Clexane and labour

[FizzingWhizzbee123]

So I’ve been put on Clexane injections due to blood clot risk. The consultant who prescribed them told me to stop taking them at 36 weeks as I haemorrhaged badly in my last labour, and that I would need a blood clotting injection in labour.

34 week appointment today so I asked if I should stop the injections within the next 2 weeks. Midwife checked with another consultant who said she was happy with me taking Clexane throughout my entire pregnancy.

I can away feeling uncomfortable because, while I can’t remember how much blood I lost last time, it’s enough that it gets mentioned at every midwife appointment. I’m fairly sure my risk of haemorrhaging again is higher than my risk of blood clots (which I was only tipped into the at risk category by virtue of just creeping into the 35+ age bracket this time, otherwise I wouldn’t even be on them).

Anyway, a quick google since I got home has also suggested

1. I wouldn’t be allowed an epidural if the Clexane was still in my system. Having an epidural where possible is a key part of my birth plan
2. Should I need an EMCS, I could t have a spinal so would need a GA, and therefore completely miss the birth of my child!

I’m really not very happy that no one has mentioned these implications to me. No one has asked me about my plans for labour at all. I don’t intend of relying on a birth plan particularly but epidural is the one thing I’m keen on, and I’ve had no warning that this could be an issue on Clexane.

If I was induced or having a ELCS, then I could plan for this as I know it only stays in your system for 12 hours. But this is a second baby and, with spontaneous labour, I may not get the luxury of 12 hours notice!

I’m really worried about haemorrhaging in labour and I can’t see how it’s ok for me to be taking Clexane in labour when I’ve been told I’ll need management to reduce the risk of haemorrhaging.

Anyone else on this and been told to stop/keep taking it up to labour?

My SIL is taking it and has been told to take it until the day before she goes into labour if she wants an epidural which is not the most helpful guidance I don't think. Would you be tempted to request an ELCS? Presumably if you knew the date, you could manage the risks around the side effects - I think that's something she's weighing up at the moment.

That really is unhelpful advice for her because who on Earth knows what day they will go into labour?! Sigh

I’d consider an ELCS but I can’t imagine for even a moment I’d been considered for one by the NHS.

I was induced last time and I really REALLY don’t want to be induced again. Especially with the current pandemic and rising second wave making it more likely that partners won’t be allowed in until active labour. I don’t want to battle through the first part of an induction all alone, last time was horrid.

You have every right to have an ELCS on the NHS - I had one by choice. You might need to pester them a bit and talk to a couple of consultants but if it's what you'd prefer, they should let you have one.

I was on blood thinning injections throughout pregnancy and was told to stop them if I felt any signs of labour. In the end I had to have a planned section as DD was breach. I just had to stop the injections the day before.

Under the circumstances, you might prefer to try to book a c section or ask for induction slightly early so that you can plan to stop the blood thinners the day before section/induction.

Hi there, I have been put on Dalteparin blood thinning injections (due to family history of thrombosis and my age) with the instructions to stop taking them as soon as I feel I may be in labour.

Unlike you, I don’t have the haemorrhage risk, it would be more so that I had the option of an epidural if I wanted it. It also takes 12 hours to leave the system so I’m hoping I might have some warning...

That’s bad that you’ve had to resort to google to discover those two facts; these things were very clearly explained to me on two separate appointments with the consultant. I also had a video appointment with an anaesthetist at 36 weeks to discuss pain relief options if I couldn’t have the epidural and she explained what would happen if I did need a GA. Maybe you will get an appointment a bit closer to due date to talk you through this?

I intend to stop the injection at the very first sign of labour, that’s all I can do really. I hope you get a more in-depth conversation about your options, it sounds like they haven’t explained things properly.

@Quercusrobur you’ve just jogged my memory of another point! I remember a consultant saying an anaesthetist would probably want to talk to me at some point, due to my high BMI I think. That’s not been mentioned since either, no appointment booked that I’m aware of. I’ll need to chase that up too.

I was on clexane in all four pregnancies right up until the babies were born, I was told to skip a dose at any sign of labour and also to contact the hospital straight away.
They offered an epidural for my first but refused, there was no mention of it in subsequent labours.
I haemorrhaged after my second, although he was born over 24 hours after my last dose I was told it wasn't related to that, more to do with him being a large baby.
I also had to continue the clexane 6 weeks after the births.

I’m also apparently having a large baby too 😩 I have one last growth scan coming up at 36 weeks but he’d jumped right to the top of the charts on the last scan. Another reason I’m worried about haemorrhaging again.

I am on clexane and having a planned section due to issues at my first birth and this popped into my head last night that what was the added risk of surgery and risk of bleeding out when on blood thinners!

I have a scan and consultant appointment next week (33 weeks) and will bring it up then as worrying me a lot.

@Sheera1 will you feedback on what your consultant says? I’ll be interested. Although if your section is planned, you’ll be able to know when to stop at least 12 hours in advance so hopefully you won’t have any problems.