We arrive one morning and Awa is doing an initial exam on a woman who is experiencing uterine bleeding and sporadic uterine contractions; she is about 8 ½ months pregnant. Please keep in mind women do not keep note their menstrual cycles and, once pregnancy has been confirmed, estimated due dates are given by noting the month of delivery, not a specific date. She has diagnosed this woman as having a marginal placenta previa and has decided to share with us her strategy for dealing with this.
She begins by administering an IV, with a drip of an anti-spasmodic medication. She then ruptures the bags of water, which she says will reduce pressure on the placenta and stop the bleeding. It does.
Once the contractions and bleeding have stopped, she slowly adds pitocin to the drip to slowly ripen the cervix. Once the cervix has ripened and dilation has begun (without the return bleeding) she discontinues any medication.
Within 4 hours the issue of marginal placenta previa has been resolved. A normal labor and delivery continues.