Complete Placenta Previa

At the end of summer I had a couple call me for prenatal care only. They were planning on moving in 3 months or so. So I agreed to meet them for 3 prenatals. At 18 weeks she had a find-out-the-gender ultrasound and found that she had complete placenta previa.
Not good. If you don't know, previa is when the placenta covers the cervix, sometimes completely, sometimes partially, or sometimes only marginally. We hoped that it would grow up and out of the way (they often do that, especially when partial) and I told her that her new midwife would have her get another ultrasound to check on it as she got closer to her due date.
Well this couple never moved away. As she progressed through pregnancy she made it known that she was afraid of labor pain and really wanted an epidural. Her husband was very against being in the hospital and I told them that I needed them both to be on board, etc. I also kept encouraging her to get some kind of insurance coverage for her and the baby, which she never did. Until today.

At 5:30 this morning my phone rang. It was my client telling me that she woke up with a lot of blood in the bed and in the toilet. I told her to go to the ER asap. She was worried about the cost of going to the hospital. I told her not to worry about it and to GO! She's almost 34 weeks and I figured that good old placenta hadn't moved much.

Fortunately, she made it just fine (the hospital is only 1/2 mile from their apartment) and the bleeding stopped. Baby is fine, but the placenta is completely covering the cervix and that smart baby who has been breech for the last two months continues to be. Amazing. So they're giving her steroids to prepare the baby's lungs for a possible early-early birth.

I seem to have a thing for placenta issues. An abruption last August, a complete previa now, and a LOT of anterior placentas that make it nearly impossible to hear with a fetoscope and usually delivers with a fast, bloody plop very soon after birth because they seem to detach so much quicker. I've got 3 clients with very anterior placentas right now. That abruption in August was a completely anterior placenta. When I saw it on ultrasound I could not believe my eyes. The darn thing went from pubis to rib cage and was fairly wide too.

At any rate, home now. It's my husband's and sister's birthday. Me and the kids are taking him out for pizza dinner.