My Placenta Accreta Experience - Erin's Inside Job

My Placenta Accreta Experience

Spoiler alert for those who don’t already know: I didn’t end up having an accreta, despite months of tests indicating that I did. Even though that was the outcome, I think it’s still important to write about my placenta accreta experience because the entire second half of my pregnancy (including the birth) were impacted in one way or another because of it. This is my story, which I hope can at least help educate others about this one (of many) possible pregnancy complications.

I didn’t learn about the term “placenta accreta” until I was 28 weeks pregnant with my daughter. At my 20 week ultrasound, they first discovered that I had a complete placenta previa, where my placenta completely covered my cervix. With Miles, I had a partial previa that eventually moved away from my cervix as my uterus grew and therefore didn’t pose any further problems. This time, because my placenta was completely covering my cervix, they wanted to follow up at 28 weeks to see if there was any movement.

During birth, the placenta is meant to be delivered after the baby. When it completely covers the cervix, it can result in life-threatening bleeding either before or during labor and requires a c-section. I had hoped this second time to try for a vaginal birth after cesarean (VBAC), but if my placenta didn’t move, then I’d have to have another c-section.

When I went in for my 28 week ultrasound, the technician also did a transvaginal ultrasound — something that they typically only do at your first appointment to confirm pregnancy. I thought this was odd, but figured that maybe they did things differently at this office vs. the practice I went to in Chicago. I was then taken to a waiting room before moving to a room to receive my results via video chat with a doctor (pandemic and all).

I was first given the news that my placenta hadn’t moved at all, which was disappointing. I had really hoped to try for a VBAC, which after not having any real birth plan at all with my first, felt like a real let down. But, I’d had a c-section before and there was still the chance that it could move as my pregnancy progressed, so I was open to the possibility of either birthing option.

What I didn’t expect was the follow up that I also had what looked like a placenta accreta — a condition where the placenta attaches too tightly to the uterine wall. When this happens, the placenta is not able to be delivered and this can also result in life-threatening bleeding. It also almost always results in a hysterectomy.

I wasn’t sure how to react. I’m not an overtly emotional person around people I don’t know, so I simply sat by myself (again, pandemic) in a cold office room while someone told me over video chat that there was a chance I could bleed out and lose my uterus. She kept asking me if I was ok or if there was someone I needed to call. I honestly wasn’t really sure what I needed, but I told her I was fine. We made a plan to continue checking with repeat ultrasounds every two weeks, that I should go very light on physical activity to prevent any bleeding that could turn into hemorrhaging, and I got up, made another appointment, and left.

It wasn’t until I got back to my car that I could let myself feel what had just happened. I called Neil immediately and broke down, relaying back to him everything that I had been told. I shared my story on Instagram after it happened and broke down on there too — something I very rarely do. I needed to process the loss of what I thought my birth was going to be vs. what it may actually be. With Miles, I didn’t even see him until 24 hours after birth because he was rushed to the NICU for respiratory distress and because I couldn’t even keep my eyes open after such long labor. I had wanted to at least have my baby given to me and put on my chest like I’d seen in so many photos, but it looked like I wouldn’t get that with this birth either. It was a tough couple days and weeks.

With every follow up ultrasound (and there were a lot), the images looked basically the same. There was no movement of the placenta over my cervix and it still seemed attached at a specific point. I had to switch from the midwives that I had been seeing to the OB practice because this was now considered a high-risk pregnancy. (If you’re not sure what the difference is, like me, I wrote a post about it here). Thankfully, my doctor was amazing and compassionate, which really helped the situation for me. They also had a great accreta team at UNC, which left me feeling better.

As we got further into my third trimester, we discussed what was going to happen. I had a lot of appointments to check on the baby, to talk about the birth plan, and even a specific one with anesthesiology to talk about their procedure. There are three types of accreta:

  • Accreta: the placenta is attached, but does not penetrate the uterus. This is the most common.
  • Increta: the placenta is attached AND penetrates the wall and muscles of the uterus.
  • Percreta: this is the most severe. The placenta passes through the uterus and begins to attach to other structures such as the bladder or intestines.

Thankfully, mine appeared to be the first kind. The problem with an accreta diagnosis is that it’s still not a definitive diagnosis (unless one of the more severe types can be determined). Ultrasounds and MRI’s can only show so much, so until the actual surgery, no one knows the extent of what happening. Obviously, this made for a stressful and emotionally exhausting second half of pregnancy for me.

With either condition — placenta previa or accreta — babies are typically delivered early to prevent the mom from going into labor naturally. This way all the variables are controlled and the risk of hemorrhaging is very low. If I had only had the previa, my hospital typically delivers around 37 weeks. Because I also had the accreta, they wanted to deliver between 34-35 weeks. The baby was also showing signs of having an intrauterine growth restriction (IUGR), which meant that she was measuring smaller than her actual gestational age. They did further tests on this and found no real reason — the flow in the umbilical cord was fine — but it was another reason to get her out and see what was going on.

Because she was going to be born 5 weeks early, I needed to go in for steroid shots the two days before surgery was scheduled to help speed up her lung development. You can read her actual birth story here, which gets into more specifics of procedures on that day — including the 16 people and 6 pints of blood in the operating room in case I needed serious intervention.

I required a vertical incision because of the delicate nature of delivering with these two conditions. The vertical incision served two purposes: 1. it allowed her to be born safely first and 2. it gave the doctors a better view of what was going on with my placenta. I remember they showed me her after she was born (so small!) and then I remember hearing the doctor say that he didn’t have to remove my uterus and they were going to close me up. Honestly, after the past few months of appointments and unknowns, it felt a little anticlimactic as I watched the support staff leave the operating room. I think I may have even apologized at one point (ha).

After her birth and 14 day stay in the NICU, I had a follow up appointment with my doctor. I made sure to make a list of questions that I had and one of them was for her to explain to me what they found when they operated. She said that my placenta actually came right out and wasn’t attached at all, which caught me a little off guard. I had spent months coming to terms with the fact that I may lose my uterus and living under a cloud of “what-ifs” that turned out to not even be relevant. This was obviously a positive placenta accreta experience, but honestly, it was a little jarring to get that news. In the end, I came to terms with it pretty quickly because everyone did the best possible job they could do with the information that they had. I’m thankful that everyone was over vs. underprepared, but a part of me also wished that I didn’t have to mentally, emotionally, and physically have to go through all of that.

I’ve had months to process my placenta accreta experience, and although writing this post made me a little emotional again, I’m happy with the way everything turned out. The health of my children is obviously important to me, so I’m glad that both turned out ok. Would it have been nice to have an uneventful pregnancy and birth (either time)? Of course – but through this I was also able to learn and bring awareness to conditions that many people may not be aware of. I was able to go through something challenging and come out of it with new perspectives and new ways of connecting with others. I found strength in myself again that helps remind me that I can get through whatever life throws at me.

Best of all, I have them.

This was my placenta accreta experience. If any of you have gone through it and want to share, please do so in the comments below. 🙂

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