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Question to the professionals: Anti-phospholipid Antibody Syndrome and home births

post #1 of 6
Thread Starter 

Hello Everyone 


New to the forums and in the beginning stages of researching. My partner and I are going to begin ttc later this winter / spring and I am in the process of educating myself on any and all subjects to do with pregnancy. 


One issue that is at the forefront of my mind is this: I have was diagnosed with anti-phospholipid antibody syndrome years ago (eight yearsish?) and I was told by my GP that if I were to get pregnant I would immediately be classified as a high-risk pregnancy. As I became more interested in the potential of starting a family I began to research what my condition is and how it would actually affect my pregnancy. I also have become fairly educated on the benefits of a home birth and know that this is the option that is deal for me for a variety of spiritual, emotional and physical reasons. 


My question is this: is there anyone out there aware of home births with people who have been diagnosed with this condition or are people immediately slated for a hospital delivery? I know that every case is unique and that my situation will be based on a number of factors BUT I just want to know if it is possible for home births to happen. I believe that my condition is in remission, I am not on any medication to treat it (nor have I been for years) and in theory, if it remains that way and I have a healthy pregnancy with no signs of it being impacted by APS I don't see why a home birth is not something I couldn't aim for... as what I am led to believe thus far is that the danger of APS is during the developmental stages of pregnancy and not during the birth... or am I wrong... ? I have scoured the internet for information but any (brief) information I have found simply states its a high risk pregnancy and that high risk pregnancies are carried out in hospitals. 


I would love to make an appt and discuss this with my doctor however I am currently overseas for 10 months and will not have the ability to talk to her for sometime and the doctors here do not have access to my personal history ergo would not really be able to offer any light on the situation. 


Any insight into the possibility of a home birth with APS would be great! 

Thank you 


post #2 of 6

Often when women have this condition they are treated with blood thinners during pregnancy. That, alone, would risk someone out of my care. APS puts someone at greater risk of blood clots, pulmonary embolism, heart attack, stroke, etc. There would be some risks associated with the birth itself and not just the pregnancy as a clot could develop on the placenta and cut oxygen to the baby..... or any of the above complications could happen during the birth or postpartum time. (sorry, not trying to scare you.... just trying to be honest and realistic)


One thing that I would recommend is to be sure your diagnosis was correct by looking up your medical records. I have known people who have been diagnosed with this based on 1 lab test, but there are supposed to be 2 positive lab tests at least 12 weeks apart to get a positive diagnosis.

post #3 of 6
Thread Starter 

Thank you for your response, it was very educational for me. While the news can be scary I am really interested in being realistic and educated so thank you! 


Your second piece of advice about the diagnosis is very interesting to me as I am 99% sure I did NOT receive a second positive test. I know several years after I was diagnosed, I was sent to a dermatologist who conducted the tests again and to my knowledge nothing came back positive. This is definitely something I will look into asap with my doctor back home. While not trying to get my hopes up too much, the possibility that I may not automatically have a high risk pregnancy gives me some hope for a home birth yet! Thank you!

post #4 of 6

Patients presenting with one or more clinical features of APS should be tested for lupus anticoagulant, anticardiolipin antibodies (IgG and IgM), and anti-beta.gif2-glycoprotein I antibodies (IgG and IgM)


Initially, positive test results should be confirmed after an interval of 12 weeks or more (15). Persistence of positive results upon repeat testing is confirmatory of the syndrome.


This last year I have looked after 5 women who have various coagulation problems --like MTHFR and Leiden V.  None had a history of miscarriages but had a mother who was positive so they were tested prior to starting contraceptives--and of course can't take birth control pills.


The ONLY one to have a complication was a young girl who was on Lovenox 40 mg a day and assured me she was taking it--I was suspicious that she wasn't as there was not a single tiny bruise on her abdomen.  I explained the risk in simple terms but she was an emancipated 16 year old.   She presented to another hospital with shortness of breath--SADDLE EMBOLISM---she's lucky she lived.  She grew up REALLY fast during that hospital trip.


AS long as you are on you Lovenox and TAKE it your obstetrical risk is not too bad.  Bleeding after delivery really has nothing to do with the coagulation -- it is a more a mechanical method--clamping off blood vessels by contractions.


I think it is WAY less risky than a HVAC2 at home--so don't give up--or try to find an OB who will work with you and has a low intervention philosophy or a midwife working with an OB---they are out there!



post #5 of 6
Thread Starter 

Thank you for your insight. I have been diagnosed with Lupus Anticoagulant but that was a one time diagnosis (the same time i was diagnosed with antiphospholipis antibody syndrome with no follow up tests 12 weeks apart. When I get back to Canada the first thing I am going to do is ask my doctor to test for that and get clear cut answers about if I have it or not and whether I am instantly classified as a high-risk pregnancy if and when I get pregnant. I am feeling better about my possibilities after talking to you wonderful people. Thank you!

post #6 of 6

All I can offer is anecdotal. One client of mine, had her 1st baby at home, no problems, then had a string of miscarriages, another successful homebirth, this time with a delayed pph, which was still successfully handled at home, herbally. We suspected APS, but she declined testing. I've never had a client actually dxed with it.

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