Midwife vs pharmacist

[Muda]

I had my booking in appointment with the midwife and she has prescribed me baby aspirin as I have high risk of high blood pressure. I went to collect it from the pharmacist And he told me I shouldn’t take it as it had a high risk of miscarriage. I’m so confused who do I trust? Should I or shouldn’t I take it?

I'd phone the midwife back. Or my hospital.

Did the midwife prescribe it or did the doctor? My midwife requests prescriptions for her patients through the doctor at our surgery so I would trust him. The pharmacist couldn’t give me over the counter medication as it claimed not to be suitable in pregnancy so told me to go to the doctor for a prescription.

It's pretty standard now for low dose aspirin to be recommended. The problem is that as it is an otc medication you don't have a prescription and some pharmacists will interrogate you about it. I ended up buying it in my supermarket shop or sending my husband for it.

He seems muddled anyway - it is thought to reduce the risk of miscarriage.

I took it on the recommendation of my ivf clinic.

I was prescribed it (obese), and the pharmacist queried it - he rang the hospital and spoke to the consultant (I have no idea how he even managed it!) and dispensed it after that chat.

In the end I read up and didn't take it - I wasn't at personal risk of high blood pressure apart from the obesity (never in my life had high blood pressure), but I did go very over-due on my first pregnancy, and what I'd read said that it increased the risk of that, so I didn't bother.

I, also thought that it was one of the medication given to women who had repeated miscarriages to try and prevent them, although they weren't sure yet why it worked.

Talk to your midwife, if you're happy with it, either have the pharmacist ring her, or just try another pharmacist :)

The midwife requested it through the dr. It’s 150mg dose. Then just went to pick up the prescription and the pharmacist said you’re pregnant do not take these it increases your risk of miscarriage and I said why would the midwife prescribe me them in the first place If that was the case?! I am only 7 weeks 4 days and would hate myself if I took them and then miscarried.

@eurochick do you know how it is supposed to reduce miscarriage?

@TreestumpsAndTrampolines thanks for your reply- why did you decide not to take it in the end?

Aspirin at either 75mg or 150mg is commonly used in pregnancy depending on your risk factors for high blood pressure.
Aspirin shouldn't be used at the higher painkiller dose of 300mg during pregnancy, better to use Paracetamol instead for pain relief.

I decided not to because of the increased risk of going overdue (I was 40+2 with my first!), and because I didn't feel that the consultant had either listened, or tailored my treatment to me (I remember her frowning and thrusting a leaflet at me when I asked why she was prescribing it, which didn't inspire confidence) - I'd never had high bloodpressure in my life or previous pregnancy, I was active, every other level was perfect, glucose tolerance, iron, the lot, my mother the same. I was active and healthy - just fat. So when I did research, I decided that the benefits (reducing risk of high blood pressure I didn't feel I was likely to have) didn't outweigh the risks (increasing risk of going overdue, which I already expected to have).

If you are at high risk of high blood pressure for other reasons, your decision making process might be different though - and if your midwife has actually read your file rather than looking at one number on your chart, there's probably a fair bit of weight (no pun intended) in that.

The pharmacist is right on a general population level.

However, your midwife is privy to your medical information on an individual level and has decided that in your personal case it is clinically indicated.

I would go with the midwifes advice, but if you're unsure then ring her to check it's absolutely the right course of medication for you

I took this dose of aspirin after a previous pregnancy with pre eclampsia. They did advise me to get someone else to buy it for me when I started looking pregnant.

I'm on asprin in pregnancy, never had a pharmacist refuse it before but he must be confused. If it's a prescription by the Dr I don't see how he can refuse to give you it. I had the similar thing when in labour last time, hospital said take cocodamol and the pharmacy wouldn't give it to my husband as they asked him who it was for and he told them. They said not in pregnancy. So he phoned the hospital to double check then went to a different chemist and said it was for himself 🤷‍♀️

I would go with your medical team. Pharmacist have their uses but they are lacking your personal medical background that allows informed decisions to be made.

When I was 7 months pregnant my partner went to collect my prescription that I had been taking the whole time as agreed with my consultants. The consultants decide that the risks associated with me not taking the medication was greater than taking it. The pharmacist was only looking at the risks of the medication. They made him waited whilst they looked it up and begrudgingly let him take them. I think the result came back as can be prescribed if necessary or similar.

I’ve had years of recurrent misscarriages, all when not taking aspirin. As soon as I found out I was pregnant this time, I was put on 150mg of aspirin daily and I’m 35 weeks with my little girl. I’ve no history of high blood pressure (in fact it’s always low) or history of any, or high bMI. Never been refused it by the pharmacy, they even helped me source it at the beginning because it was the start of the pandemic and it was in short supply. It is commonly taken by women who have suffered misscarriages, so quite the opposite of what the pharmacist said. I would listen to your midwife.

Hi OP,

I was prescribed aspirin due to being a FTM and obese.

As aspirin is so cheap, I didn't even bother going via a pharmacy, just bought some from Asda. A lot less faff.

I've been taking it since 12 weeks and I'm 27 weeks now. No issues with pregnancy, so far.

I’m on 75mg of Aspirin as I have 3 markers that make me an increased risk of preeclampsia. A prescription of low dose aspirin is very common in pregnancy x

I haven't worked in pharmacy for a few years, but was a dispenser for over a decade. Assuming nothing has changed, the issue is the licensing - most aspirin isn't licensed for use in pregnancy (due to to increased risk of miscarriage), and therefore can't be sold OTC if it's for a pregnant woman. Generally speaking, it's fine if on an FP10 prescription because the prescriber has knowledge of your individual circumstances, and has decided that the risk from taking it is less than the risk of problems if you don't. We would never have sold you it over the counter, but would have given it if you'd come in with a prescription for it.

Thanks everyone you’ve all been very helpful with your replies. I will trust in the midwife/drs choice to put me on it. I’ll be seeing her for bloods soon so will mention the conversation with the pharmacist.

I had a similar issue years ago. Midwife prescribed it. Went to collect it and they refused it. Then it was referred back to the doctor who okay'd it. Serious lack of communication tbh. I did end up having it and taking it. I have a family history or pre-eclampsia and I did have high bp with my first (this was my second I'm talking about above). No problems with it.

I took it for the first trimester in both pregnancies due to recurrent miscarriage previously. It’s really common - surprised your pharmacist wasn’t aware.

Hi,

I was put on low dosage of aspirin along with other medication to help my pregnancy by the recurrent miscarriage clinic. Seems the pharmacist had a bit of a mix up.