Hi!

I haven't had a child, but because it's medically necessary to take you off warfarin when you're pregnant, I can't see your insurance company fighting your doc too hard. The insurance company may have someone from their clinical /health management area review the request from your doctor, but I don't think it'll be a problem.

You are going to do just fine!

I agree there shouldn't be an issue with getting shots during pregnancy because it is medically necessary since you can't be on warfarin as it causes known birth defects, and you have to be protected from clotting. This isn't an unusual situation as there are plenty of women who have to take shots during pregnancy. In fact, many doctors will switch a woman who is already on anticoagulation to lovenox from the time she starts trying to get pregnant. Others wait until they are pregnant, but the change needs to be made as quickly as possible after pregnancy.

BabyCenter has a group there called Lovely Lovenox Ladies or something like that, if you want to check info with some women who are currently in that situation. There have been a few members of this group who have come back to share that they've gotten pregnant or had children, so maybe someone will see this and chime in here too.

I've not attempted pregnancy since my pe 10 months ago, but I've heard it can go well. I've spoke with both my hematologist and obgyn about it and both seemed very reassuring that it's not a huge deal. They both mentioned using Levonox, not heparin. Is that what could cause the insurance battle? I don't recall the different reasons for using Levonox vs Heparin but I would definitely be on Levonox, 2 shots each day until at least 6 weeks out and for as long as I would want to nurse a baby. I would just stop the shots when I feel myself begin labor. This would be my 2nd pregnancy and the first was completely uneventful, medically speaking.

Hi, I'm currently 7 1/2 months pregnant and taking Fragmin injections which I think are the same thing as lovenox. I live in Canada and there was never an issue with getting the injections. You can't take Coumadin if you're pregnant and my doctors said I need to take low molecular weight heparin, which is the Fragmin. I had my PE in 2012 while I was pregnant with my second child. They later found I had Factor V Leiden. Everything went very smoothly for the delivery of my son and I'm expecting the same this time around with my third. There were no clotting issues with my first child. If you have any questions just let me know. The plan is to induce me and stop the injections the day before. WHile you are taking blood thinners there's very little risk of having blood clots so I don't think about it very much. It's mainly an inconvenience to do the injections, but I've gotten used to it. I think there are lots of women out there who have healthy pregnancies post PE on blood thinners. That's been my experience so far.

I just checked online and Fragmin and Lovenox aren't the same thing, but they are both low molecular weight heparin.

thank you everyone for the responses!

Dchild, did your doctor ever push for a c-section delivery? For some reason I feel like I had heard something about getting one in order to better time the delivery. No pregnancy for me just yet, but hopefully soon. I have to admit, not knowing how my sister and I are genetically predisposed to PEs makes me nervous.

Also, I was curious if you were taking the heparin every 12hrs or just once daily (like after surgery patients). And either way, are you bruised all over and searching for new places in inject? I always remember being on the heparin injections for three months after my PE, every 12 hrs and running out of places to poke without poking into a bruise.....so to do it for nine months seems crazy!

Hi there,

My doctor never pushed for a c-section but did push to have me induced. The reason was so they could time stopping the injections beforehand, so the thinners would be out of my system when I gave birth. Of course timing these things can be difficult and as it turns out I went into labour on my own a couple of days before the planned induction (it was last week -- I have a 1 week old baby!). Because I take my injections in the morning, and I started having contractions at around 5:30 am, I just skipped my injection. I gave birth at 1 am the following day and the blood thinners were out of my system. Bleeding was fine. I started the injections again 12 hours later. I had a birth plan worked out with my hematologist and I specifically asked her to write what I should do if I went into labour on my own. I was hoping to avoid induction, even though my experience has been pretty positive with it. I was induced with my second baby post PE and it went very smoothly. I never needed a c-section. I don't see why it would be necessary to have a c-section -- it's major abdominal surgery and would seem to be higher risk with a history of blood clots. I really try to move around a lot during labour too, drink water etc... avoid being sedentary and dehydrated if possible!

For the injections, yes I got pretty bruised up. My usual place to inject is around my lovehandle area, especially when the belly is too stretched tight with growing baby. Towards the end of my pregnancy I got my husband to inject me in the back of my arms which seemed to cause less bruising. It was also nice to have someone else do the injections. Yes, it's a hassle but the injections keep you safe from clots and you get a beautiful baby at the end so it's worth it! I have 5 more weeks of injections (post partum) and then I'll be done.

Let me know if you have any more questions.

Forgot to add: this time the injections were just once a day. I was on a low dose, 5000 units. The hematologist said there was no reason to break up the dose in two injections. But for my second baby, which was post PE at 10 weeks pregnant, I was on a much higher dose, and in that case we did break the dose up in two towards the end of the pregnancy. I believe the reason was to have more control over the dose in case I went in spontaneous labour.