Blood-thinning injections in pregnancy

[Everlore]

I'm currently nearly 23 weeks pregnant with our first much longed for IVF baby. I attended a scan and appointment with a consultant today and while, thank god, everything looks good on the scan and our baby girl seems to be developing well, The doctor recommended that I start daily blood-thinning injections to reduce the risk of clots. She said I have several co-morbidities which increase my risk of thrombosis in pregnancy, I have rheumatoid arthritis, I am over 35, we used reproductive technology to conceive and my mother had a history of severe and chronic vascular blockages in her legs and feet, though after the age of 60. My pregnancy has thankfully been straightforward despite my pre-existing health conditions, but the doctor seemed to think that blood-thinning injections were a necessary precaution.
Both the doctor and the midwife assured me that the injections are perfectly safe and frequently used in pregnancy and I know I'm being unreasonable, but I'm terrified of injecting into my pregnant stomach. I have no problems with needles, I regularly inject myself with medication and am not remotely squeamish, I was quite confident administering the first injection into my belly today. It's just that an irrational part of my brain keeps telling me that I could harm the baby, even though I know she's well-protected and nowhere near the surface of my stomach so I'm not likely to accidentally poke her with the needle. I have been incredibly anxious throughout pregnancy, worrying about the sillyest things and Googling the most ridiculous foods and activities to check their safety in pregnancy. I realise this is just the latest in a long line of intrusive thoughts but I can't seem to shake it off.
I'd love to hear from any other women on here who used blood-thinning injections during pregnancy, how you found them and if you had the same ridiculous thoughts and fears I'm experiencing.

I did it everyday from 8 weeks to the day I gave birth. It's fine honestly !! They do bruise though, but you'll become a pro at it I did.
A clot is more dangerous than blood thinners

I was on them throughout my second pregnancy (started at 9 weeks) due to previous clot history. I totally get where you are coming from especially when baby moves as your just about to inject yourself.

my consultant said I could either do it in my belly or thigh so that could be an option?

I was so anxious in pregnancy after ivf, then a miscarriage then falling pregnant naturally when it was obviously least expected, you can imagine how anxious I was. I wanted the injections because I was terrified of clots (blood clotting disorder) I wouldn't eat barely anything as I was afraid of contamination, movements, boobs not sore, you name it, I was worried about it so I really do understand my ocd was through the roof

Currently injecting them and yes have had massive irrational thoughts about stabbing the baby 😂

I also inject insulin (smaller needle) so I do my clexane (blood thinner) in my thigh and insulin in my lower stomach. Both due to stupid fears! and because my insulin is less effective when injected in my thigh so I don't want to bruise up my stomach and use up my insulin injection sites.

The Dr was perfectly happy for me to do thigh injections so works out quite well!

Hi @Everlore. I had blood thinning injections throughout my pregnancy with my second baby and for 6 weeks afterwards as I had a blood clot after giving birth to my son a couple of years before. You will be absolutely fine and will soon get used to doing them. You will get some occasional small bruises on your tummy but otherwise will be fine. I would be asking about a birth plan as I had an elective c section as it was easier for them to plan around when my last jab was and when I would deliver to avoid the risk of excessive bleeding at the birth. My daughter was a healthy thriving baby and is now a beautiful teenager who is studying her a levels. I will say though that at first I felt very frightened and worried about the injections and the birth so do let your midwife know how you are feeling and ask for extra support.

Can't you inject into you upper thigh? Have to warn you the bruises are shocking !

Thanks so much for sharing your experiences anyway, it's very reassuring. I've been fortunate enough never to have had a blood clot previously, but I'm aware that due to the various risk factors I mentioned in my OP that I am at a higher risk so I can see the need for the injections.
I did ask the doctor and midwife if I could inject into my thighs and they were quite adamant that I should inject into my stomach, maybe I could ask for a second opinion.
I do inject my rheumatoid medication into my thigh so I suppose there's a danger of running out of injection sites if I were injecting both into my thighs.
Thanks again, I'm glad I'm not the only one who has these apprehensions!

I am also a bit concerned since I have read that the blood-thinner I'm taking, Fragmin, should not be combined with aspirin. I have been advised to take 150 mg of aspirin daily until I am 36 weeks pregnant and the doctor today told me it is fine to keep taking it along with the blood-thinner, even though I have read contrary information online. Has anybody else taken both together in pregnancy? I'm definitely over-thinking this now but it's really worrying me. Thanks.

