Low platelets

[wejammin]

I'm 36 weeks, at my 28 week appointment my platelet count was 139 so the midwife repeated my bloods this week and it's down to 117. My count at booking was only 179 ( normal range is 150 - 400).

I've now been booked in to see the consultant on Wednesday and I'm worried that they will say I can't use the birth centre and birthing pool.

This is DC3, I've had 2 unmedicated hypnobirths in the pool and I would be gutted if this time I couldn't try the same.

Anyone had the same and know how low platelets are dealt with? At what point is the birth centre a no go? How much can I push for a risk based assessment?

Hopeful bump

Is your birth centre next to a consultant led unit? Or does your consultant unit have a pool in?

If you’re birth centre is next to (as in under the same roof) a consultant unit then although not strictly advisable you could still choose to deliver there and I’d say that was still a safe option. Or some consultant units have pools available for high risk women.

Essentially they will be worried about you bleeding so they may advise that you have a cannula in but you could still use a pool just keep that hard out of the water!

They would also recommend an “active” third stage of labour so would suggest you get out of the pool quickly if any heavy bleeding after delivery.

Thanks @Belle723. The birth centre is down the corridor from the labour ward. The labour ward has one pool but the birth centre has 5.

I don't mind a managed 3rd stage, I had one last time as the placenta took an hour to come with DC1. No bleeding issues then though.

They might repeat your bloods again 2 weeks or maybe weekly from your last but it’s honestly not too bad. They just need to give you the risks and you can make an informed choice about your care. I’d say you could stay on the birth centre with a cannula no problem - good luck!

This happened to me with my first pregnancy and I'm worried about the same thing again. I was due to give birth in a standalone midwife-led unit in my town, but at one of my later appointments my midwife noticed that my platelet level had been steadily dropping with each blood test. So she did repeat bloods and sent me off to see the consultant, who of course said he wanted me to birth at the hospital to be on the safe side - so annoying (although I understand that caution is important of course)!

If I'd been in a situation where I had access to a MLU within a hospital then I think I'd have argued about it and asked to still birth under midwife led care. But transfer time to hospital was an issue in my case.

I didn't experience any undue effects from my supposedly low platelets during my birth and my post birth bleeding was all totally normal. Although as it turned out I ended up being induced due to rupture of membranes, so in the end I'd have birthed in the hospital anyway.

This time my starting platelet level wasn't even that high (don't have my notes on me), so I'm definitely concerned about another consultant led birth and missing out on the birth experience that I would prefer. Although obviously baby here safely and me in (the best part of) one piece is more important, but it's still frustrating!

I've had low platelets in my first and current pregnancy. Absolutely nothing was done about it with my first, no consultants, only mentioned in passing. This time it's low again and all I was told us that they'd take extra precautions for bleeding should I have a c-section.

Thanks for responses. My friend who's a junior obstetrician thinks I should be able to argue the toss for the birth centre. I really hope so. I wonder if this is a new "thing", it's never been raised with me in any other pregnancy.

Just an update in case anyone else is in this situation-

I saw a senior registrar yesterday (was supposed to be a consultant but he was busy) who was very unconcerned about the whole thing. He said it’s relatively common and nothing really to worry about unless levels get significantly low.

Midwife has to take more bloods next week and then when I’m in labour triage will do an urgent platelet count. Provided levels stay over 100 I can use the birthing centre and pool, otherwise I will be recommended to use labour ward. He did say results can take an hour so I might want to leave for hospital a little earlier than I might ordinarily do.

Am now drinking beetroot juice and taking chlorella tablets to try and keep my levels up, it might be irrelevant (dr said I can’t do anything about it) but I can’t see it can harm me.

Funnily enough, i’ve Just had a phone call from my doctor to say my platelets are low after my 28 week bloods. He wasn’t very concerned and said i’d Been the same in my last pregnancy )but nobody had told me that) but I will need to have my blood tested regularly. Hopefully the level won’t drop and I can still go to the MLU. I’ve worked too hard to keep my BMI down this time round to be defeated by a few platelets!