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Placenta Previa

9/15/2025

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What Exactly Is Placenta previa?
Placenta previa is when the placenta implants low in the uterus, covering all or part of the cervix, which is the opening of the uterus. Normally, the placenta attaches to the top or side of the inner uterine wall.

The way the placenta covers the cervix can vary, leading to different classifications:

• Placenta previa: This refers to when the placenta completely or partially covers the cervical opening. The placenta implants over or near the internal os of the cervix.
• Marginal placenta previa: This means the placenta is near the cervix (specifically, within 2 centimeters) but doesn't cover it. 
• Low-lying placenta: Here, the placental edge does not cover the internal opening but is within 2 cm of it, or sometimes defined as 2 to 3.5 cm away from it.

Placenta previa is estimated to affect around 1 in 200 pregnant women at some point during pregnancy. In the majority of cases, approximately 90%, especially with low-lying placentas, the condition resolves on its own by the third trimester. As your uterus grows and changes, the placenta appears to "migrate"—it doesn't actually move, but rather grows towards the richer blood supply at the top of the uterus, while the lower uterine segment grows, increasing the distance from the cervix. This means that only about 1 in 800 pregnant women continue to have  placenta previa at the time of delivery.

What are the symptoms of placenta previa?
Placenta previa may not cause any noticeable symptoms and may be discovered incidentally during a routine second-trimester ultrasound, such as your anatomy scan. However, the primary sign, if it does occur, is sudden, painless vaginal bleeding. This bleeding is typically bright red and usually happens after 20 weeks of pregnancy, often in the second or third trimester. The bleeding can sometimes be accompanied by uterine contractions. 

How is suspected placenta previa confirmed?
 A transvaginal ultrasound is considered the best way to confirm the exact location of the placenta.

Is home birth an option for someone with placenta previa?
For most cases where placenta previa persists until delivery, a cesarean delivery is the safest for both Mom and baby. However, there are specific circumstances where home birth might be an option. If the placenta is classified as a low-lying placenta, homebirth may be an option. Careful monitoring of the position of the placenta is an important tool in deciding what type of birth will be best for Mom and baby. 


Sources:
https://www.mayoclinic.org/diseases-conditions/placenta-previa/symptoms-causes/syc-20352768
https://www.ncbi.nlm.nih.gov/sites/books/NBK539818/
https://www.yalemedicine.org/conditions/placenta-previa
https://www.merckmanuals.com/professional/gynecology-and-obstetrics/antenatal-complications/placenta-previa

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    Author

    Gail Webster, CPM

    Gail is a Certified Professional Midwife serving Manhattan, Junction City, Fort Riley and other areas in Kansas.  


    When Gail is not occupied with birth work, she enjoys reading, quilting, baking, riding her motorcycle and spending time with family.
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