Low dose aspirin?

[ChunkyPickle]

I had a perfectly fine first pregnancy, in a different country - I was healthy throughout, booked in for a home water birth (which didn't happen as I went rather overdue, inducement didn't work, EMCS), mother and baby completely fine though - no problems whatsoever, baby average size.

I have a BMI of 40 - I did throughout the last pregnancy (didn't put any weight on), I do now, nothing has changed, I've always been porky.

This pregnancy I'm back in the UK, and everyone seems to be absolutely freaking out about my BMI - to the extent that I'm being offered extra scans to make sure the baby doesn't get too big, loads of appointments and tests.

At my first consultants appointment, at 20 weeks she said that she was giving me a prescription for low-dose aspirin to take for the next 6 months to prevent blod clots. I didn't question at the time, but the pharmacist when I filled the prescription was rather surprised, and now that I've looked around the internet (including NHS sites) I don't understand why I've been given it. The only indication (according to action on pre-eclampsia ) seems to be if I was at high risk of pre-eclampsia - which I'm not really - it's not my first pregnancy, I didn't have it before etc. My only risk factor is obesity, and I'm not sure that that balances well against the potential issues when taking aspirin in the last trimesters.

In fact, I feel a little as though they've ignored all my history, and current circumstances, and just put me on the fat woman plan.

I will call a midwife about it (not that they seem to pay much attention to history either), but I'm considering not taking the aspirin - does anyone know anything more about it?

Sorry about the essay - I wanted to get everything out in one go..

I was put on it for my first 12 weeks because I had previous mc and they said I may have to take it throughout because my bmi is 32. But I like yourself don't want to be taking it unnecessarily as I don't like the idea of keep taking tablets. Plus my midwife said the aspirin could have caused the bleeding I had so I stopped taking it at 10 weeks.
I am going to see what consultant says but don't want to take them right through pregnancy as I'm not massive (a size 16) xx

Hmm - Yes, I'd heard of it as a medication for people who'd had repeated miscarriages, but that isn't the case here - no miscarriages, and only starting at 20 weeks.....

Still not happy that 'you're obese' is enough of a reason... wonder if I can get the consultant on the phone instead.

I would because I am going to question it when I go back! I'm not happy with the ur fat take these attitude lol x

I'm on it for ore eclampsia risk and haven't had any problems with doing so, but I can see that doesn't really have anything to do with your case!

I was on aspirin with DS because one of the scans showed that the bloodflow to the placenta wasn't great, and the consultant said that aspirin would make it easier for my blood to flow to the placenta and therefore help DS grow properly - but that doesn't seem to have anything to do with your case!

Also, the pharmacist I went to refused to give me the aspirin until she'd rang the hospital to check that the (obstetric) consultant knew I was pregnant and hadn't prescribed it be mistake. And the area I live in has one of the highest obesity rates in the UK, so if the pharmacist was reacting like that, it can't be that common for pregnant women to be prescribed aspirin simply because they're obese.

I have a checklist (for ladies with a high bmi) which says to perscribe aspirin if two or more risk factors are present.
Raised bmi is one, as is being 40+, first pregnancy, previous family history of PE, large gap between DC, or previous pregnancy induced hypertension.
That said, my consultant decided not to give aspirin when I booked in at 5 weeks and I had PE last pg.

Interesting, - I have no other risk factors there RugBugs, and ShadowStorm, that's another good reason to know then - but also not a problem in my case.

Right. On the phone I get to find out exactly why she thinks I need it

It is as much for your own health as for the baby. Due to your increased weight you are at higher risks for blood clots. Pregnancy massively adds to the risk of blood clots. If you did get a thrombosis it could end up on your lungs. A blood clot to the placenta would seriously endanger the baby. Is your blood pressure higher than they would like?
I took low dose aspirin all through my last pregnancy and other anticoagulants that I had to inject. I do have a history of miscarriage though. The dosage is very very low and I saw no problem with taking it. At the end of the day it is up to you though.
I think there is no point taking offence about something offered due to your weight. The fact is that being fat does add to your risks (I am also overweight myself), you can't change your weight now so they are trying to help you manage the risk.

I'm not taking offense due to my weight at all, I know I'm obese, I know that increases many risks and that I need to manage them but I've read around and taking the low dose aspirin increases various other risks, so I need to balance those increases, vs. the risks it's lowering.

This should have been properly discussed with me, so I can make an educated decision, rather than what happened which is have the medication given to me with no explanation of the risks it's mitigating or increasing.

I have no other risk factors - I'm not over 40, I've never had high blood pressure (it's perfect every time - not even slightly high) or diabetes, I eat well (just a little too much it seems) I exercise regularly (plus I have a toddler), I had a trouble-free last pregnancy - so by everything I've read, I should not be on the aspirin because the risks out-weigh the benefits - yet the consultant has prescribed them for 6 months (again unusual - many others here stopped at 30 something weeks) with no explanation - not many people would take unexplained medication - let alone when pregnant.

OK, no more reading until I've actually managed to talk to someone qualified, but, the CLASP study (for preeclampsia) found no problems for the mother or child with taking the low dose aspirin, and a small decrease in preeclampsia for those at low risk (greater for those at high risk) - although the FDA does still warn about it in the 3rd trimester.

What's interesting is that it inhibits prostaglandin, so has a positive effect on preventing premature births - or presumably, in my case makes me go even more overdue (as an obese woman I'm at a higher risk of going overdue - 12days last time)... since she will 'allow' me to go to 41 weeks for vbac and then she will break my waters and give me a drip (will she hell.. I'm not being induced) that's something they could have mentioned surely (or are they waiting to surprise me with later?)

Really? Aspirin has a positive effect on preventing premature births?

DS was born at 34 weeks (spontaneous labour after PPROM at 33 weeks) - and I was taking aspirin daily from about 20 weeks - I wonder if he'd have been born even earlier without that?