See cover article, "Pregnant Pause."
Pregnancy and birth are often times of great joy, but they can also be times of anticipation and anxiety, especially among women with bleeding disorders.
Women and their partners can ease their anxiety and aim for a successful delivery by educating themselves and teaming up with their hemophilia treatment center (HTC) and an ob/gyn who specializes in high-risk pregnancies.
Ideally, planning for pregnancy should begin before conception. Women with bleeding disorders contemplating a pregnancy should be aware that they may be at an increased risk of bleeding complications and of having a baby with a bleeding disorder.
Before planning to conceive, women should consult their HTC or ob/gyn to find a physician or genetic counselor who can discuss the risks related to their bleeding disorder and the risk of their baby inheriting a bleeding disorder. These experts can also discuss with women and their families the various methods of prenatally diagnosing a potentially affected infant. If they are at risk of having a baby with a bleeding disorder, they should also seek out a pediatric hematologist, who can discuss the nature and severity of the condition.
[Steps for Living: Family Planning for the Next Generation]
In this day and age, women are more proactive about their health, looking for answers online and not being afraid to ask their doctors questions. In my years of practice, I’ve seen the positive results that can occur when a patient is informed and empowered, and when her providers are working together to bring her the best care possible. For women with bleeding disorders, this means meeting with a genetic counselor, having the appropriate prenatal tests and understanding the reality of childbirth.
[Steps for Living: Bleeding Disorders in Women]
Arming yourself with knowledge about the potential complications of pregnancy and your bleeding disorder, and developing a birth plan with your healthcare team, can go a long way toward easing your anxiety. Then, you and your spouse can focus on the joy of bringing home a beautiful new addition to your family.
Andra H. James, MD, is the director of the Women’s Hemostasis and Thrombosis Clinic and associate professor of obstetrics-gynecology, Division of Maternal Fetal Medicine, at Duke University in Durham, North Carolina.