We’ll never know for sure what happened to Ada. From the tests that we were able to do, it seems that she was perfect – no developmental abnormalities, and I don’t have any genetic conditions that could have caused a problem (like a blood clotting disorder). After talking with yet another doctor, it seems that partial placental abruption is a strong hypothesis for what happened. I had a trauma (minor car accident), followed by cramping (which is a symptom of abruption), and when I delivered the placenta there was old blood (indicating that there had previously been a minor abruption). And it’s entirely possible that Ada died simply because she had a loss of oxygen or nutrients due to an abruption.
The American Pregnancy Association has an article on Placental Abruption. What I find strange is that they instruct women to contact their health care provider if they have bleeding in the third trimester even though they say earlier in the article that “about 20% of cases will have no bleeding” and that abruption “usually occurs in the third trimester but can occur any time after the 20th week of pregnancy”. So what are women who suspect a placental abruption prior to the third trimester with or without bleeding supposed to do?
In my case, assuming it was a partial abruption, I should have immediately gone in for observation, and probably should have been on bed rest (based on what I have read, because of course I am not a medical professional). Yet, because I didn’t have bleeding, I was told not to worry and to go about my business. If I’d been put on bed rest would that have saved her? We’ll never know. But I do know that if I experience any trauma like a car accident or a fall during this pregnancy I will immediately go to the ER and request fetal monitoring. I’ll also put myself on bed rest or at least light activity unless I have good reason to believe it isn’t warranted. These are no-risk things that could prevent us from losing another baby.
What scares me greatly is that women who had a previous abruption are more likely to have another. Yet I had to learn this from a website, even though I have what seems to be a reasonably good team of doctors. Maybe they were just trying to not scare me but at this point, everything is scary so just give me the information already! Tomorrow is my first visit with the high risk doctor, a fetal maternal medicine specialist, and perhaps they’ll have more specific information for me (this is why I was researching abruption – so I can ask the right questions). Wish me luck.