Women with bleeding disorders or who are carriers of bleeding disorder genes may find pregnancy to be a time of anxiety and stress. Although risks vary by the severity of the bleeding disorder, taking certain precautions before and during pregnancy can result in a happy and successful childbirth.
Before Pregnancy and Birth
If you have a bleeding disorder or think you might be a carrier, you should consult with your hemophilia treatment center (HTC) before you become pregnant in order to determine your carrier status. Doctors also recommend prenatal testing in order to take the necessary precautions that may depend on the gender of the baby.
Establish a health care team, including your obstetrician, hematologist and their staffs. The team can work together to make sure you have a healthy pregnancy and to lower the risks associated with giving birth.
During Childbirth
Childbirth is perhaps the most anxious time for women with bleeding disorders. During pregnancy, it is recommended that you do not use epidural anesthesia if you have a bleeding disorder, unless factor levels are consistently above 50 IU/dL. Narcotic pain relievers can be used in place of epidural anesthesia.
You may also worry that your baby might experience an intracranial hemorrhage, or head bleeding, during birth, but there are precautions you can take to reduce this risk. Head bleeds may occur during premature childbirth, so it is important that you take the necessary prenatal care. Doctors also recommend cesarean deliveries for those babies that have potential to be affected by a bleeding disorder.
In any instances of antepartum bleeding (bleeding from the genital tract during pregnancy), a doctor should be notified at the first sign. Depending on the specific issue, treatment is possible.
Another concern you might have is postpartum bleeding and hemorrhaging. Contact your HTC as soon as possible to assess factor levels and plan for the birth.
By taking the time to research ways to keep yourself and your baby healthy, as well as establishing a strong health care team, you can help ensure the process goes as smoothly as possible and take the time to enjoy your pregnancy.
What are some of the ways in which you’ve planned for your pregnancy?
Sources:
Hemaware Magazine:
http://www.hemaware.org/women/womens-bleeding-disorders/pregnant-pause
American Society of Hematology: http://www.bloodthevitalconnection.org/find-a-hematologist.aspx
UCSF Medical Center: http://www.ucsfhealth.org/adult/medical_services/blood/hemophilia/conditions/hemophilia/diagnosis.html
National Hemophilia Foundation: http://www.hemophilia.org/NHFWeb/MainPgs/MainNHF.aspx?menuid=249&contentid=385
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