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    Questions? Ask Henci!


    Find out what other moms-to-be are asking. Join in the discussion with Henci Goer, whose expertise is determining what the research tells us best promotes safe, healthy birth. If you would like to contact Henci outside of the Ask Henci forum, send an email to Goersitemail@aol.com.

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    Archived User
    Dear Henci,
     
    My name is Jennifer Budney and I am a childbirth educator in IL. I regularly recommend your book to my students and have two copies I loan out on a regular basis. I also use your website when students want further information on a particular topic (eg. gestational diabetes).
     
    Recently I was contacted by a student who is set to begin classes shortly. She is about 21 weeks and at her ultrasound, she discovered she has placenta previa-complete. In my pregnancy, I had a low-lying placenta but it moved as the pregnancy progressed. Because of this upset, I invited her to attend my classes for free for now in the event the placenta does move. I'd like her to be prepared for an unmedicated birth in the event things move in her favor.
     
    Anyway, I was wondering if you can direct me to some good information on the topic of previa. I do know it is rare, but as I said, I like to give out the information to the students so they can make informed choices for themselves. I am also a bit leary of the practice she has chosen. They give the impression they really advocate for women because most of the docs are women (no midwives at the practice). The hospital they work at has a c-section rate of 40% and of that 75% of them are first-time moms. My concern (on the side) is that even if the placenta does look like it's moving that this practice might want to go the conservative route and recommend the c-section anyway. Do you think she should consider the second opinion? I know of a couple of great docs in the area that have c-section rates under 10% which, in IL is hard to find since we don't even have real birth centers.
     
    Thanks in advance for your help.
    Henci Goer

    I think that suggesting she get a second a opinion from a doc who tries to avoid c/secs is a great idea. You took the words right out of my mouth. Here is the argument I have used repeatedly in my responses on this Forum: if the ob has c/sec surgery rates much higher than 15%, the maximum rate recommended by the World Health Organization and backed up by any number of studies, then you know you cannot trust the ob's judgment.

    As for the chances of the placenta moving away from the cervix, I got this passage from here:

    Placentia previa may be observed in as many as 1 in every 3 pregnancies before the 20th week of pregnancy. As the uterus grows, the placenta usually moves higher in the uterus, away from the cervix. But if it remains near the cervix as your due date nears -- which happens in about 1 in 200 pregnancies -- you're at risk for bleeding, especially during labor as the cervix thins (effaces) and opens (dilates). This can cause major blood loss in the mother. For this reason, women with a placenta previa are usually delivered by cesarean delivery.

    -- Henci


    All Times America/New_York

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    Please note that this Forum is intended to help women make informed decisions about their care. The content is not a substitute for medical advice.



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