I am 14 weeks pregnant and have a complete placenta previa. I had slight spotting from week 4 to week 12, and I have had three very small, brief bleeds, mostly brown to pinkish/brown. Ultrasound confirms a healthy baby, appropriate growth and good heartbeat. I am on restricted activity -- no intercourse, exercise and so on. My question: Is it safe to float around (nothing strenuous!) in my own backyard pool? My doctor says it's okay, but I've been hearing different opinions from different sources. I've avoided taking baths, too, just in case.

--Kathleen

Placenta previa means that the placenta (the organ that nourishes the fetus during pregnancy) lies low inside the uterus, covering the cervix (the opening where the baby would normally come out). At 14 weeks this is not uncommon, as there is relatively little space within the uterus in the first place. Frequently, as the uterus grows, the placenta shifts away from the cervix. We can see this from ultrasounds done over the course of the pregnancy. If placenta previa is still present at term, a cesarean section will be necessary to deliver the baby.

Usually when we diagnose placenta previa late in the pregnancy, we recommend "pelvic rest" -- no intercourse or douching. This is to avoid starting an episode of bleeding from trauma to the part of the placenta that covers the cervix. We also recommend avoiding strenuous activity and travel; you need to be near a hospital in case you begin bleeding heavily. In general, if a placenta previa is noted on a routine ultrasound in early pregnancy, we do not impose as many restrictions. In your case, however, you are having spotting, so you should be on restrictions.

Ordinary activities are okay, like an easy stroll or light housework. If your job is relatively sedentary, continuing work is permitted most of the time as well. Floating in a swimming pool is fine -- but no swimming lap after lap after lap, and certainly no diving or even jumping into the pool. Baths, as long as they are not overly hot, are also fine; no pregnant woman should get into a hot tub or sauna.

Your doctor will probably do another ultrasound at around 20 weeks; if the placenta previa is still present, you will have ultrasounds periodically to see if it eventually moves away from the cervix as pregnancy progresses. At term, placenta previa occurs in up to 1 of every 200 deliveries. Incidence does increase with increasing age of the mother, with smoking and with prior cesarean section or D&C. I would recommend discussing these issues with your obstetrician.