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Chapter 5

The healthier we eat during pregnancy, the healthier our placenta will be. Our bodies literally grow a new organ during this marvelous time in our lives — hence why,

especially during the first trimester of pregnancy, we are so dreadfully exhausted. Our bodies are at work more than ever before and using every part of our energy to do so. As beautifully stated by Robin Lim in her book entitled “Placenta — the forgotten chakra”:

The placenta, the root of your origin, is a miraculous organ that shares and protects your life. It is the conductor that unites you with your mother and serves as the control panel of the womb-ship that sustains you until you are born. It was conceived at the moment of your genesis. Your placenta is genetically identical to you. Though you share some of your parents’ genetic identity, unless you have a monozygotic (identical) twin, no one, except your placenta, has ever been so perfectly, exactly you.

The placenta is an incredible organ which develops in your uterus and works like a two-way filter. It delivers nutrients and oxygen to the fetus via the umbilical cord, removes carbon dioxide and waste from baby’s blood and provides the fetus its early immunity. The placenta starts to develop about one week after inception and acts as a two-way filter, letting anything through to the fetus. This is why eating habits (as well as our stress levels and environmental atmospheres) directly impact the baby in utero. Health plays a huge part in our placenta’s efficiency and the better choices we make, the less likely we are to develop placental problems including placenta previa and placental abruption.

To be clear, it’s not my belief nor my desire to come across that what you eat is the exact or sole cause of these potential developments in pregnancy. Yet, I simply hope to encourage a healthier approach, in hopes of positively impacting our pregnancies.

Prior to defining the aforementioned placental issues, it’s imperative we understand that these cases impact less than 5% of all pregnancies. With one in three women having cesarean sections in the U.S. (discussed in detail in Hello, Hello: The Inspirational Guide to Delivery), the likelihood increases five-fold when a woman has had a previous cesarean section (due to scar tissue in the uterus). It’s important not to stress over these rare instances of placental problems, but to be armed with the information should it arise (and feel empowered in knowing how to overcome them).

Placenta Previa

Placenta previa is established when the placenta (which attaches to the uterine wall during pregnancy in order to maintain a flow of nutrients and oxygen to the baby) does not rise and instead sits low, covering part or all of the cervix (marginal, partial or complete). The cervix is the opening that dilates to ten centimeters during dilation, making way for the baby to push through the vagina. When it’s covered, the baby has nowhere to exit, which can cause bleeding (sometimes severe) in the mother. Although it’s not harmful to the baby in utero, severe cases of bleeding can cause mom to develop anemia, which in turn can impact the health of the baby.

Quickly mentioning the importance of your doctor and/or midwife appointments, this can typically be diagnosed early in the pregnancy with the advent of sonograms. If in fact your doctor or midwife notes that your placenta is sitting low early in pregnancy, more than likely it will rise on its own later as your belly expands and baby grows. It’s estimated that the condition occurs in approximately one in 200 women (a little less than 1% of pregnancies), but occurs in roughly 4-8% of pregnancies with a previous diagnosis from earlier pregnancies.

For moms that find placenta previa to be a diagnosis upon the time of delivery, you will likely be closely monitored in a hospital setting and may have to deliver via cesarean section if necessary. Again, keeping in mind the low likelihood that you will develop this, it’s essential not to stress about it and to focus on keeping yourself healthy. Research has shown a correspondence between certain factors and the development of placenta previa — though the exact cause is unknown. Some contributors include:

 having had placenta previa in past pregnancy

 previous cesarean section

 having multiples (or more than four pregnancies)

 being over 35

 smoking or other drug use

As the number of cesarean sections continue to rise, there has been an increase in placenta previa cases as well — as a mother who had the surgery in the past is much more likely to develop the condition in subsequent pregnancies. Yet, with the factors aforementioned, it’s still much more likely that you’ll be just fine. Focus on the things you can control and find peace in knowing that you are doing your best to be your best (whatever that means for you).

If you happen to be one of the thousands of women around the world who experience this unsettling diagnosis, the great news is that you can still deliver a healthy baby and thrive yourself postpartum. Though you may not be able to have the desired delivery of choice, with the advent of technology to help detect the condition early on, the careful attention by doctors in monitoring baby’s breathing (ensuring they receive enough oxygen) and the ability to care for moms and deliver via cesarean section, the result can still bring your dreams to life: holding your precious and healthy baby in your arms.10 Remember to mind the advice from your physician and pay attention to your body and baby. Take a deep breath and constantly tell yourself that you are adequate and still have all of the tools necessary to be the best mom you can be for your baby.

Placental Abruption

In preparation for baby’s birth, the placenta separates from the uterine wall, initiating contractions and the start of labor. In rare but severe cases, the placenta partly or completely separates from the uterine wall prior to the birth process; a condition called placental abruption. This can cause serious bleeding and indicates that baby is not receiving the proper nutrients or oxygen it needs.

Approximately 1% of pregnancies involve placental abruption and of that number 10% of those pregnancies are life- threatening for the fetus (including developmental problems, growth issues, premature birth and stillborn delivery).11 The importance of attending prenatal appointments and optimal care of oneself in pregnancy is an essential case to make. The more appointments you make, the more likely your doctor or midwife can catch and correct such developments. According to an article by March of Dimes:

The main symptom of placental abruption is vaginal bleeding. You also may have discomfort and tenderness or sudden, ongoing belly or back pain. Sometimes, these symptoms may happen without vaginal bleeding because the blood is trapped behind the placenta.

Aside from prioritizing your prenatal appointments, it’s essential to listen to your body. Following your gut and attuning yourself with baby can be lifesaving. Though rare, one could experience mild, moderate or severe placental abruption. If moderate, the bleeding may stop (allowing you the opportunity to go home) or it may stabilize (with continued monitoring in the hospital). When this occurs, you may have the ability to go full term in your pregnancy. If moderate to severe, it’s more likely that you’ll have to deliver baby immediately to ensure the best outcome. In extremely rare cases, bleeding can become so severe as to lead to a hysterectomy — but with care and attention, that’s unlikely to occur.

During wellness visits with your doctor or midwife, as they check for placenta previa, they will also check your amniotic fluid levels. Too much amniotic fluid can indicate an issue with the placenta, helping to diagnose placental abruption.

Fortunately, our personal choices during pregnancy can positively impact the health of our placenta in hopes of avoiding such developments. The healthier our choices, the healthier our placenta and the more benefits baby can garner in utero.