Our Growing Family

When do you know you know too much?

Case Study:

Healthly pregnant lady starts bleeding at 24 weeks, goes to hospital, gets ultrasound they find a complete placenta previa, they give her the steriod shots, she goes on bedrest for a week and then is on limited activities like anyone else with a previa.

Fast forward to her being close to 36 weeks and things are okay, but if during another ultrasound they find the placenta previa then its time to deliver via c-section.

Yup all of that everyone should understand....but I understand it more than others.

Like the whole fact that people are saying because she got steriod shots the baby's lungs are developed... Sorry LOAD of crap. Steriod shots given to the mother are at their peak of helpfullness 48 hours after she gets them. Then for three weeks after they are there marginally, and there is some helpfullness but not as much as in the first 48 hours. Also they DO NOT develop a babies lungs. All they do is help the Surfractant (a chemical in your lungs that you need to breath, produce more). And after the three weeks there is no trace of the steriods, and they can not give you more. So that means that she hasn't had the benifet of the steriods for weeks now.

The reason they want to deliver her at 36 weeks is to hopefully reduce the chance of major bleeding. And to hopefully reduce the risk of Accreta, which is when the placenta starts growing into the Uterus. This can happen whether you have any scarring in your uterus or not. Just having a previa puts you at risk because there isn't the blood supply at bottom of the uterus like there is at the top (where the placenta is supposed to be). But if you do have any other scarring well your risk goes way up. Accreta is also a big reason why women lose their Uterus, because they can't get the placenta to detach and the bleeding is too bad.

And unfortunately for the mass majority of people, the belief that a 36 weeker will do just fine is well, misplaced. Since I have spent soooo much time in the NICU I can tell you that not all 36 weekers are ready to go, though I also know that some come just fine. But to give people the illusion that all will be well just because babies lungs are naturally ready to produce Surfractant at 36 weeks and that they will be fine to deliver, is just wrong. People forget that just because they can breath easier and usually with minimal support that there aren't other factors that haven't matured yet. Like the most frustrating one! Breathing, Sucking, and Swallowing. I can't count how many 36 weekers I've seen in the NICU for 2-3 weeks just because they haven't figured out how to suck, swallow, and breath....you have to do this to eat.

I'm not saying she shouldn't be delived early, because it is probably safer for the baby outside instead of in. I just wish Drs. would be more truthful about what the results are likely to be. I understand they want to reassure moms especially in circumstances like this. But it does alot more harm to the moms emotions when the NICU stay becomes a reality and they weren't prepared for it. Delivering early carries risk, maybe not as much as severe bleeding from a previa, but the risks are there and shouldn't be minimized.

So yeah, its hit me, I know way too much and it drives me nutty that others don't know as much. And yet I realize I don't wish my knowledge to anyone else, other pregnant moms don't need to know how their baby looks at each week of development. They don't need to know what development milestones their baby hits each week/day.

Knowledge does have a price, and unfortunately it is steep.