WHAT?? Birth at Home With Placenta Previa?

**note** My apologies for the lack of a baby in the picture. None of the ones I drew actually looked like a fetus, so I gave up.

Placenta previa is a very dangerous condition for both the mother and the baby. It occurs when the placenta covers the cervix — causing either complete previa or partial previa (fairly self explanatory) — or when the placenta is very close to the cervix, causing marginal previa. A recent study published in AJOG found that, in cases of marginal previa, at least two-thirds of women with a placenta farther than 10 millimeters were able deliver vaginally without increased risk of hemorrhage. The study is very small, though, and I would have liked to see a third group with normal placentas as a control. In any case, when it comes to complete or partial previa, good outcomes for both infant and mother depend on prenatal diagnosis and cesarean delivery before the membranes rupture. If not, they are at risk for some very nasty complications, including preterm delivery, blood clots, infection, placental abruption, hemorrhage of both the fetus and the mother, shock, and death. Placenta previa is not a joke.

This is why it is unconscionable for Unhindered Living to continue publishing the page Handling Placenta Previa At Home.

A few choice bits:

It seems like she realizes it’s terrible advice, because she’s qualifying every other statement, yet she still gives it! Placenta previa is NOT a “variation of normal,” so if you are diagnosed and it continues late in your pregnancy, please do not consider that page as a justification for a home birth. **Note** An early diagnosis of placenta previa (with the anatomy scan, 20ish weeks) may resolve itself as the uterus grows, and if that is the case, you would not need a c-section for previa. However, this is something that should be taken care of between you and your doctor or midwife, not by taking advice from websites.

12 thoughts on “WHAT?? Birth at Home With Placenta Previa?

  1. That entire site offers up some of the very craziest info out there. And it’s often used as a REFRENCE on UC boards especially. I wonder how many deaths were related to this site?

  2. Someone on SOB said that this website makes them question the Bill of Rights, and I couldn’t agree more. What these folks don’t mention (I’m assuming because they don’t know) is that PP is often accompanied by other problems like placenta accreta (overly deep implantation that can cause fatal hemmorrage), plain old postpartum hemmorrage because the uterus is damaged in a funky place, or positional problems with the baby (jackpot).

    Yes, I’ve noticed that this site is held up as some great reference for UC. Nothing like delivering your child like you’re in a barn in the 1700’s. Unfathomable.

  3. I’m happy to report that I’ve seen this linked in (what could be referred to as) the “wooiest” of groups on CafeMom, and that the moderator (a CPM) was clear in stopping the “variation of normal” bs about previa.

    I’m stunned that someone would seriously consider this a better option than a cesarean in this case. Just because an obstetrician in India was able to MacGyver a baby through a torn placenta in 1921, doesn’t mean the universe is calling you to do the same. At least, not without some Shepherd’s Purse on hand. *gag*

  4. A friend of mine, intending on hospital birth, had an undiagnosed placenta praevia that caused a haemorrhage so early in labour that they hadn’t even considered going to the hospital yet. Luckily they were able to get to the hospital in time for an emergency c-section and both mother and baby subsequently did well. I can’t believe that anyone would do this deliberately.

  5. Oh yes. This one.

    I love the chain of information – The Unhindered Living lady found this info on a midwife’s site, where that midwife claimed to have read about this technique in a manual, in which the author described something done by another doctor. That’s, what, four degrees of separation? Almost as good as hearing that it happened to your roommate’s cousin’s friend from summer camp!

    I cannot say enough about the phrase “doesn’t automatically mean that the baby would die.”

    I run a blog about placenta previa (www.thepreviousplacenta.com), and have been emailed some awful stories. This condition can kill you. If you have it, a doctor needs to be involved.

