The placenta plays a significant role in keeping Baby alive during pregnancy; supplying blood, nutrients, and oxygen, and continuing to benefit babies after birth. But if the placenta had its own movie, it would be about a falsely accused woman who gets sent to prison for a crime she didn’t commit.
Pinning it on the placenta
When it comes to justifying bringing on birth before natural labour starts, the placenta is quick to be accused. Although there are a few legitimate placenta problems which justify intervention, often the placenta is used as a convenient excuse to perform an induction or C-section. These are the three crimes that the placenta is most commonly wrongfully accused of committing:
This is a common pathological change occurring, to some degree, in over 50% of pregnant women. An ultrasonic placental grading system is used to determine the placenta’s maturity. If a grade 3 placenta – one with significant basal calcification – is present before 32 weeks of pregnancy, intervention may be required to prevent adverse maternal and fetal outcomes.
While severe cases of placental calcification can impair blood, nutrient, and oxygen supply to the baby, minor calcification is not cause for intervention. The Royal College of Obstetricians and Gynaecologists states that a grade 3 placenta is found in 25% of healthy pregnancies at term, and has little clinical significance.
2. Implanting too low
Often, a routine ultrasound in the first half of pregnancy reveals a supposedly low-lying placenta; but the real crime is unthinkingly using this fact to scare pregnant women and influence their birth choices. Expectant women need to be reassured that, in most cases, this suspected placenta praevia resolves as the pregnancy progresses and the uterus grows – that’s if it should be mentioned at all! An ultrasound at about 32 weeks gestation will determine if it is placenta praevia, and only then the necessity (or not) of a C-section can be decided on.
3. Compromising Baby’s blood supply
When there are abnormalities in placental circulation, or one is dealing with high-risk mothers and babies, potential problems can often be detected using Doppler ultrasound, a non-invasive test which studies a baby’s blood circulation, the uterus, and the placenta. However, Doppler ultrasounds have no benefit when used as a routine screening tool in low-risk pregnancies, and can lead to unnecessary intervention.
It looks like the real crimes being committed are interfering unnecessarily with the natural birth process, and blatantly lying to, or misinforming, expectant women. Let’s strive to uphold midwife (and obstetric) honesty and stop using the placenta as a scapegoat. And thank our lucky stars that the placenta doesn’t have its own movie – because the first thing we would notice about this mostly falsely accused, miraculous organ, is that truth is on its side and in time will prevail … where will that leave the midwifery and obstetric judge and jury?