Birth planning when you're being treated for blood clots
You'll need to give birth in hospital if you're having treatment for a deep vein thrombosis (DVT) or pulmonary embolism (PE). Talk to your midwife or obstetrician about your birth preferences and any special care you may need.
You'll usually need to phone your maternity hospital as soon as you think you are in labour or if you think your waters have broken. Your maternity hospital will tell you what to do.
Make sure you tell them you are on heparin and when your last injection was. Do not take any more injections until you’ve spoken to a midwife.
You usually cannot have an epidural until 24 hours after your last heparin injection. If you want an epidural, you may be told to stop taking your heparin when you go into labour.
Your midwife and anaesthetic doctor will discuss all other methods of pain relief with you.
Induction of labour
If you are being induced, your midwife and obstetrician will tell you when to stop taking heparin. This is usually about 24 hours before your baby is expected to be born.
If you are having a caesarean, you will be told when to stop taking heparin.
This is usually about 24 hours before the caesarean. If your last injection of heparin was less than 24 hours ago and you're having an emergency caesarean, you may need a general anaesthetic.
After your baby is born
After your baby is born, you will need to take heparin for at least 6 weeks.
You may need to take it for longer if the DVT or PE was diagnosed late in your pregnancy. It is safe to breastfeed while taking heparin.
Some women may be asked to take a blood thinning tablet instead of having heparin injections. You may also be referred to a haematologist. This is a doctor who specialises in blood clot disorders.
Questions you should ask after the birth
After you've given birth, there are things you need to think about.
Ask your GP, obstetrician or haematologist if you need to have tests to see why you got a DVT or a PE.
Some conditions make blood clots more likely. These are called thrombophilias. You can have blood tests done to see if you have one of these conditions. These tests often need to be taken weeks after birth.
Ask if there is anything you can do to reduce your risk of having another clot. For example, your GP can help you reduce your BMI and to stop smoking.
You will probably need to take heparin during future pregnancies. This will usually be a lower dose. It's important that you talk to your GP as soon as you become pregnant.
Certain types of contraception will not be suitable for you after having a DVT or a PE.
Contraceptive pills containing oestrogen and progesterone are not safe for you to take.
Progesterone-only contraception is usually safe. This includes:
- the progesterone only pill ('mini pill')
- the progesterone implant
- the progesterone containing intrauterine systems (coils)
The copper coil is also safe. If you want a coil or intrauterine system, you might have to wait until you have finished your heparin.