Advice please! Blood thinning injections

[Puddinandpie]

So I had an antenatal appointment yesterday with a midwife, one who i hadn't seen before and initially seemed OK albeit a bit rushed/ talk fast scatty! Anyhow during the appointment I was informed by said midwife that I need to take Enoxaparin injections everyday up until I've had the baby and then after my csection also! Now I've had the injections before for 10 days after my csections previously but never the whole time I've been pregnant!!! That is the bit that is puzzling me, she said its because of how many children I've had (5) and my age (35) and also my bmi (32, but im a size 14/16 I think I hold my weight well just naturally quite a heavy person) I've never had this issue with any of my other pregnancies and though initially just felt confused after leaving the appointment, with it being a new day and having time to think I'm just wondering if it's a good idea to be taking blood thinning injections all the way up to my csection when i haven't before and also forgot to add I saw the consultant/registrar last week who merely looked at my notes offered me a gestational diabetes glucose test and booked my 4th csection explaining there maybe complications/there may not just keeping taking your iron tablets and well see how it goes! Also I forgot to add I have heomorrhaged several times throughout labour/csections also!!
I think I'm just asking if anyone has been in the same boat or whether any other midwifes, Dr's on here think this is ok to take and go ahead with!

Sorry if it's a bit all over the place with my typing, I just feel very confused 😕

Hi. I had blood thinning injections for my second pregnancy after having a blood clot post C-section with my first and being diagnosed with a blood clotting disorder. It was absolutely fine and I had a planned c section and as from memory you have to stop injection the day of the c-section, although my daughter was early so it just delayed what became an emergency section by a few hours. All was fine afterwards just post birth bleeding was a bit heavier due to it being thinner blood. Worst part really is your tummy will be bruised sometimes from the jabs but you will soon get used to them ( top tip is to put the needle in where your skin is whitest so you don’t hit a capillary). I would of course double check it with your consultant if you are unsure if you need it or not

I was on fragmin injections with my twins and 6 weeks after they was born

If you're not sure then call the midwives again on Tuesday and say you'd like to have another conversation about it to understand the risks and benefits

You also need to understand WHY you’ve been prescribed this medication. Have you had clotting problems in the past that nobody’s told you about? (*Never take medication unless you know exactly what it’s for and why you have been prescribed it.)

I only needed enoxaparin injections for 6 weeks after my third pregnancy but for my fourth I had them from 10 weeks until 6 weeks post-birth. They have very definite criteria around age, weight, previous clots (I'd never had one) and number of pregnancies. The fact it was my 4th tipped me into the category of 36 weeks' worth. I joked the multiple bruises on my stomach was the baby trying to kick its way out!

This is what is advised in our trust if you have those 3 risk factors which are classed as age equal to or over 35, BMI over 30, and have had 3 or more babies. You would have a pre op assessment for a planned c section and be advised on stopping the injections beforehand so that it is safe for the c section- the anaesthetist you have the appointment with should advise you on when to stop them. They will need to be stopped for you to have a spinal anaesthetic.
You could always arrange to speak to your midwife again to discuss the reasoning behind this but it is a clinical guideline she has followed. All the best with your pregnancy x

Ladies thank you so much for all your replies, they've been a big help, I just don't get why the consultant didn't say anything about it or put me on them when I saw him the week before, also I did explain to my consultant that I have endometriosis and that's another thing I'm worried about with regards to blood thinning as I already spend everyday essentially bleeding internally! I think i may have to phone the hospital which is a pain in the arse as I can never bloomin' get through to speak to anyone who knows anything!

I also think another reason it has made me think twice about taking them, is that they are just sooo unorganised there, the midwife kept saying about my due date and I kept having to say no I'm having a csection early so the due date is irrelevant!

Seems they are not very good at listening, which with all my other pregnancies at different parts of the country, every midwife I had was always so cool calm and collected and listened, this one not so much!!

Definitely ring up to have a chat with them so you can make an informed decision and put your mind at rest. The time pressures midwives and doctors often work under are very intense (appointment slots are very short for everything which potentially needs doing/explaining) which doesn’t help them give the experience they would like to. As for the focus on your confirmed due date, it still determines your current gestation so it is still very much relevant from a midwifery/obstetric assessment/care plan point of view regardless of what date your actually going to deliver on

Depending on your current gestation of course, it sounds like they’re just following the current (easily googleable) RCOG guidelines for DVT prevention in pregnancy. They will give you advice re timing the last injection before a section so that the risk of PPH returns to normal.