High-Parity Mothers Face Greater Risk of Placenta Previa, Indonesian Study Finds
A new study by Dian Rosmala Lestari, together with Ano Luthfa and Zakiyah, has found that women who have given birth four times or more face a significantly higher risk of developing placenta previa, a serious pregnancy complication that can cause life-threatening bleeding during childbirth. The research, conducted at STIKes Pelita Ibu and published in 2026 in the International Journal of Contemporary Sciences (IJCS), highlights the urgent need for stronger family planning programs and earlier prenatal screening to reduce maternal and neonatal deaths.
The findings are important because placenta previa remains one of the leading causes of obstetric hemorrhage in developing countries. The condition occurs when the placenta partially or completely covers the cervix, increasing the risk of severe bleeding, premature birth, emergency cesarean delivery, and maternal mortality if not treated quickly.
Maternal Bleeding Still Threatens Global Health
The study explains that maternal bleeding during pregnancy and childbirth continues to be a major contributor to maternal deaths worldwide. Placenta previa is among the most dangerous causes because it can lead to sudden and heavy bleeding during late pregnancy or labor.
Researchers noted that the risk increases among women with high parity, meaning women who have experienced multiple pregnancies and births. Repeated pregnancies may alter the uterine lining and blood vessels, making abnormal placental implantation more likely in future pregnancies.
The study also highlights several social and healthcare-related factors contributing to the problem, including:
- Limited access to family planning services
- Cultural preferences for large families
- Delayed emergency obstetric care
- Inadequate prenatal screening
- Low reproductive health awareness
According to the researchers, these factors continue to place many mothers in developing regions at greater risk of pregnancy complications.
Research Conducted at Bhayangkara Hospital Kendari
The study was conducted at Bhayangkara Level III Hospital Kendari using a quantitative analytical approach.
Researchers analyzed hospital medical records to examine the relationship between maternal parity and the occurrence of placenta previa. Mothers with lower parity were compared with mothers who had delivered multiple times to identify differences in pregnancy risk.
Statistical analysis showed a significant relationship between maternal parity and placenta previa incidence, with a p-value of 0.004.
The results confirmed that women with higher parity faced substantially greater risk of placenta previa than mothers with fewer previous births.
Multiple Pregnancies Increase Placental Risk
One of the study’s central findings is that women with four or more births represent a high-risk group for placenta previa.
According to the research, repeated pregnancies can weaken or alter uterine tissue over time, affecting where the placenta attaches during future pregnancies. This increases the likelihood that the placenta will implant lower in the uterus and cover the birth canal.
The researchers also noted that high parity remains common in some communities because of social, cultural, and economic influences.
Factors identified in the study include:
- Family expectations favoring large numbers of children
- Limited contraceptive access
- Insufficient maternal health education
- Lack of regular prenatal monitoring
- Delays in seeking obstetric care
The study argues that these combined factors contribute to preventable maternal health risks.
Early Detection Can Save Mothers and Babies
The research strongly emphasizes the importance of early prenatal screening for high-risk pregnancies.
According to the study, mothers with high parity should receive enhanced antenatal monitoring, especially during the third trimester. Routine ultrasound examinations are recommended to identify placental location before labor begins.
Early detection allows healthcare providers to prepare safer delivery plans, including:
- Referral to accredited hospitals
- Availability of blood transfusion services
- Planned cesarean delivery if necessary
- Emergency obstetric preparedness
The researchers explain that timely diagnosis significantly reduces the risk of severe bleeding and improves maternal and neonatal survival rates.
Dian Rosmala Lestari and her colleagues from STIKes Pelita Ibu emphasized that parity assessment should become part of routine antenatal risk screening for pregnant women.
Family Planning Programs Play a Critical Role
The study also highlights family planning as one of the most effective long-term prevention strategies.
According to the findings, promoting optimal birth spacing and limiting total fertility to three or fewer children could substantially reduce placenta previa cases and other parity-related pregnancy complications.
Researchers stressed that midwives and community health workers should actively educate women and families about the risks associated with repeated pregnancies.
The study recommends that information about high-parity pregnancy risks should be integrated into regular prenatal counseling and reproductive health education.
Additionally, the researchers advise that all high-risk deliveries should take place in healthcare facilities equipped with emergency obstetric services.
Important Implications for Maternal Healthcare Policy
The findings carry important implications for maternal healthcare systems in Indonesia and other developing countries.
The study argues that reducing maternal mortality requires more than expanding access to childbirth services. Healthcare systems must also strengthen risk detection, family planning support, and high-quality prenatal care.
Researchers believe high-parity mothers should become a priority group within maternal health monitoring programs because they face significantly elevated risks during pregnancy and childbirth.
The study also reinforces the broader importance of reproductive health education, particularly in communities where large family norms remain culturally strong.
According to the research, improving maternal outcomes will require closer collaboration between hospitals, midwives, public health agencies, and family planning programs.
Author Profile
Dian Rosmala Lestari is a midwifery researcher at STIKes Pelita Ibu whose academic interests focus on maternal health, pregnancy complications, reproductive health, and obstetric care.
Ano Luthfa is an academic specializing in maternal and neonatal health, obstetric risk factors, and community-based maternal healthcare in Indonesia.
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