Clexane/Anticoags and a home birth??

[BelleEtLaBete]

Hi all:

Am pg with dc2 (6weeks).

I know I am thinking way ahead, but I would really like to explore the idea of a home birth this time around. I had a hospital birth with DS and didn't really enjoy the experience - it felt so wrong to not be at home with DH and in my own bed.

However, I am on a low dose Clexane injection this time around as since having DS I had multiple blood clots on my lungs (not pg related - I broke my foot and got a DVT which was misdiagnosed as cramp and ended up shattering into my lungs). I've been told the dose is very low, and shouldn't increase my risk of bleeding if I were to be injured etc.

Will this stop me having the home birth I'm dreaming about? I'm going to see the midwife in a few weeks and I'll talk it through then, but I was wondering what other MN-ers experiences were? Any thoughts much appreciated. Thanks.

You would probably be advised not to homebirth because you are not standard low risk. If that is the case, you can request to meet with a supervisor of midwives and get them to help you achieve what you want.

Thanks mayhew. I'm so sure this is what I want, although I am prepared to listen if its not safe.

Any idea if I might be allowed straight home from labour ward instead of having to stay in? All being well, and it being baby number two?

Hi, I'm not any sort of expert, Mayhew is the one to listen to but I did look up Clexane in regard to risk - I was intending to have a home birth, and had a suspected DVT (not an actual one) and they wanted to give me clexane.

Apparently if you're on it through the pregnancy you would stop it a day or two before you were due to have the baby and that should be enough to make the bleeding risk negligible.

I think that's right. I hope you manage to have a HB. I ended up at hospital as they told me my iron was too low - but I was glad to go anyway as I'd have woken the kids with my shouting. Had to stay in till evening, and hated that, no reason just paperwork/discharge protocol but still, all in all it was over quickly. (had HB with ds2 and it was lovely - but no pain relief!!)

My team supported a woman on clexane to home birth. The main concern is if the dose is too high then you can have heavy bleeding. This can be checked with clotting screen at 36 weeks. She was fine.

Unfortunately she had a repeat pulmonary embolus at 5 days but that would have happened wherever she had delivered. That was fine too after treatment.

Thanks Rooney & Mayhew. Glad to see it is possible. Have been told I should be remaining on it afterwards to negate PE risk. My dose is very low - I think it's called a prophylactic dose? The needles are tiny in comparison to the ones I was on when I came out of hospital!

Any advice on how to approach this with the mw? How they might be likely to react?

Thanks so much.

Hi Belle, I'm high-risk for different reasons. My advice is to talk to local doulas/IMs, they will know the local maternity system inside out and can advise you on who to talk to. I avoided seeing an obstetrician but I appreciate you may want to see one for information, just keep checking that what they say is evidence-based rather than their opinion on HB. Do lots of reading. See if there's a HB group locally. It's a journey and only you (hopefully with your partner's support) can decide what's right for you and your baby's birth. Good luck.