Declining DVT injections.

[najs89]

Has anyone previously declined DVT injections? I was told at my initial midwife appointment that I would need them due to my BMI. I told her I have a lot of anxiety around this and she became quite rude with me. I understand that they have to be honest and to the point but having one of my reasons being called 'ridiculous'. I'm needle phobic. I can just about bare having an injection but there's no way that I could inject myself which would be on a daily basis. My only risk factor is my BMI (but I'm also 6FT tall 🤭). Was really hard being spoken to like that as a young first time mum. I found her patronising from the beginning of my appointment. I have an appointment at the end of this month with the consultant where they are going to start me on the injections. But I've decided I want to decline the injections but I'm really anxious about how to tell them this, if they're going to question me or my decision and overall just being judged. Anyone experienced this before? 😔

100% it’s your decision but have you really thought about this? The dangers of DVT are very serious (but I completely understand the problem, I have severe anxiety and absolutely avoid a hell of a lot because of it)

Could you have someone there to inject you instead of injecting yourself? Like an epipen is ideally done by yourself but can be done by someone else and it’s very hard to screw it up!

I’m not trying to invalidate your fears just trying to find a possible solution round the problem that doesn’t pose a risk to yourself or the baby.

Your fears are valid but a DVT or worst case a pulmonary embolism can be fatal, although your only risk factor is BMI this combined with pregnancy which alone increases your risk of a blood clot is good reason to have the injections.

I had them after my baby was born and although I was hesitant at first, after the first few Injections they were fine

What was your BMI at the booking visit? You mention one of your reasons was called ridiculous - which one?

I agree with the others. You are of course free to decline any treatment you don’t want, but it would be a shame if your phobia prevents you from getting the care you need, especially for something so important. Hopefully the consultant will be a bit more sympathetic than your midwife, but my advice would be to go into the appointment ready to have an honest discussion about what the risks are for you as an individual, and to have a good think about whether there is anything that can be done so you might be able to face the injections (eg arranging for someone else to do them)

I would focus more on getting some help regarding your phobia than dismissing potentially life saving injections. There are plenty of free online cbt courses and books/audiobooks you can get.

Depending on what happens during your birth you may have to take the injections afterwards, so just avoiding them isn't really an option. I agree that you would be better looking into ways to deal with your phobia than avoiding the injections.

I understand you think having just one risk factor doesn't matter.... But they have found that is a risk factor for a reason. I wouldn't ignore that reason.

You need to get help for your needle phobia as the outcome could be so much worse if you dont do it. I understand as i have a needle phobia but i just get on and do it now if i need any needles doing. The midwife shouldnt be rude at all but she could be very stressed with whats going on in the world that someones refusing a potentially life saving treatment is bound to irritate. (Again not condoning her being rude.) What reason did she say was ridiculous?

I think you need to speak to the consultant about your concerns. BMI alone is not generally enough to recommend thromboprophylaxis so unless it is extremely high or you have other risk factors that your midwife didn’t point out it may be that you don’t actually need them. Of course if they are recommended you can decline them, just like any treatment, but thromboembolism is one of the main causes of maternal death in this country so if you are considered high risk I would consider this very carefully indeed.

It’s your decision, I’m just not sure why you would decline something which is intended to offset a real and present risk of DVT/PE, which is fatal. You have two risk factors - being pregnant is a risk factor on its own.
Nobody likes needles or injections but they wouldn’t be offering these things to you without a good reason. I advise you have a good think about it before you decline as you may end up regretting it if you develop an avoidable complication like a PE

I should say, potentially fatal. Usually not fatal

‘I’m also 6ft tall’

BMI takes height into consideration, so I don’t see how that is relevant. A high BMI is a concern in a person who is 4ft 11 or 6ft 2.

Aside from that, @MadameJosephine‘s advice is sound. I’d go with that. All the best with your pregnancy and birth, OP.

