Guide for Partners & Families

What Is PAS? A Quick Overview for Families

Placenta Accreta Spectrum (PAS) is a pregnancy complication where the placenta — the organ that nourishes the baby during pregnancy — has grown too deeply into the wall of the uterus. Normally, the placenta detaches on its own after delivery. With PAS, it doesn’t, and that makes delivery more complicated and potentially dangerous.

Here is what you need to understand:

• The placenta has attached too deeply into the uterine wall, and in severe cases, it can grow into surrounding organs like the bladder
• This makes delivery more complicated and requires a specialized surgical team
• It does not mean she did anything wrong — PAS is caused by scarring from prior cesarean sections or other uterine surgeries
• With the right medical team and planning, outcomes are very good

What to Expect: The Timeline

Every PAS journey is different, but here is a general overview of what happens from diagnosis through recovery. Knowing what’s coming can help you prepare and feel less caught off guard.

How You Can Help

During the Pregnancy

• Go to appointments with her — especially the big ones like ultrasounds and MFM (maternal-fetal medicine) visits
• Help research hospitals and doctors — but let her drive the final decisions
• Handle logistics: insurance calls, preauthorization paperwork, travel planning if the hospital is far away
• Take on more household responsibilities — she needs to conserve her energy
• Be the point person for family and friends who want updates, so she doesn’t have to repeat the story over and over
• Don’t minimize her fears — saying “It’ll be fine” can feel dismissive. Instead try: “I’m here with you no matter what”

During the Hospital Stay

• Be her advocate with medical staff — she may be too exhausted or medicated to speak up for herself
• Keep a notebook of what doctors say: names, instructions, medications, next steps
• Manage visitors — she may not want many. Respect her wishes, even if family members are eager to visit
• Bring comfort items: her favorite snacks, lip balm, a phone charger, familiar blanket or pillow
• Understand ICU rules — if she needs ICU time, visiting may be limited. Ask staff about the policy early
• Take care of the baby when she can’t — especially if she needs ICU time, the baby will need you
• Ask nurses questions — they are your best resource. Don’t be afraid to speak up if something seems off

After Discharge

• Expect a slow recovery — PAS surgery is major surgery, often more extensive than a standard cesarean
• Acknowledge her feelings — she may have complicated emotions about the birth experience
• Watch for warning signs of postpartum depression and PTSD (see the emotions section below)
• Help with baby care, especially during the first weeks when she has lifting and activity restrictions
• Encourage follow-up appointments — it can be tempting to skip them when things feel okay, but they matter
• Be patient — healing takes time, both physically and emotionally

Understanding Her Emotions

A PAS diagnosis is a life-altering event. The emotional impact is real and can be just as significant as the physical recovery. Here is what she may be experiencing — and what you should know.

Fear

PAS carries real risks. Her fear is rational, not an overreaction. She may be afraid for her own life, for the baby, or for what happens to the family if something goes wrong. Don’t try to talk her out of her fear. Sit with it alongside her.

Grief

She may grieve the “normal” birth experience she expected. If a hysterectomy is needed, she may also grieve the loss of future fertility — even if your family feels complete. This grief is valid and deserves space.

Loss of Control

Medical decisions may feel like they’re being made for her rather than with her. Help her maintain agency where possible: make sure she’s included in conversations with her care team, ask her what she wants, and advocate for her preferences.

Guilt

Some patients feel guilty — about the diagnosis, about being “difficult,” about the cost, about taking resources, about not being able to care for older children. Reassure her, clearly and often, that none of this is her fault.

PTSD and Trauma

Research shows that 36% of PAS patients have elevated PTSD risk scores.2 Birth trauma is real and it is not a sign of weakness. Professional support — therapy, counseling, support groups — can make a significant difference.

Numbness or Disconnect

Some patients feel detached from the experience, as if it’s happening to someone else. This is a normal trauma response, not a sign that something is wrong with her. It may take time for the full emotional weight to land.

Sources: Einerson et al. 2021, BMJ Open (PMID: 34732490); Freitas et al. 2024, Eur J Obstet Gynecol Reprod Biol (PMID: 39298827)

Taking Care of Yourself

This section is specifically for you — the partner, the parent, the sibling, the friend. You are going through this too. Your feelings matter.

• It’s okay to be scared, angry, or overwhelmed. You don’t have to be the strong one every second of every day.
• Talk to someone — a trusted friend, a therapist, or a support group. You need an outlet that isn’t her, so you can process your own fears without adding to hers.
• Accept help from others. When people offer to bring meals, watch older kids, or help around the house — say yes.
• Maintain the basics: eat real food, sleep when you can, move your body. You cannot pour from an empty cup.
• Don’t try to be superhuman. Ask for what you need. Tell people specifically what would help.
• Consider couples counseling after the experience. A PAS journey puts enormous strain on relationships, and having a professional to help you process it together can strengthen your bond.

If There Are Older Children

If there are other kids in the family, they will sense that something is different. How much you share depends on their age, but honesty (in age-appropriate terms) is almost always better than silence.

Toddlers (1–3 years)

They won’t understand what’s happening, but they will sense stress and disruption. Focus on maintaining their routines as much as possible. Extra cuddles, familiar caregivers, and predictability go a long way.

Preschoolers (3–5 years)

A simple explanation works best: “Mommy is having the baby at the hospital. The doctors need to take extra special care of her, so she’ll be there a little longer than usual.” Expect some clinginess and regression (like a potty-trained child having accidents). This is normal and temporary.

School-Age (6–12 years)

Children this age can understand more. Be honest in terms they can grasp. Answer their questions directly. Reassure them that mommy will be taken care of by very good doctors. Let them visit the hospital if it’s appropriate and if the patient wants it — seeing mom can be reassuring for them.

Teenagers (13+ years)

Teens can handle more details and may want them. They may worry intensely but try to hide it. Check in with them individually — not just in front of the whole family. They may want to help, so give them a role: watching younger siblings, helping at home, or being the one who picks up groceries.

General Tips for All Ages

• Maintain routines as much as possible — school, bedtime, activities
• Arrange consistent childcare during the hospital stay, ideally with someone the children know well
• Let school or daycare know what’s happening so teachers can watch for behavioral changes
• A special “gift from the new baby” can help smooth the sibling transition

Questions to Ask the Medical Team

You are part of this care team too. Here are questions worth asking — write them down and bring them to appointments.

1. What is the plan for delivery, and what are the possible scenarios?
2. How much blood might she lose, and what is the transfusion plan?
3. Will she need ICU time? If so, for how long?
4. Where can I be during the surgery? Can I be in the operating room?
5. How long will the hospital stay likely be?
6. What signs should I watch for after discharge that would need emergency care?
7. When can she hold and breastfeed the baby?
8. What restrictions will she have during recovery?
9. Who should I call if something seems wrong after we go home?
10. Are there support groups or counseling services you recommend?

Resources

• National Accreta Foundation — The leading PAS patient advocacy organization. Has a dedicated section for partners and families.
• Postpartum Support International — Resources for postpartum depression and PTSD, including a helpline and support groups.
• HAND (Hospital Alliance for Neonatal Development) — Support resources if your baby needs time in the NICU.
• Hospital social workers — Ask the hospital to connect you with a social worker. They can help with insurance questions, emotional support referrals, lodging, and practical logistics.

More on This Site

• PAS Preparation Checklist — A step-by-step checklist to help you prepare
• Treatment Pathways — Understand the surgical and management options
• Understanding PAS — A deeper look at what PAS is and how it is classified

References