Placenta Previa: Can I Still Have a Natural Birth?

It’s disappointing to find out you have placenta previa. What does this mean for you and baby? What does it mean for your natural birth plan? Find out here.

It's disappointing to find out you have placenta previa. What does this mean for you and baby? What does it mean for your natural birth plan? Find out here.

You go to your 20-week anatomy scan and find out that your placenta is low lying or covering the cervix, known as placenta previa.

Or perhaps you skipped the 20-week scan and instead found out about your previa because of third trimester bleeding.

Either way, you’re disappointed and possibly scared.

What does this mean for you and your baby? And what does it mean for your natural birth plan?

We’ll answer those questions and more in this post.

Check out my video! Placenta Previa: Can You Still Have a Natural Birth?

What Is Placenta Previa?

Typically the placenta (the organ that nourishes your baby during gestation) attaches to the upper part of the uterus. Placenta previa is a condition where the placenta is very low lying and/or covering all or part of the cervix. It affects 1 in 200 pregnancies by the third trimester. There are a few different kinds of previa:

  • Total or complete previa – The placenta is covering the entire cervix.
  • Marginal previa – The placenta is on the border of the cervix.
  • Low-lying placenta – The placenta is within 2cm of the cervix but not bordering it.

What’s the big deal?

If you have placenta previa and the placenta is blocking your cervix, there’s no way for the baby to get out. Even if it’s only partly blocking or low lying, dilation may cause profuse bleeding which could cause death or require a blood transfusion. Additionally, placenta previa may cause:

  • Slow fetal growth due to insufficient blood supply
  • Fetal anemia
  • Fetal distress due to low oxygen supply
  • Infection and formation of blood clots

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Can I Prevent Placenta Previa?

There’s not much you can do to prevent placenta previa, though there are risk factors that you may or may not have any control over. These include:

  • Carrying multiples
  • Having previously had a c-section
  • Having had surgery on the uterus (fibroid removal, dilation and curettage (D&C), abortion, etc.)
  • Having a short interpregnancy interval (the time between one pregnancy and the next)
  • Being older than 35
  • A previous condition of placenta previa

Diagnosis of Placenta Previa

Like placenta accreta, placenta previa doesn’t have many signs or symptoms. One most common sign is painless bleeding in the third trimester.

Other signs include:

  • Pre-term contractions
  • A transverse or breech baby
  • Fundal measurements larger than expected

Diagnosis is often made from an ultrasound ordered after third trimester bleeding, or during the 20-week anatomy scan. However, as much as 90% of  placentas seen as low-lying in the 20-week scan are no longer an issue in the third trimester. Because diagnosing a previa at that time is inaccurate at best, some mamas prefer to wait until closer to the third trimester for an ultrasound if they’re at all concerned about previa.

Treatment for Placenta Previa

When the placenta is low lying, like with a previa, there is increased risk of bleeding. This happens because the placenta is attached near or on the cervix which, when it dilates, can cause separation of the placenta from the uterus.

Treatment is bedrest and pelvic rest to reduce the risk of placental separation until as close to the due date as is safe. (Here’s our super accurate due-date calculator.) For many experiencing placenta previa, an early c-section may be necessary to avoid going into labor on your own.

What are my Birth Options with Placenta Previa?

With a marginal previa, where the placenta is near but not covering the cervix, you may be able to have a vaginal delivery. Many doctors will feel most comfortable if the placenta is 2cm away from the cervix, but talk with your doctor since each case is different. One study found that at least 60% of low-lying placenta cases ended with successful vaginal delivery. Your doctor will take into account whether there is also a placenta accreta present, which would likely mean a c-section is the safest route.

What’s a Natural Mama to Do?

If you have gotten a placenta previa diagnosis at your 20-week ultrasound, you will likely have nothing to worry about by delivery. Most placentas “move” higher in the uterus as the uterus grows so aren’t a problem by delivery.

If you are in your third trimester and your practitioner is still concerned about the placement of your placenta, you still have some options. As mentioned earlier, if your placenta is far enough away from the cervix, many doctors will be comfortable with a vaginal delivery (though they may ask you to labor in an operating room as a precaution). Ask for a second opinion if your doctor’s approach isn’t feeling right to you.

If you have a complete placenta previa, especially if an accreta is present, you likely need a c-section. This can be very disappointing for a natural mama. Just remember that your desire for a natural birth was so that you and your baby would have the safest birth experience. If a cesarean birth is medically needed to reach that goal, you are still a rockstar natural mama! Prepare for a gentle cesarean so that you and baby will have many of the health benefits of natural birth.

How About You?

What was your experience like with placenta previa? How did it affect your birth outcome?

Genevieve Howland

About the Author

Genevieve Howland is a doula and childbirth educator. She is the bestselling author of The Mama Natural Week-by-Week Guide to Pregnancy and Childbirth and creator of the Mama Natural Birth Course. A mother of three, graduate of the University of Colorado, and YouTuber with over 135,000,000 views, she helps mothers and moms-to-be lead healthier and more natural lives.

