accreta experience: Megan Moody
Planning for your Physical and Emotional Recovery
So you’ve just heard the word, potentially for the very first time. “Accreta,” she or he spoke it aloud after scrunching up their face at the ultrasound images. Maybe you’d been getting extra imaging because your OB diagnosed placenta previa, or maybe they simply sounded concerned about a placenta’s location. But, if your case was at all like mine, you’d never even heard of accreta; much less that it had been your very own “worst case scenario” from the moment your OB first sounded that concern.
It’s been three years since that moment for me, and not a day goes by that isn’t somehow colored by that experience. I often lay awake at night, composing a letter I have yet to write to my once-beloved OB practice: begging to know why the risk was never articulated, or why they so assuredly repeated to me “3 c-sections or less are totally safe for mother!”. My accreta (percreta) diagnosis happened during my third (viable) pregnancy, well within that supposed window of safety. And yet, there I am in the moment of diagnosis being told that at 26 weeks I was to immediately report to our hospital’s high risk pregnancy unit and to “get my things in order” because my life was now at risk.
I survived that childbirth because I was at a well-known accreta “center” with the best practitioners in the area. The center had hemorrhage protocols and interventional radiology that both provided rapid transfusion and methods to stave off blood loss, respectively. I lost my body’s volume of blood nearly three times over, and owe my life to dozens of selfless blood donors. My daughter born at 33 weeks? An absolute rockstar. She shocked us all with a NICU discharge only 10 days after her birth. She suffers no developmental or medical issues from prematurity and is the absolute light of our family. My recovery was brutal, as all c-section/hysterectomies are; and unfortunately it was compounded with an incisional hernia that required follow-up surgery less than 6 months later. I suffer some minor complications that will be with me for my lifetime, but I am largely fortunate considering how my placenta grew through my uterine walls and invaded my bladder.
But back to you, in this moment at your diagnosis. What would I want to say to you? First and foremost, I am so sorry. I am sorry that this condition exists and I am so sorry that it has landed on your proverbial plate. My heart aches when I hear that anyone else has to go through this. But here you are, so let’s make a plan. Your specialists: ask them everything. How many similar cases have they seen? What procedures does your hospital have in place for accreta patients and the hemorrhage risks they carry? Is it a well-regarded accreta “center”? (And to that last question, if the answer is no--then promise me you will move mountains to get yourself to one. Fight insurance, ignore anyone who says you may be “overreacting”, and do what is best for your safety.)
Once you feel confident you are in the best hands, then please start making plans to take care of yourself. Remember that brutal recovery I mentioned? When you and your loved ones are rallying all of your available helpers and giving them lists of helpful actions (for women who do not like asking for help, this task is difficult...but important), please do not assume you’ll be up and at-’em after a few short days post-operatively. Spoiler alert: you will not be. Make plans for childcare etc. accordingly.
And speaking of taking care of yourself, I cannot emphasize enough how important therapy was to my emotional recovery. In hindsight, I wish I had set it up as soon as I got the diagnosis. Because honestly, our best case scenario is that it is just a “scare” and there will be no birth trauma. But there are those days/weeks/months of simply grappling with a life threatening diagnosis. And those fears don’t just go away without talking about how they affected you. So best case? You arrange to talk to someone after baby is born. And you talk for a session or two about how scary it was to have that diagnosis and how thankful you are that it didn’t come to fruition, and then you never have to return. No harm! But worst case scenario, you may know the terror of waking up in an Intensive Care Unit and not knowing the outcome of your child’s birth. And even though you will be grateful to have survived and your baby will be OK, it is overall (most certainly!) not an experience you can shrug off. Please put self-care somehow, any way you can, into your recovery plans.
And once you’ve taken all of these important steps in physical and emotional recovery, find us. Find the women who know and understand this experience. Join in social media threads just to know that you are not alone. Your friend who has four healthy children via four typical vaginal deliveries is not going to be the one to understand. She will try! She will hold your hand and be sad with you, but she will never “get it”. If you’d rather talk IRL (“in real life”, see how hip of a 40 year old I am?), ask your local specialists if they’ve ever considered a support group for survivors. Ask them how you can connect and make it happen. You will never regret putting yourself out there with fellow survivors, trust me. It is a sisterhood no one wants to be a part of, but it is a beautiful place of fellowship and healing.
Take care of yourself, accreta sister. And know that our hearts are with you.
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Megan Moody lives in Fairfax, Virginia with her husband Brett and their three children. She is a lifelong educator and spends her spare time creating art, shelling (yes, it is a verb), and listening to every podcast she can.