Talk to your midwife or obstetrician about your birth options if you're having treatment for a blood clot. You will need to give birth in hospital.
As soon as you think that you are in labour or that your waters have broken:
- Phone your maternity hospital.
- Tell them you are on heparin and when you had your last injection.
They will ask you to go to the hospital to see if labour has started.
Labour and birth
Your midwife or doctor will tell you when to stop taking heparin if:
This is usually 24 hours before the birth.
If you need an emergency caesarean, your doctor will ask you when you last had a heparin injection. If it was less than 24 hours beforehand, you may need a general anaesthetic.
Epidurals
If you want an epidural, your midwife or doctor may tell you to stop taking your heparin when you go into labour. You usually cannot have an epidural until 12 to 24 hours after your last injection. It depends on your dose.
Your midwife and anaesthetic doctor will discuss other types of pain relief with you.
Treatment after the birth
After your baby is born, your doctor will explain what treatment you need. You will usually need to take heparin for at least 6 weeks.
You may need to take it for longer if you started treatment late in your pregnancy. It is safe to breastfeed while taking heparin.
Your doctor may prescribe a blood-thinning tablet instead of heparin injections. They may also refer you to a haematologist. This is a doctor who specialises in blood clot disorders.
Preventing future blood clots
After the birth, there are things you may need to do to prevent future blood clots.
Ask your GP, obstetrician or haematologist if you:
- need to have tests to see why you got a blood clot
- can reduce your risk of future clots - for example, by stopping smoking or reducing your BMI
Some conditions make blood clots more likely. These are called thrombophilias. Your doctor may do blood tests to see if you have one of these conditions. You may need to wait for several weeks after the birth to do these tests.
If you get pregnant again, talk to your GP as soon as possible. You will probably need to take heparin during future pregnancies.
Contraception after having a blood clot
You cannot take contraceptive pills that contain oestrogen after having a blood clot. They are not safe for you to take.
Progesterone-only contraception is usually safe.
You can get this as:
- a mini pill
- an intrauterine system (IUS)
- an implant
The copper coil is also safe.
You may have to wait until you have finished heparin treatment before having an implant, coil or intrauterine system inserted.
