Dear TEB,
"I’m 20 weeks pregnant, and at a recent ultrasound the doctor said that it looked like I have placenta previa. I’m nervous about what this means for my pregnancy. Can you explain what placenta previa is and what I might expect as my pregnancy progresses?"

Dear Reader,
Placenta previa is the technical name for when the placenta is positioned low in the uterus, covering the cervix — the opening to the birth canal — in part, or completely. At 20 weeks, this is a relatively common finding and you can take comfort in knowing that it is often temporary. As the uterus grows, the placenta typically moves higher, making previa no longer a concern by the third trimester in most cases.

It sounds like you have a supportive medical team and doctor keeping an eye on this, which is great. Now — if placenta previa were to remain an issue closer to the end of your pregnancy, your care team will revisit the topic with you to discuss data, recommendations, and options for maintaining safe birth outcomes. If/when a placenta is over the cervix during labor or birth, it can lead to complications like too much bleeding — so measures are often recommended to prevent this altogether.

Recommendations may involve modifying activities, monitoring for symptoms like bleeding, and discussing what may be a different birth plan — typically an abdominal/cesarean birth to make sure you and your baby are safe. Staying informed, making sure you have a care team who you can communicate with well and who you trust, and attending follow-ups to see which situation is really relevant to you can help you navigate this with confidence.

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Dear TEB,
"During my last appointment, my doctor mentioned something about monitoring for ‘placental insufficiency’. What exactly is that? Do placentas go bad?"

Dear Reader,
The placenta’s job is to provide oxygen and nutrients to the baby. So placental insufficiency is really just a medical term for when it isn’t doing that — or isn’t doing it well enough that it’s a cause for concern. When that’s the case, it can affect a baby’s growth and overall development — of course, making close monitoring important.

Now — if you’re not sure why your doctor mentioned that to you we recommend following up to reopen the conversation for clarity. You can send a message via an online portal, or call directly and leave a message — just essentially saying, 

“Hey Dr. Name! I wanted to follow-up on what you mentioned about placental insufficiency in our last appointment. I’d like to know if there was something specifically related to my baby or my pregnancy that indicated we need to monitor this, or if this is something you generally mention monitoring with patients at this point in their pregnancy. And in either case, I may have some follow-up questions, too.”

Providers may use ultrasounds, blood flow studies, and other tests to assess and get an idea of how well the placenta is functioning — and they may also look at what they’re seeing happen with the baby to see if there are any indications there of something that may be the responsibility of the placenta. 

To answer the last part of your question, “Do placentas go bad?” Sometimes placentas can have complications that result in them not working properly. Outside of that, all placentas age. Now normally, placentas age without causing any issues — but there are some cases where a placenta can age before birth to the point that calcium deposits start to build up around it and break it down — this is called a calcified placenta. Again — not common.

As we always say, at the end of the day, it’s important to remember that every person and pregnancy is different, and clear, comprehensive communication with care teams we trust can help us navigate whatever our unique pregnancies bring.

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Dear TEB,
"At my recent anatomy scan, the ultrasound tech mentioned I have an anterior placenta but it was just something said quickly and then they moved onto something else. What does that mean, and how does the placenta’s location affect my pregnancy?"

Dear Reader,
An anterior placenta simply means your placenta is attached to the front wall of your uterus, which is on the side closer to your belly button. If your placenta were on the back wall of your uterus, closer to your back, it would be called posterior. Both anterior and posterior placentas are normal and don’t typically affect pregnancy health.

Now — since you do have an anterior placenta, you may notice that it takes a bit longer to feel your baby’s movements because the placenta can act as a cushion between your baby and your abdominal wall. When you do start feeling those first kicks, they might be a little more subtle at first, but they’ll still become stronger as your baby grows. 

Whenever you’re ever curious about how your placenta’s location may impact certain aspects of your pregnancy or delivery, bring it up with your provider — they can give you tailored insights based on the data, their experience, and most importantly what’s specifically going on with your body and your baby in their care.

The Final Word

Pregnancy comes with a whole new vocabulary, and "placenta" is often one of those words you may not have really heard before! The placenta is an incredible organ, working tirelessly to support your baby. Understanding its role, how and why it’s monitored during pregnancy, and what your options are for engaging with it after birth, can help you feel more connected to your care and better equipped to advocate for yourself.

Whenever you have specific questions about your pregnancy, always bring them up with your provider. Dr. Google is not a great help! And often a greater source of anxiety than truly helpful and relevant information. There’s no such thing as a “silly” or “unnecessary” question when it comes to your health and your baby’s well-being.

For even more tips and insights, explore our Dear TEB, Dear Reader series — your go-to for compassionate answers to the questions you care about most.

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