15 Comments

  1. I have marginal placenta previa so my placenta is 2cm away from the cervix . I am 31 weeks so my ob is certain that it will move one more cm in 4 weeks and that I will be able to deliver vaginally. However I have been having light to moderate bleeding for about a week where it starts in the morning and ends by the afternoon but everyday. If this continues is it still safe to deliver vaginally?

    • This is a conversation to have with your doctor. They will scan again before moving to a vaginal birth to insure your placenta has moved enough for a safe birth. There’s still lots of time for that to happen!

  2. Hi, I have a low lying posterior placenta which is 2.8 cms away from the cervix and I am also rh- I am 36 weeks pregnant and the doctor advised for a c sec. Is there any chance that it will move up further and I can have a normal delivery?

    • 36 weeks is pretty late in pregnancy for a placenta to shift, since the placenta movement is caused by uterine growth, not the actual movement of the placenta. While not impossible, it is unlikely that the placenta will shift enough at this point. These are also all great questions for your doctor since they will be the ones to diagnose the issue and make delivery recommendations in relation to your specific risk factors. All that being said, you can still have a lovely and family-centered cesarean! It sounds like now is the time to dig into your doctor’s recommendations further so you can begin planning for whatever may come for you!

  3. Hello I went for a 32 week scan yesterday as found at my 20 week scan I have low lying placenta, yesterday the midwife said I’m 1.6mm away from the cervix ,what does this mean am I going to be able to have a natural labour?

    • I have the same issue…did my 32 week scan today and was told its 2.1 cm away…were you able to have your vaginal birth???

  4. Hi. What can I do naturally to make sure that low placenta resolves after 20 weeks? What exercises I can do to help it? Keegles, pelvic tilts ? …. and what exercise are safe ?

    • Marianna, there’s nothing you can do except wait. The uterus is still quite small at 20wks, baby is only around 1lb and by birth will weigh 6-9x that with a LOT more growth and fluid. This filling up of the uterus will push it up even higher and in most cases significantly raise the placenta. Unless baby attaches in the beginning very close to the cervix or on the cervix, it’s just not all that likely that it won’t love up and out of the way. Keep your fluids up, keep baby in and have a follow up ultrasound closer to the end of 2nd trimester or in early 3rd trimester to confirm. I’ve had low lying placenta in 3/4 pregnancies and every single time the placenta was well enough out of the way by 24-30wks.

  5. I ate the placenta after my son was born, I cooked it with some egg and tomato to make a power food for the first few days. I remember feeling really tired a week after my son was born and I didn’t understand why. Then I realized the energizing effect of the placenta must’ve worn off. Also, my breasts were like balloons. I don’t know how much of this was because of the placenta, but I really do feel like it gave me a lot of energy

  6. Hello. It would be really helpful to know what year this was posted in so as to ensure the information you provide is still accurate. Thank you!

    • It’s listed at the top of the article. November 2018. ?

    • This info is still accurate. I’m 33 weeks pregnant with total placenta previa. My c section is scheduled for 36.5 weeks 🙁

  7. “Is natural birth possible with placenta previa?” This paragraph seems misleading as it doesn’t address the fact that with complete or partial placenta previa it is not possible and would be deadly for mom and baby. This is a situation where we are thankful that cesarean sections exist because without it, childbirth would be deadly.
    It’s a scary diagnosis but if your cervix is long, you can experience no bleeding, as I did. Having to have a section early at 37 weeks was the worst aspect of it as I would have preferred to go closer to 40 weeks.

    • In the first sentace she talks about finding out you have placenta previa at the 20wk ultrasound… Most people reading this are here because they got that diagnosis at the 20 anatomy scan and are unsure of what that means. Of course it could be discovered nearer the end of pregnancy, but it’s usually found much earlier and in many, many situations, the placenta previa does resolve to either a low lying placenta (where a vaginal birth still could be possible) or move to within the normal range for a vaginal delivery.

      I’m sure the emotion behind it is heightened for you due to having had it previously and requiring a cesarean. Diagnosised early, it really does have a great likelihood of resolving by birth, hence the title to give all those people googling for more info a little hope due to stats. It is scary to be told that for people who don’t know much about it, despite the fact that it typically resolves. This article lays it out very simply, realistically and educationally.

    • Some women don’t bleed, as far as I understand, it doesn’t happen to everyone, and no one knows why! But in most cases they occur. In addition, after 36 weeks – for those who are lucky – the placenta moved away from the cervix… I do not know how it actually works. Because in the beginning, everyone may have the same experience, but in the end someone gets a cesarean section, someone has a vaginal birth… There is no single way for everyone to solve this problem, I think it actually depends a lot on luck, in general!


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