My Journey to VBAC Now Includes an Anterior Placenta
I don’t know if every woman planning to VBAC considers the location of her placenta at all when preparing to birth. I don’t know if it is something commonly thought about or it is brought up by the midwife or doctor at some point. I tend to think that if the mom has an ultrasound and the placenta is posterior (on the back wall of the uterus) that nothing is ever brought up at all and most moms probably never really think much of it. On the flip side, if an u/s is done and the placenta is found to be anterior (on the front wall) then it is mentioned and the mom begins to learn about the risks associated with an anterior placenta when planning to VBAC and she begins crossing her fingers that as her uterus grows that her placenta moves up high above her c section scar. For a mom with a prior bikini cut, ‘high above the scar’ doesn’t require a whole lot of movement as the scar is in the lower segment of the uterus.
I went into my pregnancy thinking about an anterior placenta. I didn’t dwell on it, it just crossed my mind a couple of times because of my inverted t incision. I don’t think I manifested an anterior placenta or anything but because it can create real problems and because I know (too much sometimes) this, I just thought a few times that “I really hope my placenta is not anterior because I don’t want the added worry. ” I began to suspect that it was a week ago though. I found the baby’s heartbeat with my doppler at home at 9weeks and 5 days. It was really hard to find but definitely there. Almost two weeks later I couldn’t find it. I could see it pick up briefly so I knew it was there (plus I totally still feel pregnant!). I never thought I had miscarried or anything like that, I just thought ‘hmm wonder if the placenta is in the way.’ By 11 weeks the placenta is a good size and I figured it was big enough to block the heart tones.
I had my 12 week appointment today and my doc offered to do an u/s. He is a solo practitioner and has a machine in house and I think he likes doing them himself. He would probably offer every month, of course, I have no intention of having a monthly u/s but today when he offered I told him no that I didn’t need one. I found the heartbeat with a doppler and if he wanted to check he could that way. Then I told him I found it a few weeks ago but I couldn’t find it last week and that I thought the placenta was anterior. So he said ‘let’s take a look.’ I knew immediately when I saw the screen and he confirmed. He didn’t seemed worried at all which is great. Most mainstream and American docs would have gotten nervous. He just said, it’s early and it will move and hopefully it moves way up high and out of the way. He also reminded me that scar tissue was very strong. Then he said that if it stayed in the front on top of my scar as it is now, because it is big and my uterus is still small, then it probably wouldn’t cause problems in labor but could cause detachment problems after. He said, ‘you’d still have your vaginal birth and I would take care of everything after, don’t worry.’ I really appreciate his mentality. I can’t imagine too many docs that have that kind of attitude. There are some serious complications that can occur from placentas attaching to c section scars.
AIP= accreta, increta and percreta, where the placenta attaches to the scar or grows into the scar or grows through the scar to the outside of the uterus. It can cause massive hemorrhage and often require hysterectomy. I’m not going to go into too much detail on all this because I am not really too hung up on it. I just didn’t want the anterior placenta so that none of this would have to cross my mind. Because it has crossed my mind I will now think about it until I see that the placenta has moved up and safely away from the scar. If I find that it hasn’t moved, a 3D u/s or an MRI can detect AIP. If there is any AIP then I will obviously have a very different remainder of pregnancy and birth and I can live with it because our safety would be compromised.
Chances are it will probably move up. There is a lot of growing left to do and I know this. There is not any information to be found on VBAC with an inverted t incision and an anterior placenta so I thought I post about it and see what kind of feedback and response I got. If anyone has VBACd with an anterior placenta, please share, regardless of incision type.