Second opinions

I come to appreciate that it is good to ask for a second opinion when I find it hard to agree to decision made by a doctor. Two weeks a go my consultant told me to stop taking the low molecular weight heparin (tinzaparin) at 36 weeks. It worried me, of course, because the body’s own blood clotting machine kicks into gear before delivery of the baby so that mum doesn’t bleed to death. That also means that the risk of thrombosis increase in that time period. If they felt it necessary for me to be on LMWH during my pregnancy then surely they shouldn’t take me off it now?

When I asked another doctor he told me it was perfectly fine for me stay on the prophylactic dose until I go into labor. Lots of women do so. The only problem with it is that I can’t have an epidural within 12 hours from the last injection. I am quite willing to take that risk.  The chance of me needing an epidural immediately is extremely slim and there is other pain relief available should I require it. And if they needed to do an emergency caesarean then it would be done under full anesthetic. Ok, that’s not ideal but certainly a risk I can take.  And last but not least: the midwife led unit won’t admit me because of the LMWH and I should not deliver in the birthing pool (but can stay there during labor). The reason for that is that a water birth is very hands off and can lead to severe tears and bruising. That could be a bit of a problem if the tinzaparin hasn’t fully cleared by then. Again, that is a small disadvantage I am prepared to take.

I also asked if the vitamin K shot for the baby could be a problem if he turns out to also be Factor V Leiden positive. Apparently the vitamin K does support clotting when needed (a dn may save the baby from brain haemorrhage) but doesn’t increase the thrombosis risk. Good.  I am quite relieved now.

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