me and DH had pre-conception counselling to ensure we knew the risks to me and baby and to make sure we wanted to get pregnant.

However, even though I knew I'd be high risk, seeing it written in red letters all over my notes made me feel very disheartened. I'm under 3 specialist teams to monitor my health conditions which I thought was extreme enough but things were then further complicated by unexplained bleeding. I have actually been signed off work for 13 weeks. I had a big bleed when I was 14 weeks and it was questioned then if there were problems with my placenta (be it low lying or there being cysts) but thankfully a specialist Scan I had last week (I'm under the care of a Foetal Development Team as opposed to just normal midwifery services) showed that although my placenta is low it isn't over my cervix so the doctors are hopeful here won't be a problem. I am however being scanned every 4 weeks so at least I know they can keep an eye on it.

I have always known I may potentially need a C-section (due to my existing health conditions) so thankfully it is a hurdle I'm ready to accept if it comes to it.

The good news is that I'm now 21 weeks and have a perfectly happy and healthy baby. I just keep focusing on that otherwise I'd probably sink into a heap of worry and concern.

I'm sorry things haven't planned out as you so wished but when your baby arrives it will all have been worth it x x

It sounds like the issues you are having are unlikely to show up in a future pregnancy, so hang onto that thought!

I am sorry to hear you're having such a hard time. Like you, my first pregnancy went relatively well (PGP, and a not quite ideal birth aside) but my second catapulted me into the world of extremely high risk. It is a big mental adjustment to make, particularly when you have dreams of a nice labour at term etc.

This is DC4 now, and DC2 and DC3 were both high risk so I've adjusted now, but I still get the odd twinge of jealousy when I hear people talk about their labour plans as they still have a choice (whether it works out that way is another matter!!) I am doomed to ELCS and have been since DC3.. and I'm a homebirth-style mummy really

One of the silver linings to being high risk is that you get much better care, well, so long as the doctor isn't crap anyway - but usually at the very high risk end you get to see the decent doctors and bypass the registrars. You also get more scans, and more attention paid to you in general, and at the birth.

I hope you have no more surprises and that things settle down a bit for you!

I started out as 'high risk', because of my weight and age. Then a pre PG diagnosis of GBS was thrown into the mix. I was determined on a home birth with a pool, I refused to consider being on the labour ward on my back with a permanent monitor attached, I was going to stamp my feet for the MLU...
But, then DD was diagnosed as having problems which means we are now properly 'high risk'.
TBH, I don't care now. It's not about me anymore, and I just want her here safe and sound. I'm still not keen on continuous monitoring, but if we need it, we need it.
Anyway, what Im trying to say is, try and keep an open mind. PROM and low lying placenta could both be serious issues, its surely better to deliver safely. Being induced, Ive had it twice or even a cesareameans that the medics are in control and the situation is monitored.

Low lying placentas do, as you've said, most often rise up, so I don't know why the sonographer thinks they can see the future.

I don't see why a threatened miscarriage would mean that early induction is a good idea. I don't see any reason why, to avoid a baby coming a bit early (if they're talking about inducing at term) you'd - erm - try to get them to come early.

Sonogrophers do scans. Obstetricians deal with low lying placentas. I would entirely disregard anything the sonographer says at this point!

You can, if you wish, have antibiotics at home if you choose to have them for Strep B. If you go to www.aims.org.uk and click on "Top Tips and FAQ" on the top left, it will lead you to useful information on Strep B and labour. If you find AIMS helps, do consider joining as a member as your £25 not only gets you an amazing journal and access to the brilliant AIMS members e-group (with loads of wonderful wise women) but you help others to get support, too.

Please ask to see a consultant to go through all this properly. Sonographers whilst knowledgeable are probably do not have the most official word!

Thanks for all your advice and comments.

I should have mentioned in my OP that I'm not in the UK so some of the advice is not all relevent - eg I would LOVE to demand IV antibiotics at home but I know that here it simply isn't an option.

Fortunately though, where I live there are only consultants and midwives, (and sonographers obv) so the doctors I do see are good and thorough. But fairly conservative. Bizarrely I have seen the consultants for a few scans recently and none of them have even mentioned the low lying placenta. But the 20wk scan is done on different machines by senior sonographers so maybe they can see more. But yes, he shouldn't have really commented on what it might mean.

I am seeing the consultant at 30 weeks following a GTT at 28, so hopefully they'll be more positive then.

I know my pg is not super super high risk but it just feels like its gone from low risk to quite medical and complicated in such a short time. And there is still so long ahead for things to change, and I'm impatient! I find it hard not knowing how its going to pan out.

I'm a very anxious person and yet in pregnancy one of the only things I'm not afraid of is labour and childbirth - and now my perception of how that will be is changing, I'm freaking out somewhat.

saggy you're right though, and I'm sure that soon enough I'll find myself not caring and just wanting baby to arrive safely. The PROM was never really confirmed, in fact they don't really believe it happened because the fluid levels around the baby have never reduced, they could see no fluid trickling down the cervix, and I haven't had any more wetness since - and I'm inclined to think it was wee anyway! BUT they did test with an Amnisure swab and it came back positive. My consultant was hopeful it was a false positive but they are very accurate and so cannot be ignored. So its on my notes...

take a look at a few of these. just thinknig from an alternative perspective for you (just in case)

www.caesarean.org.uk/articles/CSAPosBirthExp.html
www.caesarean.org.uk/birthReports/LucyCS.html