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Many women with a hereditary bleeding or clotting disorder often ask the same question: How does it affect pregnancy and birth?
“Pregnancy is a stronger risk factor for blood clots than almost anything else,” says Dr. Marshall, a Mayo Clinic hematologist. “During pregnancy, women are exposed to really high levels of hormones.”
In women who do not have any mutations or pro-clotting conditions, the risk of a blood clot is nearly five times greater than a non-pregnancy state. According to Dr. Marshall, the greatest time of risk for a blood clot is during delivery to a couple of weeks post-delivery where the risk can be as high as 20 times greater than non-pregnancy.
So, what if you also have a clotting disorder?
“It really depends, with pregnancy, what condition a female has,” Dr. Marshall says. “For example, Factor V Leiden is common, but one of the less risky conditions where our recommendation is typically to be aware of your condition and to minimize risk factors.”
According to Dr. Marshall, medical management may be necessary when a woman has a more serious or multiple clotting disorders, such as a prothrombin gene mutation or antithrombin deficiency.
“In some cases, we will recommend prophylactic or low-dose blood-thinners throughout pregnancy,” Dr. Marshall says. “Guidelines can differ, but in the United States, prophylaxis is not recommended during pregnancy unless there is a family history of blood clots, however, we do recommend prophylaxis after delivery.”
A person with a clotting disorder can help minimize the risk of a blood clot by managing factors that increase the risk of blood clots. Some of those factors include:
- Age
- Smoking
- Being overweight
- Sedentary lifestyle
- Estrogen-containing birth control pills
- Flying
- Previous blood clot
Dr. Marshall stresses the importance of letting your OBGYN provider know about your clotting disorder and to speak with your hematologist. Awareness of the clotting disorder, open communication with your providers, and affective management of risk factors can help minimize the risk of a blood clot during and after pregnancy.
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