  6. I planned a homebirth with my midwife/CNM (*waves to Deb!*) and we discovered my complete placenta previa early on.

    I figured it would move. Most do, no worries. But, of course, mine decided to have an attitude, stay put, taunt me, etc. Yes, as a matter of fact, I do like to anthropomorphize placentas. It’s a coping mechanism. 😉

    I am a firm believer that in all things, we have a choice. Rarely in life do we truly not have a choice and this was no different. So, I could give up my images of what my planned homebirth would be (I envisioned something between the extremes of screaming out for transfer for any narcotic anyone was willing to give me vs. butterflies coming out of my vagina just before birth to sing my baby the rest of the way out) and schedule a cesarean. Or, I could proceed with a homebirth and choose to have my baby die (I gave that 99%+ chance) and have myself suffer severe morbidity (I also gave that a 99%+ chance) or mortality (I thought a 50% chance of that sounded reasonable).

    One helluva choice! At least it was an easy one. I chose the homebirth because I really wanted to see those butterflies work their magic. Kidding! No, we continued to work with our midwife and consulted with a fantastic Ob who worked with us to have a beautiful cesarean birth. Alas, due to the anterior placenta, my daughter had to come out first and the butterflies didn’t come flying out until after she was born. *sigh* Damn the medical model.

    It was not the birth of my dreams I planned in my mind. But it did end up being the birth of my dreams in my reality. It was absolutely wonderful in so many ways. Still room for improvement in the hospital system (and many other systems), but it was more than we ever hoped for. But that’s another story for another day.

    I do believe I had a choice, but again, it was a no-brainer choice. Although I didn’t have anyone directly chastise me in the NCB community, a few folks did hint that they may be “options.” Some suggested methods of getting the placenta to move (I was willing to try the most absurd thing if it was otherwise safe–why not?!?) but there were hints at more than just getting it to move. I didn’t investigate those conversations/hints at all because I knew they would only make my blood boil.

    I did do plenty of research on my own. I’m an RN myself. Planning to become a CNM. But right now, working in an ER to learn as much as I can about broad topics and especially how to handle myself in the rare emergency. I’m also a doula, childbirth educator, and hippie-out-of-her-decade. A little woowoo and a little practical. So I hunted down current medical texts that really only said “cesarean” and obscure older texts that talked physicians through tamponading the placenta with foley catheters, cutting through the placenta once the cervix dilated, a semi-stripping the membranes type procedure to lift the placenta up during dilation, and other maneuvers. All other maneuvers reported a near 100% fatality rate for babies with complete previas. There was the very rare and unexpected exception. These were potentially life-saving interventions for mom only. Partial previas reported around a 50% chance of survival for the baby. Probably due to varying degrees of “partial” not so clearly measured/diagnosed at the time. Mom had better chances with partials as well. But no one had really good outcomes for previa. And I’m sure plenty of the babies and mothers who died due to hemorrhage “way back when” were due to previa. Sometimes the human body slips up and makes a mistake, isn’t normal, goes haywire. Thank heavens I had better choices than available in India in 1921 because my daughter and I came through very healthy in every way.

    My amniotic sac was pure vessels, too, which would have been a complication by itself without the previa. I sometimes wonder if my daughter/embryo/blastocyst didn’t develop quite right and implanted “funkily” as a last ditch effort to save the pregnancy. Maybe this “mistake” was actually an attempt to save her. Or, maybe it’s all just coincidence. Either way, the point is the body sometimes does stuff that seems weird to us and it often needs some help to get this back on track.

    Anyway… All that being said, I struggled with “having” to have a cesarean. Hated the idea. I mourned my vaginal birth that was not to be, because that was important to me. (While I simultaneously celebrated a safe way to birth her.) I’m okay with it now, though. If we have another child, I plan to try for VBAC, absolutely. But if need be for my or my child’s safety, sure, I’ll absolutely have a cesarean again and won’t be consulting any physicians from 1921 India. I’ll still with my local Ob and OR, thanks.

  7. These people are just nuts, and make the people who make an informed decision to have a homebirth with a low risk pregnancy seem crazy too. I am planning an out of hospital birth, but have been diagnosed with partial previa at 16 weeks, and I can sure as heck tell you that if it hasn’t moved up sufficiently to be considered safe, I will be heading straight to the hospital for a c-section. Don’t these people take it seriously that they and their child could very likely die???

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