conception... pregnancy... breastfeeding?

if you've got the questions, 
Barbara Dehn, RN MS NP has the answers.

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What is the difference between a low dose epidural vs. a classic epidural?

Glad you asked. In the past, classic or conventional epidurals only used an anesthetic that was injected into the epidural space between the spinal membranes to provide pain relief to a woman in labor. A low dose epidural has become standard practice now, as it involves using less anesthetic and adding a small amount of a pain reliever. The combination helps decrease the pain women experience in labor and has some very clear advantages - including a decreased likelihood that forceps or a vacuum will be necessary.

A lower dose of anesthetic also may help preserve some of the woman’s ability to move her legs, which makes pushing much more effective. Most midwives and obstetricians recommend that a pump be attached to the epidural so that a precise amount can be given. When the cervix is fully dilated, the amount is typically decreased to help the mommy-to-be regain more feeling so that she can push more effectively.


I was told that I have a low-lying placenta. What is this? And should I be worried?

A low-lying placenta is another one of those worrisome conditions identified early in pregnancy that 9 times out of 10 resolves itself and doesn’t affect the baby or the mom.

With a low-lying placenta, we are looking to see if any part of the placenta is close to the cervix. The good news is that as the baby grows, so does the uterus - and it grows and stretches from the bottom up. What looks like a low placenta at 18 weeks often looks like a placenta in a much higher position at 32 weeks. 

Why do we care about the position of the placenta? Well, this is important for a number of reasons. Primarily, the placenta is responsible for transferring all of the oxygen and nutrient rich blood from mom to baby through the umbilical cord, so it’s absolutely essential that there is no interruption in blood flow.

As health care providers, we need to know if any part of the placenta is covering part of or the entire cervix. This is known as placenta previa and can take two forms - a total previa, where the cervix is completely covered by the placenta, or a partial previa, where the cervix is only partially covered. As you know, when labor begins, the cervix dilates or opens up. When that happens in the case of a placenta previa, there would not be any blood flow from that area, which could have dire consequences to the baby.

When a woman is told that her placenta is low-lying, she will need to have at least one more ultrasound - maybe even several - to evaluate where the placenta is as her baby and uterus continue to grow. Most of the time, a later ultrasound will find that as the lower part of the uterus grew, the placenta moved much further away from the cervix and is no longer low-lying.

Good luck and enjoy those extra ultrasounds - it’s a great way to peek at your baby before you deliver.



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