How to Prepare for An Accreta Delivery

Written by Kristen Terlizzi, February 2019

During my placenta accreta experience I spent over two months in the hospital. Between Antepartum, ICU, the Gynecological Oncology unit to Maternity recovery and discharge to then be re-admitted a week later for re-operation and another ICU stay, I occupied no fewer than 9 hospital rooms. I learned a lot about what to bring to the hospital from home, and the logistics of managing personal items. I’d love to pass on these learnings to you.

Some things to think about:

If you are admitted prior to your placenta accreta birth, remember that when you go into surgery you lose your antepartum in-patient room. And if you require ICU after surgery your family may be without a “landing pad” for items and gathering until you are transferred to a recovery unit, which can be days in some cases. Some hospitals may have lockers, but most likely your family will be responsible for maintaining your belongings by either carrying them around, sending them home, or locking them in a car. Keep this in mind when packing bulky items or extra options. And also for flowers or arrangements, people like to send them in the days before or when baby is born, but the reality is that your family may not have anywhere to put them (3). While a lovely gesture, you can enjoy them more if senders are told to wait until you’re settled in a recovery room, or even to instead send as a welcome home gift upon discharge.

Here are my recommendations for what to pack in your hospital bag:

All Purpose / Antepartum:

• Power adapters for electronic devices and an extension cord. Those hospital beds are pushed out from the wall and you’ll want the extra length.

• I lived in nightshirts for comfort and bathrobes for coverage, mostly from Target (bonus if the bathrobe had phone sized pockets). My aunt gifted me a beautiful Anthopologie bathrobe that was one of the most thoughtful care package items I received. The nightshirts were good for postpartum as well (vertical incision and catheter). (8)

• Large volume cup for water, with straw for post op ease of use. (4)

• Easy slip on shoe option like flip flops.

• If you bring a pillow from home, bring it in a colorful or non-hospital looking pillowcase. (2) It adds cheer to your room and is less likely to be lost with hospital laundry.

• A framed picture of your family! Eyes on the prize, and also can be a nice conversation starter with nurses and doctors. (5)

• Chapstick and hand cream for that dry hospital air. Teas can also be a nice treat for hospital air dry throat, I liked lemon and mint.

• Hairbrush, hairbands (9), some moms like to have dry shampoo for non shower days.

• Activities to keep busy / relieve stress. Some moms love adult coloring books like Zen Doodle, or this could be a good time to learn how to knit or crochet. Some hospitals have programs where volunteers come teach skills like this or bring materials for art projects.

• Guided Meditations to Promote Successful Surgery by Belleruth Naparstek; plastic no-metal headphones that can be worn during surgery and an iPod or music player for OR (if your team allows this). (7)

  • While in the hospital awaiting delivery I often felt frustrated that there wasn’t much I could do to impact my situation, using this soundtrack gave me an activity that I felt was proactive, productive and a way to invest in my surgical outcome and recovery. And it’s not just me, you can actually read a journal article study about this exact album; the results were that participants had lower levels of anxiety on the day of their surgery. My team was supportive and recommended I get plastic no-metal headphones (“like those cheap ones you get on an airplane”) so that I could listen to the surgery track in the operating room. I got these ones.

• Treats / activities for when your kids come to visit. I had coloring books and markers and a few toys. I would order extra cookies or packaged snacks with meals and stash them in a designated treat drawer for when my older son came to visit. He knew visiting mama also got him an oatmeal cookie! (6)

• Consider keeping a journal, you may actually get nostalgic for this time later and/or want a record of what happened when and your thoughts. Same for photos, don’t be afraid of photos at your worst - it gives you a benchmark to compare how far you’ve come.

• Believe it or not, you can get mail in the hospital. I don’t know why it took me weeks to figure this out, but if you forget anything you can probably amazon prime it to yourself referencing your name and room number. And it’s super fun to get hospital mail.

Postpartum:

• Postpartum / Nursing bras.

• If you’re planning to breastfeed and pump, pack a hands-free pumping bra and lanolin cream. The hospital / NICU will have a hospital grade pump and containers for milk so don’t worry about those.

• Blankets for baby / mom to sleep with and pass off to one another. This is a nice touch when mom and baby are separated.

• Some moms and surgical teams swear by abdominal binders. Ask your nurses about these - your hospital may have one to give you. Pro tip - if its not wide enough for postpartum + swelling, you can velcro two together.

• Some people like to bring clothes and blankets for baby while in the hospital. If you do this, don’t bring anything too special as items can get mixed in with the hospital laundry and lost. Stay away from footed onesies and zippers, you’ll want snap closures and open feet to accommodate any NICU wires and tubes.

Going Home:

• If bladder repair, make sure going home clothing supports catheter and isn’t tight over incision (soft waistband Maxi skirts work well).

• May need those flip flops again for post surgical swelling.

Some good pre-delivery topics for discussion with your partner, family and support network:

• In the event that mom and baby are separated after birth (i.e. mom in ICU and/or baby in NICU):

  • How can partner help bridge this gap? How much detail does mom want to know about how baby is doing if she’s not able to participate in baby’s care yet? Talking about these scenarios beforehand can help eliminate anxiety on all fronts.

  • It can also be helpful to talk through any preferences mom has about things like posting on social media and birth announcements etc.

• If you plan to breastfeed and/or pump, discuss how this can be supported if mom is in ICU and needs assistance.

• If you have a large network of concerned family and friends, consider designating someone who will be at the hospital for birth to manage communications. In my family, we chose an aunt I am close with. It gave my friends and family an alternate contact they could reach out to on the big day (so they didn’t feel like they were bothering or distracting my husband or parents) and it took the pressure off my mom and my husband to make sure everyone who wanted to be in the loop was getting updates. My aunt sent out text messages to a list of friends (provided by me beforehand) and extended family with updates on when my son was born, how he was doing, when I was out of surgery etc. This strategy worked well for us.

• By nature of a complicated delivery, an accreta mom may end up missing events that are important to her (first cries, first bath, feedings etc). Think about special first things that can wait for her, such as siblings meeting for the first time and ensure she doesn’t miss them.

Ways people can support you:

• Direct them to this page for ideas and insight into the complexities of preparing for an accreta delivery.

• Come visit! Assuming you’re up for having visitors, it can be great to see a familiar face. I can still list off by name those who came to visit me in the hospital, and bonus points to those who brought tabloid magazines and treats from the outside world. If you’re not up for visitors - say so. In the days after delivery many friends wanted to come visit which I really appreciated, but I needed to prioritize recovery and getting mobile to visit my son in the NICU at that time, my family was happy to relay that message and people completely understood.

• Send a care package! Either to mom directly in the hospital, or deliver to a family member who can bring while visiting. Receiving unexpected (and inexpensive!) items like hairbands or slippers, chapstick, a baby outfit, candy and a card can make mom’s day and be a much remembered and cherished gesture.

• Childcare or fun outings for your other children (both while you’re in the hospital and back home recovering).

• Remember the note about flowers above, sometimes they make a better welcome home gift upon discharge than something sent to the hospital.

• Have a friend setup a meal train for your husband and children while you’re in the hospital, and/or everyone once you’re back home recovering. Recovering from an accreta delivery is challenging and any extra help can make a big impact.

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