A cautionary tale

[Fuschia]

http://www.rcht.nhs.uk/DocumentsLibrary/RoyalCornwallHospitalsTrust/NursingMidwiferyAHP/ThromboprophylaxisDuringPregnancyLabourAndAfterVaginalDelivery.pdf

[Vickster]

Yeah, I thought as much myyself. The manufacturers also list the possible side effects to the baby that have been reported, but then go on to say that the reported instances are no higher than that in the general population, so important to put these things into context.

[Fuschia]

I would worry more abou the timing of labour than the bf after side. I note from that Cornwall NHS guideline it says 12h after prophlyactic dose, 24h after treatment dose (for epidural or spinal anaesthesia) so depending on Kings guidelines, unfortunately you do have a bit of a dilemma about whether to opt for induction to guarantee your access to those things...

Are you under consultant care now for the pregnancy? If you haven't yet been referred to a particular one, i'd suggest leonie penna. Good to have a nice clear discussion about the various ins and outs.

[Fuschia]

PS Not that I am usually keen on induction AT ALL but once you choose against it, you do risk needing a GA if a CS becomes necessary, so it was certainly a bit of a gamble in our birthplan for the twins.

DS1 being a fast, easy birth, luckily epidural never became an issue 9and I'd taken my dose in the morning, missed the evening as I was in labour. . I don't think Kings have a 24h policy, because IIRC we would have been OK with my last dose being 12h previously.

I had agreed if I used the pool to get out before the birth in case of bleeding after. There was also some discussion about injecting vs oral Vit K, but I got the oral protocol i wanted. Also worth agreeing how quickly you can leave hospital after.

Def worth discussing with obstetrician, the supervisor of midwives and if you have one, your own midwife, so you can formulate a plan you're happy with with the switch from home to hospital birth.

[Fuschia]

PS Might see you in haematology clinic, I go Tuesday ams, monthtly atm. They are lovely there, much more caring than antenatal or scanning depts, ironically! The receptionists are so apologetic if things runs late.

[Vickster]

All really good advice, thanks. I am seeing the consultant on Wed so will see what she says. As if labour wasn't stressful enough!

[Fuschia]

Vickster Wrote:

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> All really good advice, thanks. I am seeing the

> consultant on Wed so will see what she says. As if

> labour wasn't stressful enough!

It should be a question of them explaining the issues to you so you can agree on a plan... there is nothing that is FIXED and you MUST do, more a question of exploring how you can get the best fit between their protocols and your birth plan wishes while minimising risk. Take someone with you? You have tiem to finetune and discuss further with MWS anyway. MWs are less risk averse and don't "lay it on the line" in the same way, I've found.

[Vickster]

May well see you at the clinic Tues am, I am due to see them at 9.45.

[Fuschia]

I will be there this Tues. My appt isn't till 11 but they always let me come straight after the school drop and squeeze me in. I get my blood taken in clinic as I am in a study, see the dr then usually have something to eat while I wait for my drugs from the pharmacy. Perhaps we can have a coffee. Wull PM you my mobile no if you like.

[Vickster]

Sounds good, thanks

[pripolla]

Re breastfeeding: I was on warfarin for 9 months post birth and breastfeeding all the time.