By Jalynne, September 2016
One Pregnancy Risk Every C-section Mom Should Know About
C-Sections have become common now more than they have ever before. And there is a lot of controversy surrounding the benefits, risks, etc. Why women should or should not be able to choose C-section over natural birth, whether there is a certain number of C-sections a woman can have, whether or not a VBAC is safe or risky and so on. I’m not here to talk about my opinion on any of those matters. I’m here to tell you about one of the risks associated with repeat c-sections, and why every woman should know about it. And hopefully, in doing so, I can help share with you the importance of prenatal care, and offer support to those that have endured pregnancy and delivery with this complication, or who may now be facing this complication.
Our first baby, born in 2003, was an unplanned emergency c-section. It was absolutely necessary for the situation and I am very thankful for it. That being said, had I known the risks of c-sections, I likely would have been more firm in wanting to have my other children via VBAC. Our hospital at the time had a policy: “one a c-section, always a c-section” and that was just the way it was. I didn’t know I could argue against it. So, in 2004, ’06, ’08, ’10 and 2012, I had babies, all via cesarean.
With number 5, we learned of the risk of something called Placenta Accreta (my risk for it was 67%!). Fortunately, we did not encounter it but because of previous sections, and the way my body likes to go into labor early, he was born at 35 weeks. Very healthy, but early still.
We had thought about one more, and knowing the risk at this point, decided it was best to look at adoption or fostering if we were going to grow our family anymore. We had JUST finished training and getting licensed as foster/adoptive parents when we surprisingly found out we were expecting. From the VERY beginning of this pregnancy, everything was different. I had excessive bleeding on 3 separate occasions and thought we were losing a baby all three times. The first was right around when we found out we were pregnant, the second was around 13 weeks, and the third time was at 23 weeks. At approximately 18 weeks, doctors determined I had a condition known as Placenta Accreta.
If you’ve never heard of it, don’t worry. I hadn’t either until I had my 5th baby! But that’s why I’m telling you about it now – it’s so important to know this risk if you have multiple c-sections! It is a risk associated with pregnancy that can be life-threatening if not discovered before delivery and even if found, can still become life-threatening.
According to ACOG, Placenta Accreta is a clinical condition in which a part of the placenta or the entire placenta invades the uterine wall. When the chorionic villi invade only the myometrium, the term placenta increta is appropriate; whereas placenta percreta describes invasion through the myometrium and serosa, and occasionally into adjacent organs, such as the bladder. Clinically, placenta accreta becomes problematic during delivery when the placenta does not completely separate from the uterus and is followed by massive obstetric hemorrhage, leading to disseminated intravascular coagulopathy; the need for hysterectomy; surgical injury to the ureters, bladder, bowel, or neurovascular structures; adult respiratory distress syndrome; acute transfusion reaction; electrolyte imbalance; and renal failure. The average blood loss at delivery in women with placenta accreta is 3,000-5,000mL. As many as 90% of patients with placenta accreta require a blood transfusion and 40% require more than 10 units of packed red blood cells.
Women at greatest risk of placenta accreta, increta, or percreta are those with previous scarring or myometrail damage due to previous c-sections. The risk of placenta accreta is 3%, 11%, 40%, 61%, and 67% for the first, second, third, fourth, and fifth or great repeat cesarean deliveries, respectively. I was diagnosed with placenta accreta and complete placenta previa at the same time, commonly associated together. I was immediately put on pelvic rest (for those who don’t know, this means no Sex. Period.) and I was put on bed rest.
When I had bleeding at 23 weeks, I was put on hospital bed rest for 1 week. It felt like the LONGEST week of my life. I was not able to get up unless I need to use the restroom or shower. Nothing more. We were terrified we were going to be delivering a baby at 23 weeks. It was scary and stressful. Any sign of bleeding with this condition is a HUGE red flag and could be a sign of the placenta tearing away from the uterine wall, which is extremely dangerous for both mom and baby.
I went home after one week in the hospital and was able to stay home a short time before having more complications on Valentine’s Day 2015. Back to the hospital we went and I was immediately put on hospital bed rest again. Indefinitely. This time I was in the hospital 20 days. It was awful. I had to worry about 5 other kids at home and whether they were getting enough love and attention from whoever was watching them while my husband was at work. And I constantly worried that we would be delivering a baby incredibly early. On top of that, I was terrified that I wouldn’t survive the surgery.
Reposted with permission from Raising6.com