There are a few things that can complicate a normal baby delivery. While it may be frightening for a mother to think of these things it is also good to understand the possible risks and events that can happen leading up to labor. If the birth canal has a block in its opening the baby will not be able to be delivered the traditional way. Sometimes this can occur with the placenta. 

This is referred to at either placenta previa or low-lying placenta. Here Is what you need to know. 

What is Placenta Previa?

Placenta Previa is often referred to as low-lying placenta because it blocks some or all of the cervix based on its low position. The placenta plays such an important role in the baby’s development as the baby gets its food through the placenta but also it secretes the waste from the baby.  

When the cervix is blocked by the placenta it can cause bleeding pre-labor or during labor and complicate the delivery. In the early stages of pregnancy, the placenta usually remains low in the womb but as the baby develops it is meant to move to the top out of the way. 

Placenta previa has different treatment plans for different levels of severity. A doctor may just order bed rest if there are no major signs of complications and reevaluate as the due date approaches. 

Types of Placenta Previa

There are essentially three types of Placenta Previa with a fourth subcategory if you will. While the names may imply their own characteristics, it’s worth breaking them down individually as they have different aftercare approaches. 

Complete Placenta Previa

This is where the cervix canal is completely blocked and covered up by the placenta. This is the most serious of the four different types and almost always the baby is delivered by C-section. In some cases, this may call for an early or premature delivery if there is heavy bleeding involved. 

Partial Placenta Previa

Only a part of the cervix is being covered and, in this event, normal delivery is still possible.

Low-Lying

Some doctors like to classify this as its category separate from Marginal Placenta Previa. Low-Lying Placenta Previa is when in early or mid-pregnancy the placenta is just on the outside edge of the cervix but not covering it. 

Marginal Placenta Previa

Similar to low-lying this is when the placenta is growing just outside the cervix or may have the small touching and overlapping of the cervix. This may cause minor bleeding. 

How Is Placenta Previa Diagnosed?

The condition of Placenta Previa is likely diagnosed in the second trimester of pregnancy. This is because in the first trimester it may still be a low-lying placenta and is completely normal. During a routine check, a doctor will likely perform an ultrasound to see how things are going. An ultrasound is the easiest way for the doctor to see that the placenta is low-lying. 

Three different ultrasounds can be performed either by routine checkup or after reporting vaginal bleeding.

Transvaginal

One of the most accurate ways to see what is going on is by using a Transvaginal ultrasound. This is when a tube is inserted through your vagina to see a close-up image of the cervix canal and the baby to diagnose the low-lying placenta. 

Transabdominal

This is the standard ultrasound where the doctor may place gel on your stomach and move an instrument over your abdomen so that ultrasound waves can produce a picture on your screen to show you what’s going on. 

MRI

This is a standard MRI like you would take if you needed clear imaging for a certain part of your body if it were broken or something else. This gives doctors clear views of the placenta. 

Placenta Previa Symptoms

Two main symptoms are often associated with Placenta Previa. Sometimes a mother may not experience anything at all or they may see bright red blood in vaginal bleeding. This may worry a mother because it can be a sign of miscarriage or other health complications.  If you experience this symptom, you should call your doctor right away.

The other symptom is contractions. You may have some pain in your abdominal area or even tightening and pressure in your lower back. Because both of these symptoms can be easily interchanged with others, it’s best to go to your doctors and get treated while ruling out other health problems. 

Placenta Previa Risks

Placenta Previa poses the main risk of having to have a c-section and possibly preterm labor. The risks associated with that waterfall down because of the dangerous possibility of childbirth defects and death. 

Hemorrhaging 

When your cervix is blocked by your placenta, this is because it hasn’t attached itself properly to the uterus. When the cervix starts to dilate and get ready to give birth it stretches out the placenta as well. This causes internal bleeding and can result in a hemorrhage. Because vaginal birth is too risky an emergency or planned c-section will need to happen. This can lead to preterm labor. 

Preterm Labor

While preterm labor is common, the earlier a baby is delivered the more risk the baby will take on. Preterm deliveries result in low birth weight and can lead to slower development for your baby. Your doctor will determine how much bleeding you are experiencing and monitor your condition. The heavier the bleeding the more likely you are going to have an early c-section. 

Oxygen or Blood Loss for Baby

Because the placenta provides oxygen and blood flow to the baby it is possible that birth defects can stem from the dysfunction of the placenta. In worst-case scenarios, this can result in the death of a baby. 

Hysterectomy 

If the placenta can’t detach itself from the uterine lining, it’s possible that a hysterectomy can occur. This is where the mother will need to have surgery where her uterus is removed. This can be a partial removal or a full removal including the ovaries. 

