High-Risk Pregnancy: A Mom’s Story
March 16th, 2014
by Michelle Maslov Forman
“It’s positive!” I called my husband at work to tell him the great news.
This was going to be our second child, so I thought I knew what to expect. I quickly learned that every pregnancy is different, and it is important to understand the risks associated with possible complications, even if all went smoothly before. This is my story of how I became acutely familiar with placenta previa and accreta, how I came to value the trusting relationship I had with my doctors, and why I encourage you to do the same.
At my 18 week visit we had our anatomy scan which revealed both good and bad news. The good news was that the baby looked perfect! The bad news was that my placenta was very low and covering my cervix. I asked what that meant and asked repeatedly if the baby and I were going to be ok. My OB first very clearly stated that we were both fine. But he explained that I had complete placenta previa, a condition that could be very dangerous. Any contractions or dilation could cause the placenta to pull away from my uterus leading to severe bleeding. My OB was generally a very relaxed doctor, a great compliment to my personality. When he got serious, I listened.
I was put on pelvic rest — no heavy lifting (including my two year old daughter), no sex and generally taking it very easy. How was this going to work? How is everything going to get done? At that moment I realized: Things just got very hard.
I went home and started Googling. I read that placenta previa corrects itself in 90-95% of women; while the odds were in my favor, I still worried about being in that 5-10% where it doesn’t. I needed to stop reading, but I also wanted to know every risk and every possible way to avoid a scary situation.
I was terrified. It consumed me.
My husband and I worked out various systems at home to make our daily lives continue to function. He was incredibly supportive, and happily stepped in to handle almost everything around the house. Both of us agreed that making things work at home, as stressful as it may be, was better than me pushing it and ending up on bedrest or delivering prematurely. It wasn’t ideal, but it worked. It had to.
I couldn’t enjoy my pregnancy because of the stress. I just wanted it to be over and for both of us to be ok. As each week passed, I felt a bit of relief knowing it was another week that my baby was safe inside.
As I moved into my third trimester my placenta moved a bit. I went from complete previa to marginal; my placenta was only covering my cervix by less than two centimeters. It was still too much for a vaginal delivery and I was still at risk of bleeding, but it was progress.
With any type of previa, it is important that a woman not carry to her due date because of the risk of contractions and dilation. My OB felt I could make it safely to 38 weeks. He weighed the risks of going that far and the benefits for the baby; he decided it was worth the risks. At the same time I was seeing a perinatologist — a doctor who handles high-risk cases. She wanted me to deliver at 37 weeks just to be on the safe side. I liked having two highly qualified sets of eyes on me and my baby, but now their recommendations were different. My two doctors spoke to each other to make sure each wasn’t missing anything. Rather than making a decision on my own, I deferred to my OB as he knew me better. They both explained that if I had any contractions or any spot of blood, I needed to go to the hospital immediately; they also both reiterated the importance of being very careful. I continued to obey.
January 1st — 37 weeks and six days. Twenty weeks prior I was certain I’d deliver early or end up on bed rest. It was the day before my scheduled c-section and nothing out of the ordinary had occurred so far.
We headed to the hospital the next morning to deliver our baby boy. I was prepped for surgery. With oldies tunes entertaining his team, my OB began to operate. “Ok, Michelle… you’re going to feel some pressure…” he told me as he reached for my baby. “Wow, he’s a chubbo!” He was here and he was safe. My husband jumped up to join Jonas as he was cleaned and examined.
As my OB continued to work on me, the situation became complicated. “Michelle, you actually have something called accreta,” my OB said to me. “It’s where your placenta grows deeply into your uterine wall. It’s only about 15% of the placenta and the bleeding is still manageable, but we’re working to get things under control.” Suddenly fear washed over me again. My doctor worked quickly to stitch all of the areas where I was bleeding.
Once in recovery he came to explain everything again. He told me that he was 95% sure that they had stopped the bleeding, but that we needed to keep a close eye for the next few days. If I started to bleed again, he would have to do a hysterectomy. “You were very lucky, Michelle.”
As I sat in that bed I knew just how lucky I was. My husband was next to me calling our families to tell them Jonas was here. My baby was asleep in the bassinet next to him. And there I was — placenta previa and 15% accreta — doing great. I never had a bleed. My baby was never at risk.
Per the American College of Obstetricians and Gynecologists (ACOG), accreta is generally discovered before delivery and a hysterectomy is performed following delivery. My accreta was not discovered until delivery (neither of my doctors saw it on an ultrasound) and, as ACOG says occurs on an individual basis, my OB chose to attempt to stop the bleeding without a hysterectomy. I’m glad he made that decision and I’m glad it worked.
I’ll never know for sure why I did so well, but I like to think it was a combination of my doctors’ experience and me following their strict rules. I had two terrific doctors and they were stern with me about my restrictions early on and I listened. What if I hadn’t? I’ll never have to know.
My pregnancy with Jonas was consumed by fear. I didn’t have a chance to enjoy it because I just wanted it to be over safely. Even without experiencing any of the physical trauma associated with previa and accreta, I wouldn’t wish a fear-filled pregnancy on anyone.
My OB advised me not to carry any more children because of the extensive scarring inside my uterus. Luckily my husband and I planned to have two children and now we have them. Even if another was in the cards, I will follow my doctor’s recommendation just like I did throughout my pregnancy. He clearly knows best.