Me. Used it during IVF then from round 20 odd weeks to the birth. Then for 6 weeks after the c section. Babies (it was twins) were fine. I was totally sick of it by the end though. I went for injections in the bum as the skin on my stomach was too taut in the end and thighs hurt too much

If you already inject into your thighs then they wouldn't like to increase the amount of injection into that area.
Regarding the aspirin, the BNF advises to use with caution. Your consultant will have assessed the risk against the benefit and have a far deeper understanding of the interactions than a quick google will provide either you or I with. If you are very concerned then ask your Midwife, however I would personally be placing my trust in my consultant and his years of training rather than google.

It will be because they are both blood thinners, there is often a flag for drugs that have the same mechanism of action. There is usually the caveat of *unless clinically necessary and under medical supervision.
They just don't want a person taking one blood thinners to then get aspirin from the supermarket for a headache.

The antiemetic I was prescribed for pregnancy sickness is available over the counter but I can't get it over the counter because of another medication I am on means a pharmacist can't prescribe it.

It will be because they are both blood thinners, there is often a flag for drugs that have the same mechanism of action. There is usually the caveat of *unless clinically necessary and under medical supervision.
They just don't want a person taking one blood thinners to then get aspirin from the supermarket for a headache.

The antiemetic I was prescribed for pregnancy sickness is available over the counter but I can't get it over the counter because of another medication I am on means a pharmacist can't prescribe it.

I am needlephobic but I had to use them through both my pregnancies. I never liked doing it but it became tolerable. Both babies were fine. I preferred to inject into my stomach as I found it less painful. The only problem it created was when they wanted to do an EmCS but I had recently taken my blood thinner (for numerous reasons they decided against it at the last minute but they were talking about blood transfusions, etc and it got a bit scary).

Just be aware that, as far as I know, you won’t be able to have an epidural (this is what my consultant told me). My last delivery was 10+ years ago and things may have changed since I was told this. Maybe other posters can/will correct me if I’m wrong.

that's not completely true. So long as there's a 12 hour interval after the last dose of fragmin/clexane when it's being used prophylactically then a spinal or epidural should be possible (24 hours interval needed for a treatment dose). Same advice existed 10 yrs ago so perhaps something got lost in translation.

Usual advice for women who are still taking LMWH at term and planning a vaginal delivery is to stop taking it at the first sign of labour (or stop taking before starting the induction process). It may be worth exploring the other modes of analgesia available in case you need something stronger before the fragmin's gone (eg. remifentanil). For a planned c-section usual advice is to stop the day before. If an expedited delivery is needed before the drugs have had chance to wear off then a GA would usually be the safer anaesthetic. HTH.

I injected Fragmin throughout my third full-term pregnancy, after a total of 6 mcs, so you can safely assume I wouldn't have done anything to jeopardise the baby (who is now 9 and across the room from me).

I took it from 6w through to a few months after birth. I was also on 150mg of aspirin.

I found my stomach the less painful option, try and ignore the irrational thoughts, after a week you won’t even think about it anymore.

I went into labour early (planned section), but still had the section and had taken the aspirin and injections the night before as usual. No problems at all.

(To add: I injected into the abdomen)

I had to do these injections in my last 3 pregnancies due to age and other health problems I started them when I first saw the consultant at around 13 weeks. I couldn't inject myself in the stomach so I used to inject into my thigh. I also had to carry on taking them after giving birth for 1 month

I have been injecting fragmin and on 150mg aspirin since positive test. Well ive just stopped both now at 36 weeks as instructed. I really didn't like injecting but I managed every day. I used an ice pack before and after. It really helped.

I injected into upper thighs

My eldest asked if the baby was trying to kick its way out!

I was in hospital overnight for an op more recently and a nurse gave me one in my upper thigh - the bruise was something else I never bruised that badly from doing the stomach.

I've been on the blood thinner injections since 28 weeks & will be until 6 weeks postpartum. I was told thighs or abdomen but have been mainly doing abdomen as like some PP have said thighs hurt wayyy more and bruise a lot more too. I felt weird injecting in the stomach where the baby is too so it's not just you! But you do quickly get used to it. I'm also on 150mg aspirin until 36 weeks x

Me too, the bruises were unbelievable, had to do it myself every day for 10 days, I was black and blue!!