If you have been told that you have a high chance of developing a blood clot during pregnancy and have been prescribed a PREVENTION dose of blood thinning injections, here is some important information for you.Also read:
If you think labour has started or your waters have broken or you experience vaginal bleeding
Do not take further blood thinning injections and make contact with your maternity team to arrange a review). Aim for vaginal birth on the labour ward with spontaneous onset of labour.
If the birth is planned as an elective caesarean section
Stop taking blood thinning injections 12 hours prior to planned operation date (so the last dose should be at around 18.00 on the night before admission).
If you require induction of labour
Stop taking blood thinning injections 12 hours prior to admission for induction of labour (so the last dose would be around 18.00 on the night before admission). On admission, tell the midwife the time you took your last injection.
In labour
All efforts will be made to reduce the time that you are without blood thinning injections, to help keep your blood clot risk low. For the delivery of the placenta. active management is recommended. See here for more information:
If postpartum haemorrhage (PPH) occurs, this will be managed promptly by senior members of the maternity team.
If you are considering an epidural in labour
The safe time interval between blood thinning injections and having an epidural is at least 12 hours. This this is to minimise the risk of bleeding.
After the birth
The injections will be restarted as soon as possible after the birth and will depend on your risk of bleeding.
Duration of medication after the birth
Blood thinning injections must continue for at least 6 weeks after the birth as the chance of developing a blood clot is highest after the birth. Warfarin and LMWH are safe with breastfeeding. Switching to an oral medication may be considered after 5 days after the birth. However, direct oral anticoagulant therapy is only an option if you are bottle feeding your baby.
Decide family planning method
Progesterone Only Pill (POP)/Implant/Intrauterine device/other. See here for more information:
