Natural Birth with DVT or Lovenox?

[mysonshine]

I am 14 weeks and a couple days. A few weeks ago I ended up in the hospital with a large DVT in my leg, from my groin to knee area. I am now on lovenox (generic) until 6 weeks post-partum, switching to heprin closer to due date.

What implications will this have on a natural birth? Are there things I will *have* to have or do during delivery? Or things I can't do - position, massage, etc?

My last birth was at a hospital but completely no interventions (for lack of better word right now) - no monitoring, no iv start, nothing. And we went home after 24 hours. I was hoping for similar this time around but am now afraid I won't get it. My Dr basically said yesterday "let's wait and see how your leg does" and is having me consult with a high rick OB just to get another opinion. I'm praying the clot will be dissolved by Oct and I won't have these worries.

Any advice or BTDT would be great.

[primipara]

Hi, I'm in a similar situation seeking information...I conceived through IVF, which meant a huge battery of testing. I had a cousin who died from a heart attack at age 31; her twin was subsequently found to have elevated Lipoprotein (a). Sure enough, I was tested and found to have the same thing. The hematologist put me on Lovenox from the day of my embryo transfer. I am now 9.5 weeks pregnant.

I'm hoping for a homebirth.

I've interviewed 5 midwives and the 2 I liked the most, were both very negative about having me on Lovenox for a homebirth. They've referred me to a homebirth-friendly perinatologist for a second opinion. I'm hoping either a) he says I don't need to be on it after all (I am SO Sick of the daily shots!!) or b) he agrees and one of the midwives agrees, to monitor me and come up with a birth plan that will work for everyone. 

hope this is helpful!! 

[rareimer]

i had a DVT in my leg/groin during my first pregnancy.  i ended up having a c-section, but it was unrelated to the DVT and heparin.  there was a bit of a concern about me bleeding more than usual, but the plan was to keep an eye on that and possibly give me pitocin after the birth to contract my uterus more in order to stop the bleeding.  but other than that, i could have had a natural birth.  midwives have the supplies and capabilities to give pitocin to stop bleeding after the birth.

i've been on the injections every pregnancy since.  i tried for a VBAC with a midwife the second time, but for different reasons had another c/s.  i am trying for a VBA2C this time, and there has been no concern regarding the anti-coagulants.  your provider, whether a doctor or a midwife, will know to keep an eye for excessive bleeding, and they have the means to stop it if it does happen.  you will be fine, and there should be no reason you can't have the birth you want :)

[primipara]

Thanks rareimer ! your story is inspiring!
The perinatologist didn't agree to take me off the Lovenox (grr) but he did agree to serve as a consult IF I can get one of the midwives to agree to take me on. I talked to them today and they are both thinking it over. Keeping my fingers crossed! 

[rareimer]

i'm assuming they did testing to see if you have any clotting disorders?  they never found any evidence of one with me, so that's one reason that my pregnancies haven't been *too* medically managed.  a friend of mine has two clotting disorders, and it was strongly advised that she have a c-section with her third baby (they didn't know about the disorders for her first two children.) 

you'll definitely want to stay on the Lovenox for the pregnancy and 6 weeks or so postpartum (and i can't remember why, but switching to heparin shortly before your due date is advised.)  but assuming you have no clotting disorders, there shouldn't be any reason why you can't have a normal birth, even with the Lovenox.

i hope you can find a midwife who will take you!  i wanted one this time, but our town only has 3, one of which i do not get along with, and the other two were all booked up around my due date.  will be thinking of you!