We had always planned on two, maybe three kids so when we decided to have our fourth baby this year I knew it would raise some eyebrows. I wasn’t seeking approval from anyone, but you could clearly see the look of confusion and doubt when we told people. I was beginning to think that maybe all those people that either told us we were crazy or just gave us a look of disbelief were right when we reached the half way point of the pregnancy. Other than some really bad morning sickness this has been a pretty easy pregnancy, and was looking forward to my 20-week ultrasound. The ultrasound tech seemed concerned that I wasn’t meeting with my midwife until a week later and when I came home that afternoon my midwife office called to tell me that I had complete placenta previa.

I wasn’t a stranger to placenta previa, I had a low lying placenta with my third baby that had moved up by 30 weeks. All the sudden I was told that I needed “pelvic rest”, which means not to exercise (no big stretch there), rest as much as possible, no sex and heavy lifting. If I were to experience any spotting or bleeding I should call the office immediately and be prepared to head to the hospital get checked out.

There are three types of placenta previa.

• Complete placenta previa (CPP) occurs when the placenta completely covers the opening from the womb to the cervix.
• Partial placenta previa occurs when the placenta partially covers the cervical opening
• Marginal placenta previa occurs when the placenta is located adjacent to, but not covering, the cervical opening.

Over time and growth of the uterus, the placenta can “move” out of the way and a vaginal delivery would be possible. If the CPP persists it will mean a cesarean birth. My main concern was that I tend to start dilating early, around 34ish weeks, and then have a “quick” labor because most of the work of dilation is done before I feel like I am in active labor. With my last birth I was 8 cm and had no idea until the midwife told me at my 38-week appointment. If I do start to dilate early it increases the chances of bleeding and having a preterm baby.

 While this is not at all how I imagined this pregnancy, there are some bright spots.

1. After reading some support group boards on Facebook, I have learned that my midwives are a lot more relaxed and positive than the majority of the forum contributors. My next ultrasound isn’t until I am 30 weeks which will have given the placenta 10 whole weeks to get its act together. I can’t image having to go in every two weeks to gauge the movement, too much stress for my liking.

2. People really want to help. My daughter’s preschool requires me to go in and sign her in and take two flights of stairs. Not so easy with a 15 month old. The parents have been so kind and willing to help me get her into school and bring her out so I am not getting my youngest in and out of the car multiple times and walking with him. I am really lucky to have so much help. My doula partners at Balanced Beginning Doulas have also been extremely helpful around my house, assisting on photo shoots, and spreading the word about my photography and placenta encapsulation services while doula work probably isn’t the best way to get rest.

3. I have had 3 natural, drug-free births that I am proud of. As a doula and birth photographer I have witnessed and supported cesarean births and have the knowledge of what to expect, but also what to ask for. I am not afraid to present a birth plan that includes having a photographer in the OR, skin-to-skin contact while in the OR and not have the gender or weight/height announced until I am physically and mentally ready to take that information in. I know this might mean changing care providers at the 11th hour, but I don’t care. I also know that I have to be willing to be flexible if my birth becomes an emergency. I have made plans with fellow birth photographers on what Plan B will look like in the event of an emergency.

4. If I do have a cesarean birth it will give me a completely different perspective to offer future clients. Being present and supporting mothers who give birth surgically has given me some perspective;  I can only imagine that it will be amplified going through it myself.

So now I wait about four more weeks to find out if my placenta has taken up residency higher up in my uterus and try and rest. I know there isn’t any treatment that can speed the process along so I will practice patience and positive imagery.

If you would like more information on placenta previa I would recommend:

• http://placentaprevia.wordpress.com
• http://americanpregnancy.org/pregnancy-complications/placenta-previa/
• http://sogc.org/wp-content/uploads/2013/01/189E-CPG-March2007.pdf

Just like any issue that may arise during your pregnancy – surround yourself with people that are positive, you know you are going to do online research but try not to get caught up in the doom and gloom that is so readily available online, don’t be afraid to ask for and receive help.