When is caesarean section recommended for placental abruption?

Placental abruption happens when the placenta separates from the uterine wall before birth. This can reduce the baby's oxygen supply and cause bleeding, abdominal pain or a tense, tender uterus. Visible bleeding may not show the full amount of blood loss because blood can remain behind the placenta.

The team checks the baby's heart rate, contractions, blood pressure, pulse, pain and bleeding. If the baby is distressed or the mother is becoming unwell and birth cannot happen safely through the vagina quickly, caesarean birth may be advised. If both are stable and vaginal birth is progressing, another route may sometimes be considered.

Treat sudden abdominal pain, vaginal bleeding, frequent contractions or a change in fetal movement as a reason to contact maternity services immediately. Do not wait for a routine appointment. Take your pregnancy records if this does not delay help, and tell the team about blood loss, pain onset, trauma or medicines.

Call emergency services for severe or persistent abdominal pain, heavy bleeding, faintness, confusion, marked weakness, breathing difficulty or reduced fetal movement. Abruption can occur with little or no visible bleeding, so severe pain or a hard, tender abdomen also needs urgent assessment. Remain with someone while waiting for help and avoid driving if unwell.

Ask what the monitoring shows, whether your blood count and clotting need checking, how the baby's heart rate affects the birth decision, and what would make caesarean birth necessary. Ask who will explain anaesthesia, newborn support and recovery if an urgent operation is needed.