Placenta previa and exercise in pregnancy

What is Placenta Previa?

Placenta previa is a explained as a full or partial covering of the cervix with the placenta…

The placenta is the organ grown in the first 8/10 weeks of pregnancy. The placenta beds into the uterine wall and is connected to the baby via the umbilical chord. This organ nourishes baby with both nutrients and blood. It’s is the only organ that we as humans grow from scratch in adult life. It is awesome!!! Placentas are BIG! And they are beautiful! (They look a little bit like the top of a tree with all of the blood vessels replicating the branches) 

When the placenta lies low in the uterus it can partially or completely cover the cervix. 

When this occurs there is a higher risk of preterm delivery and of haemorrhage for the mother.

Recognising the symptoms of placenta previa.

Without the development of ultra sound placenta previa would be quite hard to pick up in early pregnancy. There are some signs that may suggest this has happened in pregnancy 

Painless biright read bleed

Mild bleeding that reoccurs

Potential signs of pre term labour - contractions 

Understanding the risk factors of placenta previa. 

Before we continue here I think it is very important to identify that placenta previa is DIFFERENT to a low lying placenta. Placenta previa is is where the placenta is covering the cervix either partially or completely. A low lying placenta is when the placenta with with 2 cm of the cervix. Now this is key as low lying placentas will often move further away from the cervix as the uterus grows to accommodate the baby. This happens often and is a normal part of pregnancy. 

Let’s start with the risk factors that increase the likely hood of placenta previa 

Previous C section placentas tend to attach to areas where there is tissue scarring. 

Multiple pregnancies

Age over 35 - this seems to be a blanket judgment given to women who are over 35 in pregnancy. Rather than looking at the individual and assessing  thier health. 

SOmking 

Uterine surgeries - again due to tissue scarring. Placentas seem to cover up areas of damaged tissue and if these happen to be towards the bottom of the uterus the placenta could be close to the cervix as it grows. 

Now this is where we need to do a little explaining. Because placenta previa is different to a low lying placenta. A low lying placenta in early pregnancy up until 30ish weeks is actually pretty common. I see many women now leaving their 12 and 20 week scans being told they have a low lying placenta. And when exercise is concerned it very much depends on the midwife / sonogroaher that they see as to the advice they are given about thier condition. A low lying placenta does not automatically mean you need to stop exercise. It is not a complete contraindication. In fact moving in pregnancy is advised to support both the health of mother and baby. A scan identifying the placenta falls into the 2cm close the cervix bracket is something to watch but in most cases the placenta will rise up and away from the cervix as baby grows.

This study combines a range of current contraindications to exercise in pregnancy. And covers placenta previa AFTER 28 weeks of gestation.

 https://bjsm.bmj.com/content/54/23/139

The study states that low lying placentas occur in 42.3% of women at 11–14 weeks and 3.9% of women at 20–24 weeks. 0.4% of pregnancies have placenta previa after 28th week of pregnancy. This study advises that women with the condition who feel well and have no bleeding between 11 & 28 weeks gestation should continue with moderate intensity exercise and be reassessed at 28 weeks. 

If you are advised that you have a low lying placenta you need to seek more information. Ask how close exactly is the placenta to the cervix if it is possible to tell. And then discuss your options around movement with your midwife. And if you feel as though you want a second opinion then seek it.

Preventive measures: can placenta previa be avoided?

Placenta previa cannot really be avoided it is a physiological process of attachment to the uterine wall  that the body makes as part of your pregnancy but studies have shown that smoking might contribute to a low lying placenta and having pregnancies close together could also be a contributing factor. 

What we do need to consider is how the advice we are given if diagnosed with condition effects our physical and mental wellbeing. 

Coping Strategies and management

If you do have true placenta previa then you may be told to avoid movement. You will see the study referenced above states that women who are feeling well with no bleeding should continue  low intensity life activities including walking. Reading nhs guidance those diagnosed with placenta previa should.

Adhere to hospital advice

Avoid activities such as intercourse OR vigorous exercise (low or moderate intensity exercise could be beneficial if mother is well and has no signs of bleeding.)

Prepare for a possible c-section delivery.

If you are someone who enjoys movement and you are told to alter your regular activity it can REALLY impact on your mental wellbeing. It maybe that you turn to other activities that support the down regulation of the nervous system such as guided relaxation, meditation, breath work and journaling to help you make sense of your feelings and emotions. 

Research and studies on placenta previa?

https://bjsm.bmj.com/content/54/23/1395

https://en.wikipedia.org/wiki/Placenta_praevia - Higher prevalance in certain regions

Conclusion:Empowering Expectant Mothers 

In conclusion we need to be clear on the condition we are being diagnosed with.
Placenta previa is a complete or partial covering of the cervix with the placenta. - if you feel well and have no bleeding recommendations to continue moderate intensity activity until 28 weeks when you can reassess the proximity of the placenta to the cervix maybe be the best course of action according to research. 

Low lying placenta is NOT a contraindication to exercise especially in the first and second trimester. It is VERY likely that you placenta will move away from your cervix as your baby grows. The advice of moderate intensity exercise in pregnancy is advised. Again you will likely be invited to a scan at 28 weeks to review the position of your placenta in relation to the cervix. 

This topic is becoming more and more important as we see so many more diagnosis of low lying placentas in the first and second trimester. If you are feeling uncertain and need more reassurance then do seek support from your immediate health care team.

I work with women on a one to one basis in person and online and can support you through moderate intensity movement that could help you to stay active in your pregnancy if you have a low lying placenta before 28 weeks. You can get in touch with me here to explain your circumstances and book a one to one session.

How can I help if you have low lying placenta or placenta previa

If you have a partial or complete covering of the cervix we need to work with your mind and your body to ensure you stay well physically and mentally! Here I offer a personalised service of relaxations, meditations and journaling prompts along with gentle breath to help you support yourself at the time. We also need to explore your feelings around your birth as your plans may have significantly changed which too can be hard to manage.

My move to birth pregnancy yoga course is prefect for women who want to move in pregnancy in a gentle and mindful way. Each of the flows is jam packed with useful information about your pregnant body and how the movements you practice can support your birth! 

Button - take me to the pregnancy yoga course. 

The online pregnancy yoga course is also included in any birth education package you may embark on with me to! 

Click HERE to contact directly to talk about how I can support you.