Accreta Awareness Month
Several weeks ago, I was watching “The Captain” on ESPN with my husband, who is a die-hard Yankees fan. As a Red Sox fan myself, I resisted the invitation to join him in binge-watching, but on this particular night he said I needed to watch a segment. He pressed play and I listened to Hannah Jeter share her story of being diagnosed with placenta accreta and the emergency hysterectomy that followed the birth of her third child. This was the first time I had heard someone give voice to an experience that I had lived just months before.
October marks Accreta Awareness month and with it, a chance to share my story.
Rewind to December of 2021. I had never heard the term placenta accreta, and as avid Googler, that’s saying something. I was nearing the end of my second pregnancy and worked closely with a maternal fetal medicine doctor who managed anticipated complications. Together, we decided a scheduled cesarean section (C-section) was the safest route to a healthy mom and baby.
On a rainy morning, my husband and I said goodbye to our toddler as we headed to University Hospital prepared to meet our second baby. Our excitement about meeting our son or daughter that day balanced the nerves and anticipation of all that lay ahead. My husband was convinced we were having a boy and I was 110% certain the baby was a girl. We laughed thinking how surprised one of us was about to be.
We checked into the hospital and anxiously awaited lab results to determine if my C-section would be under local or general anesthesia. When blood work came back, our entire medical team cheered as we celebrated the ability to move forward with a “routine C-section.” We were so relieved as our first delivery was anything but routine.
After crossing what we thought was the final hurdle, I walked down the hall to the operating room (OR) (such a weird experience!) and blasted Christmas tunes feeling so ready to meet our new baby. The mood was relaxed and excited. It felt like Christmas was coming early and to keep with the spirit, the OR team and I debated the better Christmas movie – “Love Actually” or “The Holiday.”
At 37 weeks and five days, we welcomed our son Charlie – my husband won the bet! Charlie’s birth was everything we hoped for – he cried, my husband announced the sex and we got to enjoy skin to skin time, which was so important to me. Charlie was the tiniest little guy weighing 6 pounds, 5 ounces, but he sure had a voice. I was overwhelmed with joy upon meeting him. I was relieved that everything went according to plan…until it didn’t.
While my husband and I were savoring our initial moments with Charlie, our doctor knelt by my head and shared that we had a problem. He proceeded to tell me I had placenta accreta. I had never heard the word accreta before but hearing the world problem while on an operating table was enough to make my vision go fuzzy and the room feel like it was moving in slow motion.
I now know that placenta accreta is a serious pregnancy condition that occurs when the placenta grows too deeply into the uterine wall.
Typically, the “placenta detaches from the uterine wall after childbirth. With placenta accreta, part or all of the placenta remains attached. This can cause severe blood loss after delivery.”1
The prevalence of placenta accreta has increased steadily since the 1970s2. Studies show that prevalence of placenta accreta was between 1 in 2,510 and 1 in 4,017 in the 1970s and 1980s3. According to data through 2011, accreta now affects as many as 1 in 272 pregnancies4. This increase coincides with the increase in cesarean rates.
Placenta accreta is not usually diagnosed by ultrasound unless it is seen in association with placenta previa which is a condition where the “placenta completely or partially covers the opening of the uterus.”5
Many factors can increase the risk of placenta accreta, including prior uterine surgery, placenta position, maternal age and previous childbirth6. It poses several risks to the birthing individual – the most common of which are preterm labor and hemorrhage. A 2021 study estimated a mortality rate as high as 7% for birthing individuals with accreta6.
A quick Google search of this condition will lead you to terrifying stories from birthing individuals and their families who have received this diagnosis and the complications that followed. In my case, my doctor informed me that due to severity of my accreta, the only option for treatment was a complete hysterectomy. The celebration of our routine procedure that happened just minutes before transpired to an emergent situation. Coolers of blood were brought to the OR, the medical team doubled in size and debate over the best Christmas movie was a distant memory. Charlie was taken off my chest and he and my husband were directed to the post-anesthesia care unit (PACU) while I was prepped for an extensive surgery. The feelings of Christmas cheer shifted to reserved caution, overwhelming fear, and sadness.
It felt like cruel joke to celebrate being a mom again and in the very next moment learn that I would never have the ability to bear a child again. While on the operating table staring at blinding light, I felt scared and overcome with grief. These feelings are in direct contrast with how one is “supposed to feel” upon the arrival of a new baby – joy, elation, gratitude. These feelings came in waves and I felt them all at once.
With all that said, my experience with an accreta was uneventful when compared to the experiences of others with the same diagnosis, but quite severe when compared to childbirth generally. I ended up receiving a blood platelet transfusion – likely due to confounding factors and not solely the result of having an accreta. I did not experience extreme hemorrhaging and while my accreta was invasive, it didn’t impact other organs or systems. Even still, it required my husband to wait on the wall opposite me and wonder how severe my case would get and separated me and my new baby for hours. It added complexity to my recovery and prevented me from lifting more than 10 pounds for eight weeks. My newborn in his car seat exceeded that limit. Lastly, it cemented the decision that my family is complete at two kids. While my husband and I were 99.9% sure this was case prior to this event, having the choice made for us has been hard at times.
When you receive a diagnosis you have never heard of that has lasting impact on your life during an experience that is touted as the “best day of your life” there is a lot to wrestle with. If you find yourself in a position where your birth plan didn’t go as you hoped or was even traumatic, here are a few lessons I have learned that I hope are helpful.
- Feeling lonely doesn’t mean you are alone. It can feel very isolating when your birth experience is marked by trauma. Well-intentioned friends and family can often remind you of the gift that you and baby are healthy – and yet, grief still marks the experience. It can feel like your true experience is yours to deal with all on your own.
- Needing help doesn’t mean you aren’t capable. It was really hard for me to be so dependent on others following my surgery. There were times where I tried to push it just to remind myself I wasn’t weak and I paid the price in pain, fatigue and added struggle the next day. Accepting help is often the strongest thing you can do in support of those you love most.
- Hold space for healing. Once your body heals, the wound of your experience can still linger. When my son’s schoolteacher asks when a little sister is joining our family, I am reminded of choices I no longer get to make for myself. When I am asked about the date of my last menstrual cycle at every single doctor’s appointment, I am reminded of ways my body is forever changed. While the acuity of my experience has lessened, its impact still lingers and often catches me off guard in seemingly mundane times like school pick up.
There are as many birth stories as there are babies on the Earth. For families who receive an accreta diagnosis, the potential outcomes can be devastating. I am grateful that my experience was described as one of the smoothest Caesarian-hysterectomies my medical team has seen. Even still I wish I had known more about this potential diagnosis before I found myself in the operating room. In sharing our story, I’m hopeful that anyone who has had an accreta diagnosis feels less alone and anyone who is at risk for this condition feels more aware and empowered to ask questions.
If you are interested in learning more about placenta accreta, visit:
preventaccreta.org/accreta-awareness
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