Like many pregnant women, as Simone Pavils’ due date approached, she decided to write a birth plan. But Simone included one item most women wouldn’t even think about, one that she hoped would never be put into place. “Our birth plan included details of what I wanted to happen if I was put on life support,” Simone says.
The pregnancy, Simone’s second, had already been classed as high risk due to her having a congenital heart defect. Despite this, up until 20 weeks Simone’s pregnancy had been relatively smooth.
But then, at a routine appointment, Simone was told the doctors suspected she had placenta accreta, a condition in which the placenta forms an abnormally deep attachment to the uterus. There are three stages to this life threatening condition – accreta, increta and percreta – and with each stage, the possibility of the mother’s survival rate dwindles to almost zero. “I was given a 1 in 20 chance of dying,” Simone says, “and a 70 per cent chance of complications.”
Simone tried to keep positive for the remainder of her pregnancy, but admits things weren’t looking good. “I spent many nights watching my two-year-old daughter sleep, and making special gifts for her and my unborn son,” she says. “I cried almost every night in the shower while my husband slept and during the day while he worked. I tried to enjoy what I believed to be the last few months of my life spending quality time with my daughter.”
At 35 weeks, Simone’s amniotic fluid became dangerously low, as her placenta had stopped working properly. It was decided that she would deliver via caesarean section the next day.
“I raced around the hospital updating my will, getting it printed and signed, as well as finishing off our birth plan,” Simone says. “I wrote letters to my family, my husband and children, and recorded videos for them. That night one of my closest friends and sisters came to visit, and although it was unspoken, we all knew they were there to say goodbye to me.”
Noah was born early in the morning, an hour after Simone was put under a general anaesthetic. She then needed further hours of surgery – and finally, as she woke up, Simone and her family were astonished that she had survived.
“I couldn’t believe I was alive,” remembers Simone. “I cried and thanked the doctors, and they told me that I had placenta percreta.”
Placenta percreta, the most serious form of placenta accreta, occurs when the placenta penetrates the entire uterine wall. In some cases, the placenta can attach to other organs, such as the rectum or bladder. Both Noah and Simone were lucky to be alive.
Noah required incubating after the surgery and spent nine days in the neonatal intensive care unit, while Simone recovered from the caesarean and the hysterectomy doctors had needed to perform after the birth. While Simone recovered well physically, she says it was difficult to process everything that had happened.
“About three months after Noah was born I was still struggling to feel like his mum,” Simone says. “Although I had carried him for 35 weeks, I was so disconnected from the pregnancy and birth that I felt as if I’d just been handed a baby.”
Simone had wanted to breastfeed Noah, but thinking that she would probably end up on life support, she had written in her birth plan that she didn’t intend to breastfeed. “When we got home I did try to breastfeed Noah, but he didn’t latch properly and I didn’t know who to ask for help,” Simone says.
When Noah was 11 weeks old, Simone was determined to try to re-lactate to breastfeed Noah. “After two weeks of trying to re-lactate I was able to pump colostrum and milk,” Simone says. “I succeeded. Noah is now a breastfed baby.”
Simone says she knew nothing of placenta accreta before she was diagnosed with it, but wants to let others know about the potentially fatal condition.
“Placenta accreta does not play favourites,” she says. “It can affect pregnant women of all ages, all nationalities, all over the world.”
Simone hopes to attend the inaugural the Hope for Accreta Foundation conference in Tennessee later this year. For more information about this condition, visit hopeforaccreta.org.