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Epidurals and Blood Thinners: What Expectant Mothers Need to Know
Published: Feb 22, 2024
Many pregnant women use blood thinners to prevent clots, but these medications can complicate the use of epidurals during labor. Understanding how these treatments interact is crucial for a safe delivery.
What is an Epidural?
An epidural is a type of anesthesia commonly used for pain relief during labor. It involves injecting medication into the space around the spinal cord. This numbs the lower body, reducing or eliminating labor pain. Epidurals are used in over 60% of vaginal deliveries in the United States.
The Challenge with Blood Thinners
Blood thinners, while important for preventing clots, can increase the risk of bleeding. When it comes to epidurals, there's a small risk of bleeding around the spinal cord. This rare but serious complication is more likely if a woman is taking blood thinners. Therefore, careful timing of blood thinner doses and epidural placement is crucial.
Timing is Everything
To safely receive an epidural, blood thinners must be stopped for a certain period before the procedure. The exact timing depends on the type of blood thinner. For low-dose heparin, it's typically 12 hours. For higher doses or different types of blood thinners, it may be 24 hours or more. Your doctor will create a plan to manage this timing.
Planning for Delivery
If you're on blood thinners and want an epidural, your healthcare team will develop a plan. This might involve scheduling an induction or C-section to control the timing. In some cases, you might switch to a different type of blood thinner as your due date approaches. The goal is to balance clot prevention with the ability to safely use pain relief during labor.
Frequently Asked Questions
Often yes, but it requires careful planning and timing of your medication.
Your doctor will assess if it's safe to give an epidural or if alternative pain management is needed.
There's a slight increase in clot risk, but it's usually outweighed by the benefits for most women.
Usually within 4-6 hours after the epidural catheter is removed, but follow your doctor's instructions.
Other options include intravenous pain medication, nitrous oxide, or natural techniques like breathing exercises.
The Bottom Line
With proper planning, most women on blood thinners can safely receive epidurals during labor.
References
- American College of Obstetricians and Gynecologists. ACOG Practice Bulletin No. 196: Thromboembolism in Pregnancy. Obstet Gynecol 2018; 132:e1.
- Leffert L, et al. The Society for Obstetric Anesthesia and Perinatology Consensus Statement on the Anesthetic Management of Pregnant and Postpartum Women Receiving Thromboprophylaxis or Higher Dose Anticoagulants. Anesth Analg 2018; 126:928.
This article has been reviewed for accuracy by one of the licensed medical doctors working for Doctronic. Always discuss health information with your healthcare provider.
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