Friday, September 12, 2014

Placenta Previa

Most people believe that a diagnosis of placenta previa means an automatic c-section.   Placenta previa involves partial or complete coverage of the cervix by at least a portion of the placenta.  The danger of placenta previa lies mostly in the possibility of hemorrhage.  It is believed by most health care providers that babies cannot be born through a completely or partially covered cervix.

However, in my research on placenta previa, I ran across this reference to a technique invented by a medical doctor for vaginal birth before c-sections were routinely performed.   This quote was found on a midwife's site:

"I came across the following in "The Accoucheur's Emergency Manual" by Yingling, first published in 1921 in India, at a time and place where cesareans were not readily available.  I think most of us agree that a cesarean section is the preferred approach with placenta previa, but I also think it's important to have this tucked away in the back of your mind, just in case:

In placenta praevia I fully recommend the method or plan of Dr. H. N. Guernsey, which is 'in puncturing the membranes through the placenta and evacuating the liquor amnii.'  'The finger must explore a sulcus between the cotyledons of the placenta, and with the same hand a female catheter, previously concealed in the palm, must be forced through the placenta and the membranes during a pain.' 'The liquor amnii must be drawn off slowly: and as surely as it thus flows, so surely will the haemorrhage cease.  After the waters have pretty much escaped, the finger may take the place of the catheter, and aid in tearing the orifice larger, so that the presenting parts may descend.'  This method applies whether the placenta is central or only partially over the os uteri.

Actually, a midwife friend told me of assisting at a birth in a very rural area where there was an undiagnosed placenta previa.  The mom was a multip and the birth was proceeding very quickly.  They tore an opening in the placenta, and it must have moved around the baby as the cervix dilated, and baby was born just fine.  I'd hate to think of the stress level for everyone involved, but this kind of approach doesn't automatically mean that the baby would die."  

My first comment is that the doctor secretly concealed the catheter in his hand and had to explore the placenta and introduce the catheter during a contraction, presumably without the knowledge of the laboring woman.  This would, I think, be very painful, and this furtive approach might take longer than just telling the woman what was happening.

However, in an unassisted birth, the woman will be either alone or with a family member who may or may not be able to help with this.  Using a catheter is asking a lot, and time will be of the essence.  The mother MUST use her intuition to determine when it is the right time to tear the hole, or use muscle testing to determine this.  The birth must be fairly close to taking place.  The mother also must feel fairly certain intuitively that she would not be better off in the hospital.

I am not telling anyone with placenta previa what to do.   Whether you choose to go to the hospital, or choose to stay home, this must be your decision, and you must be sure intuitively of what you are supposed to do.  My experience with the intuition of birthing mothers is that you will get a very strong feeling of what you are supposed to do.  Either you feel that the situation is life and death and that you cannot handle it, or you feel strongly that the situation will resolve itself.  Follow that intuition.  When you feel that the baby is presenting itself and that no further progress can be made unless the placenta is removed from the opening, tear a hole, allow the fluid to empty out, and help guide the membranes around the baby's head, bearing down gently as the contractions direct you.

Ask guidance from the baby, who will know what to do and can direct you.
I would definitely have on hand cayenne tincture and shepherd's purse, just in case you need help with hemorrhaging.  See Hemorrhaging Before, During and After Birth
You may be thinking...."Why would someone in their right mind stay home if they know or suspect they have this condition?"  Probably because they are aware of the many dangers that await them in the hospital, and how atrocious the American infant mortality statistics are for hospital birth.  Possibly because they have had a previous birth experience that was very traumatic, and they refuse to subject themselves to the dangers of doctors and hospitals.  And most importantly, they feel sure intuitively that the situation will be resolved safely.

Each person has a right to make this decision for themselves.  If you feel it is right for you to stay home, don't let anyone try to force you to do otherwise.  You have a legal right to refuse testing or treatment.

My purpose in presenting this is simply to allow your rational mind to see that other people have done this safely.  And when you are doubting your intuition, you can remind yourself of this and use it as validation that staying home is right for you.  If however, you still feel that it's not right at the time, follow your intuition and go to the hospital.

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