Low platelets, not allowed homebirth... What happens during hospital birth?

[AtticusTheRoman]

I'm 33 weeks pregnant with DC 4.

My platelets were at 89 last check.... They were low-ish, but never this low with previous pregnancies.

Midwife was very laid back about it but today consultant haematologist told me I would definitely not be allowed a homebirth and may not even be allowed an epidural...

I don't want to be constantly monitored, have a drip and examined all the time, this is what has stressed me so much with my previous hospital births and the reason they were so awful.

Anyone know the protocol?

[Pinklily1]

Hi Atticus

I also have low platelets, hovering around the 115 mark at the minute (week 33). I've been told is that if they drop below 100 i'll have to meet with the anaesthetist. If they go below 80 by the time I give birth and I need a c section, ventouse or forceps, midwife has said I wouldn't be able to have an epidural and may have to have a general anaesthetic.

[Mummyme87]

Only difference is they may want you to have a cannula during labour, active management of third stage and less likely to have an epidural or spinal. Cut off is different at different hospitals for epidurals. Our cut off is 70

[Mummyme87]

You shouldn't need continuous monitoring or extra examinations

[AtticusTheRoman]

Thanks all. What is active management of the third stage? I am really really against having a cannula, I can't bear them.

[Mummyme87]

Active management of third stage is injection of syntocinon to help contract your uterus after birth, reduce bleeding and assist in delivering your placenta soon after birth. Cannula is to have immediate access incase you bled heavily after birth. This is more likely due to low platelets. In a woman after birth you can bleed out 500ml per minute and in doing that your body shuts down can be very difficult to get IV access .
However, it's all advice, you can decline as long as you are aware of the rationale for the advice and make an informed decision

[iCloud]

They've bloody dropped to 77....

Getting a bit worried now as if they carry on at this rate they'll be below 50 at delivery. I'm 34 weeks.

Apparently homebirth wouldn't be safe and not allowed epidural either.

[Pinklily1]

Hi icloud, sorry to hear they have dropped. Have the hospital said an absolute no to an epidural in any circumstance?

I'm awaiting a consultant appointment to discuss birth options. Mine are hovering around 120 but have dropped at every test so far in the third trimester (currently 34 +2) and midwife is expecting them to drop more