Are There Certain People or Factors That Can Contribute to Placenta Previa?

Certain factors are known to have possible links to placenta previa. While some may be avoidable others are not such as age. Let’s talk about the common factors that have possibly led to placenta previa. 

Women Older Than 34

Women who have babies at older ages in general risk more complications to themselves and the baby. Age has been a correlated factor showing that women in general over the age of 34 have a two to three times likelier chance of getting placenta previa. 

Previous Pregnancy with Placenta Previa

If a woman had placenta previa in any of her past pregnancies a doctor may recommend alternatives if the mother is planning to have more children. This depends on the severity of the placenta previa and may recommend a surrogate if it becomes dangerous to the mother to continue to have children. 

Smoking

While the data is limited studies suggest that the chances for the mother who has “ever smoked” even just a little during pregnancy have elevated the risk significantly. The possible link comes from Carbon Monoxide Hypoxia which could result in compensatory placental hypertrophy. In other words, the possibility for an increased surface area of the placenta leading to the greater likelihood of covering the cervix opening. Cocaine use has also been linked with placenta previa. 

Women Pregnant with a Boy

Boys have been linked more commonly to low-lying placentas than girls have been. The placenta has been used as a prediction as to whether a woman is having a boy or a girl because ultrasounds weren’t 100 percent reliable. 

Placenta Previa FAQs

Placenta Previa may sound deeply concerning to expecting mothers. It is not something to take lightly while at the same time unless the condition is severe and risks the mother’s health. Either way, it is good to understand all the information and most frequently asked questions. 

How Common is Placenta Previa?

About 1 in 200 women experience some sort of Placenta Previa. This can be marginal or even low-lying placenta previa which means it is more common in early pregnancy. While some forms of placenta previa have light bleeding and no pain, more serious cases of placenta previa can cause internal bleeding among other side effects. 

Regardless of how serious or non-serious the symptoms are it is always important that an expecting mother keeps in contact with her doctor to have routine checkups and monitoring of the situation in case things were to develop further. 

If I Have Placenta Previa, Do I Need to Get Blood Transfusions? 

If you are experiencing little to no bleeding most likely the doctor will recommend that you go home and stick to bed rest for a few days. However, as the symptoms become more severe the more treatment you will need to receive. Some doctors may order you to stay in a hospital bed for monitoring if the bleeding gets heavier. In worst-case scenarios, if you are losing quite a bit of blood you will need to undergo a blood transfusion. This is not a given if you have been diagnosed with placenta previa. 

Between 36 and 37 weeks your doctor may have you return for some testing to ensure the baby is doing OK. They likely will perform an amniocentesis to take a closer look at the amniotic fluid in your baby. This will let the doctor know how your baby’s lungs are developing and how they are breathing. 

When Will I Know if I Need to Have a C-Section?

Each woman's experience will be different based on a few of the factors discussed. If you have a marginal, partial, or low-lying placenta previa you may be able to go ahead and deliver at your normal due date through the cervix canal. This can change though if your situation changes. Your doctor may recommend at a different stage in your pregnancy that it is best to have a c-section for the health of the baby and for the mother. 

In the event of an emergency c-section, this can happen inexpertly around your due date or in preterm labor as talked about. In this case, you won’t be able to prepare or plan for this as it is done as a medical emergency. 

How Do I Know if it is Placenta Previa or a Miscarriage?

While it may be difficult for women to know the difference because of the stress of bleeding while pregnant, it's goodto note that there are a few small differences in some scenarios. Placenta previa will not have tissue and instead, it will be a bright red blood. Where the symptoms are more similar is the fact that you may experience abdominal cramping with both as well as lower back pain. Likely you are to experience more serious side effects from a miscarriage than you are with the less serious cases of placenta previa. 

Keep Checking In

Placenta Previa is not something to be stressing about as an expecting mother. The odds are low and even if you are that one in a couple hundred, there are many instances where it is only a partial, marginal, or low-lying placenta previa. Through these cases, you still may be able to have the baby normal and will likely experience little to no bleeding. 

Your doctor will be able to monitor the placenta while you continue to come in for checkups to ensure the baby and your health is doing alright. If the doctor wants to take a closer look they may surpass the traditional abdomen ultrasound and opt for a transvaginal ultrasound or even an MRI. 

From this point on your doctor may continue monitoring you at either the hospital or just ask you to commit to bed rest until things further develop if they should. If it is not safe to deliver a baby vaginally then a doctor will schedule a c-section.