So glad to have found this thread. I'm hoping to share my story and get advice/opinions. Please be brutally honest with me and if I'm being stupid or ignorant, let me know.
My mother died of "String clots" in 1982 when I was 5 months old. She was taking BCP and smoked 2 packs of cigarettes a day.
In 2003, 16 months after an unwanted cesarean, I was on BCP and developed a PE with no evidence of DVT. I was treated for 6 months with Warfarin.
In 2005, another cesarean. I was on Lovenox pre conception and during the pregnancy. Blood levels (The anti Xfactor or something like that) was not monitored. At 36 weeks, was switched to heparin. I discontinued it at 38 weeks AMA. No problems with clotting during or after birth. OB I saw told me I was at high risk for clots and said I needed to be on the lovenox. Those were in my "Yes Doctor, whatever you say" days.
In 2007, wonderful homewater birth. Baby had pnemonia at birth, and we transfered him to hospital approx 6 hours after birth. He spent 7 days in NICU for IV antibiotics. During this time, I sat at his bedside for at least 16 hours a day, most of the time cross-legged. At 6 weeks pp, I developed leg pain, went to clinic, D-Dimer was 3475 and was Dx'd with dvt and a CT showed suspected PE. The hemotologist tested for Antithrobin 3, Factor 5 leiden, and one other while I was on warfarin, and all came back negative. He suggested a 12 month treatment of coumadin, followed by a Protein C, protien S, and a Mayo coagulation test after discontinuing for 2 weeks at the end of the 12 month treatment.
March 2008 Surprise pregnancy. Conceived while on Warfarin (5mg 4 days a week, 7.5 mg 3 days/week). Discontinued use of warfarin at 7wks 3 days gestational age. Dr & perinatologist said I needed Lovenox with testing to monitor my dose. I said no as I wanted to have the Mayo & protein tests done, so AMA, I discontinued and was tested. Still waiting for results. In the meantime, I did start Lovenox. I'm just a bit scared.
So here's my plan....I will continue Lovenox the entire pregnancy without monitoring of my dose. (I was not monitored in my second pregnancy.) My family dr wants me to see an OB, I do not. Seeing an OB means a cesarean. Since my labors are long, it is likely the lovenox will be out of my system in time for a birth. After birth, I will start warfarin and take it for 6 months (as long as mayo tests come back fine. If they don't then I'll have to see another hemotologist and come up with a different postpartum plan. we're thinking good thoughts though) and have my regular dr follow up with PT/INR. I will have baby at home. The only thing I'm a bit worried about is pph. I do not have access to pitocin. And of course, my family dr will not order it for me since he thinks I need an ob. Also, I can't switch to heparin since I don't have anyone to prescribe it for me.
What do you think?
Sorry this is so long, but if anyone understands my desire for a homebirth, it is you guys. I CAN'T HAVE ANOTHER CESAREAN. I CAN NOT!!
Thank you for reading my story. I hope to get some advice from mamas more experienced than I in this area.