previous Blood Clot

Archived User

previous Blood Clot

About a year and a half prior to my first pregnancy I got a DVT.  At my first OB doctor appointment I was placed on a low dose of Lovenox to thin my blood. My OB also informed me that because of my blood clot history, I would need to be taken off of Lovenox and placed on an IV Heparin drip for 24 hours prior to delivery.

Because of my need for blood thinners she is planning to induce me at 39 weeks. Do you have any suggestions on how I can help make this a "natural" process?

Henci Goer

RE: previous Blood Clot
(in response to Archived User)

Let's start with the induction process itself. Here are some suggestions that maximize your chances of having a complication free induction. To begin with, confirm that your ob plans the induction at 39 completed weeks, which would be the beginning of the week that ends with your due date. If your cervix is not yet ready for labor and needs ripening, refuse misoprostol (trade name: Cytotec). For more information on why, I wrote a blog post on Cytotec inductions for Science and Sensibility. Prostaglandin E2 (trade names: Cervidil and Prepidil) work equally well.   I recommend not agreeing to having membranes ruptured until labor is well established and you are making progress if you agree to it at all. If membranes are intact, and the induction isn't working, you can stop the induction, go home, and try again another day, but if the bag of waters has been broken, you are committed to delivery. Once you are in active labor, the oxytocin drip can be turned off to see if labor continues on its own. Often, it will, and if not, the drip can be restarted. You will need to arrange for this ahead of time because it isn't usual practice.

As for making the experience more natural, find out if your hospital has telemetry electronic fetal monitoring or whether you can be monitored intermittently, especially in early labor before things kick in. This will enable you to be up and around, which will make you feel better and can help the labor. Even if you must be tethered to the monitor, you can be detached to use the bathroom, which you should do periodically, and there is no reason you cannot stand up, sit in a chair, or change positions on the bed. It is also possible to avoid pain medication, although it can be more difficult because induced contractions tend to be harder to handle. A good set of childbirth classes oriented toward natural birth can help you with alternative strategies. Finally, I strongly recommend hiring a good doula. Unlike the nurse, who does not know you, has other responsibilities, and will almost certainly spend little time with you, a doula meets with you and your partner ahead of time, knows you and your partner and your goals, will be with you continuously, and has special training in providing supportive care in labor--physically supportive to you and emotionally supportive to you and your partner.  

-- Henci

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