Updated: May 20, 2019
We see this question all the time, "I have an anterior placenta, can I still have a VBAC?". The answer is, yes! Here are the details, and what you want to watch for.
What is Anterior Placenta?
When the egg implants into the uterus, typically it implants on the back (posterior) side. Wherever the egg implants is where the placenta will grow. An anterior placenta happens when it implants on the front side, the side against the belly of the mother, and is a perfectly normal place for the placenta to grow. Having an anterior placenta does not automatically exclude you from VBAC; however, at your 20-week scan, there are a couple things your provider will look at to make sure it doesn't interfere with your delivery.
Anterior Placenta Risks
The main concern with an anterior placenta is making sure it has implanted far away from the previous Cesarean scar—that it is not likely to grow into or over the scar as it grows. At your 20-week growth scan, a sonographer will measure how high above your scar the placenta lies. As long as the bottom of the placenta is more than 1-2cm above the scar, you are typically good to go. If it is less than that, your provider will likely want to do another scan around 30-32 weeks gestation to make sure everything is growing in an uncomplicated way.
If the placenta grows into the scar (Placenta Accreta), or partially or fully covers the cervix (Placenta Previa) an early, repeat Cesarean delivery, is typically necessary. Good news though—as your baby and belly grow, your placenta grows upwards, so even with a lower-lying placenta, it is likely there will be no issues as it gets closer to delivery day.
If you have a Special Scar AND an anterior placenta, you are at a higher risk for placenta complications and careful consult with a specialized provider would be necessary, but should not automatically rule out VBAC.
Additional Facts About Anterior Placentas
Typically, it will take longer for you to feel baby movements, especially on the outside as the placenta essentially shields his/her kicks.
It will be harder to find the baby’s heartbeat, mainly in the first trimester.
It can interfere with medical procedures such as amniocentesis.
An anterior placenta can cause you to feel labor more in your back if it hasn’t move up high enough late in your pregnancy, especially with a posterior baby.
Listen to episode 26 on our podcast for a story about Aly who had a VBAC with her placenta just 2mm away from her scar!
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