I know needles are horrible but the anticoagulant ones are only into your fatty tissue and don’t hurt anywhere near as much as a vaccination into muscle. Is there someone else who could inject you? Your partner or a neighbour?
I’ve worked in rehab before and we had a patient who had developed a DVT (clot in a big vessel) following a c-section. It had broken off and gone to her brain causing her to have a stroke. As a result she was weak on one side of her body, she couldn’t shower herself, communicate clearly and had some major personality changes. Much of this damage was permanent and she was unable to ever go home and care for her baby. Of course you can refuse the injections but really think about the pros and cons and weigh up what you can live with first.

I have a needle phobia too. Like I get close to crying and the anxiety before having them is unreal. But I know I have to be healthy and the health of my child comes first too. It’s your responsibility to make sure you are in good health, especially if it can affect your child.

Hello. I'm new here so I hope I'm doing this correctly. I'm currently pregnant with my 4th baby. Im Due in October. 13 years ago I had a suspected PE which the doctors think travelled from my leg. I had injections in the hospital and never had an issue again. I had my last baby 10 years ago, so because of these two factors, the consultant has told me to take 150mg of Asprin daily to prevent pre-eclampsia and I'm to have daily injections of Dalteparin. I thought this was excessive and have the choice to decline, I'm sure the doctors will keep us right. I hope all goes well for you :)

I'm sorry - it is horrible - I just wanted to share my story.

My sister had DVT a few years ago. As a result, when she became pregnant a couple of years later she was on blood thinning injections from the start of her pregnancy. I was three months ahead of her with my first pregnancy and ended up having to have the injections also - I moaned so much about them.

Three months after I had my child, she delivered a stillborn which was directly related to another (undiagnosed) blood clot.

I'm pregnant again and have been injecting myself since the earliest I could. She had a stillbirth even when she thought she was doing everything she could - I personally would do anything I could to minimise that risk.

I appreciate that my scenario is different - we have a couple of blood clotting disorders so the need for the blood thinners is really important. And I'm extremely fortunate to not have a phobia of needles. But I just remember how much I begrudged doing those injections the first time round (sometimes skipping a day) and the guilt I felt knowing that 'could' have been my outcome also.

I really am not trying to trivialise a phobia - I've thought long and hard before posting and I hope this isn't taken the wrong way. My family have lived through the heartache of a blood clot through pregnancy (twice - she went on to have another baby!) and just wanted to say that it does happen and in my experience unfortunately the consequences can be tragic.

Sorry for the late night ramblings!! I wish you all the best in your pregnancy x

DVT and PE used to be the leading cause of maternal death in this country. Then, after years of research and endless begging and fighting for funding, risk assessment and thromboprophylaxis in the form of injections was introduced.
I wouldn't recommend refusing the injections if you have been assessed correctly.
Has your midwife suggested any strategies to help you with your needle phobia?
What about blood tests?
My dd had needle phobia and she did self hypnosis, music and getting someone else to do the injection while she focused on looking at a distant object.
It is worth a try.

There’s some evidence that being tall (6 foot plus) can increase your risk of DVT or PE, I’m afraid. Please think very carefully before declining the injections.

Hi!

As everyone has said I really would recommend speaking to someone about your needle phobia, before getting pregnant I had a horrific needle phobia and would hyperventilate and pass out after getting bloods etc , I didn’t sleep for a week before my first booking appointment and almost cancelled as I was terrified.

I told my midwife before the appointment and she really helped me manage it, she let me lie down, told me to manage my breathing and advised different ways to help which I have been looking in to. I have found headphones with music helps distract my brain.

Don’t get me wrong I still get anxiety around needles but I’m able to manage it much better and I find that thinking of baby and how I’m doing it for him and just not allowing my mind to drift into my panic really helps!

I hope all goes well for you, I know how horrible needle phobia is in pregnancy

Its not just for DVT. It can (with aspirin) help prevent pre-eclampsia / placental blood clots in obese / morbidly obese people too (these can cause growth problems and still birth).