Decided on general anesthesia. Struggling.

[autumnx]

I'm 34 weeks pregnant. I was diagnosed with Factor V Leiden after three losses. At 4 weeks, I started taking 81mg of baby aspirin prescribed by a RE to avoid IUGR and placental clots. MFM/OB denied blood thinners in my situation even though hematologist said otherwise. It was a long, stressful process. I dealt with it. At my 34 week appointment, my OB and MFM said I must go off the aspirin to avoid bleeding from epidural/spinal block in case I need it. Baby has been transverse or breech since day 1, never head down. I'm really not sure she is going to turn and iffy about a ECV.

I mentally cannot go off the baby aspirin. I explained this to both MFM/OB and they're not very understanding which is expected. That's fine. I suffered the losses and really have some type of PTSD from it. I tried going off of it and would end up in a full on panic attack. That means that I'll need general anesthesia apparently even though I've read multiple websites that getting an epidural is perfectly safe on low dose aspirin and done regularly. I asked to talk to anesthesia about my options and they told me I need to go through my OB. They won't give me the time of day.

I want to be able to enjoy the rest of my pregnancy and stopping the aspirin this early is too much on me mentally. My SO says to just stop taking it so I can have an epidural but I literally can't. I feel like if I stop the aspirin, I'm putting her at risk and I feel like if I don't stop it, I'm putting me at risk. It's putting me in a really bad place and I'm just very depressed.

Anyway, has anyone gotten general for a c-section? I'm really nervous about it but I know it's the best option for me if I indeed need one.

 

[DrMum]

How long in advance would they want you to stop it! If it's only a couple of days you could maybe ask to be admitted then so baby can be monitored to give you peace of mind, then be induced and have your pain relief without risk?
Or could you politely ask for a second opinion from a different OB?
Good luck!!

 

[autumnx]

How long in advance would they want you to stop it! If it's only a couple of days you could maybe ask to be admitted then so baby can be monitored to give you peace of mind, then be induced and have your pain relief without risk?
Or could you politely ask for a second opinion from a different OB?
Good luck!!

They prefer it to be 7 days out of your system. They said to stop at 34 weeks in case I go into labor but I'm not comfortable with that. I could not go into labor until 40 weeks. I rather stop at 38 or 39. I'm not sure if I can switch OB's or ask for a different opinion.

 

[Annika1]

I'm in anesthesiologist; there are NO contraindications to being on aspirin and having a spinal. The university of Washington has excellent posted guidelines (available on the internet) for neuraxial procedures. (I can't put the link in here because of a spam filter on this site)
I'm very surprised you've been told this; it is routine to do procedures on patients on aspirin.

Spinal anesthesia is much better for you and baby.

 

[Annika1]

It's also ok to be on aspirin for epidurals.

I'm in anesthesiologist; there are NO contraindications to being on aspirin and having a spinal. The university of Washington has excellent posted guidelines (available on the internet) for neuraxial procedures. (I can't put the link in here because of a spam filter on this site)
I'm very surprised you've been told this; it is routine to do procedures on patients on aspirin.

Spinal anesthesia is much better for you and baby.

 

[autumnx]

I'm in anesthesiologist; there are NO contraindications to being on aspirin and having a spinal. The university of Washington has excellent posted guidelines (available on the internet) for neuraxial procedures. (I can't put the link in here because of a spam filter on this site)
I'm very surprised you've been told this; it is routine to do procedures on patients on aspirin.

Spinal anesthesia is much better for you and baby.

That's exactly what I read. I don't know if they're just misinformed or want to scare me out of it so it's easier, honestly. I'm only on 81mg. They said I cannot get an epidural and they "think" it is the same for spinal but no anesthesiologist will actually talk to me so I can't verify.

 

[RcdM]

My dr told me to stop the aspirin a week before my c-section as well, but not for the reason of the spinal or epidural, more so for the surgery itself. They don't want your blood to be thin during the surgery as it can make it difficult to control or stop the bleeding from the incision.

I don't know why she'd want you to stop now, so early at 34 weeks. Yeah you could go into labor prior to your section but at 34 weeks it's not very likely. Maybe at 36 or 37... I don't know. Keep pushing for a second opinion!

 

[autumnx]

My dr told me to stop the aspirin a week before my c-section as well, but not for the reason of the spinal or epidural, more so for the surgery itself. They don't want your blood to be thin during the surgery as it can make it difficult to control or stop the bleeding from the incision.

I don't know why she'd want you to stop now, so early at 34 weeks. Yeah you could go into labor prior to your section but at 34 weeks it's not very likely. Maybe at 36 or 37... I don't know. Keep pushing for a second opinion!

Yeah, 34 is too early for me. I have no signs of preterm labor or history of such. No contractions and mucus plug is staying put. I'd prefer to wait and then if I do need to be scheduled for a c-section due to her being breech, at least that way I can go off the aspirin a week prior like they'd want me to. Not 6 weeks prior!

 

[petitpas]

I also have FVL and suffered recurrent miscarriages (this is my eighth pregnancy). Since I have clotted in the past I take baby aspirin and blood thinning injections during and after pregnancy. With my son I stopped the aspirin at 36w and the injections 48h before my scheduled section at 38w. I had a spinal and really enjoyed the birth.

I wonder, since you are so anxious about this (understandably!) whether you could have the injections until shortly before the birth? Then you would feel protected and still have a spinal? I know that heparin works differently to aspirin but if that's what it takes to keep you calm and happy...?
My dose was quite high but with a normal heparin dose you can usually take your last injection 24h before the birth.

 

[petitpas]

Another thought: could you request to see a bereavement midwife? They are usually quite good at advocating on your behalf, especially in terms of helping your anxiety due to previous losses.

 

[sethsmummy]

I was told to stop my aspirin at 36 weeks x

 

[autumnx]

Another thought: could you request to see a bereavement midwife? They are usually quite good at advocating on your behalf, especially in terms of helping your anxiety due to previous losses.

I didn't know these existed! Since I'm high risk, I don't think I can get a midwife. The hospital I deliver at makes you go through a perinatal center.

 

[autumnx]

Had an appt with OB. She said that it's so dangerous and all of these scary things. Ugh. I'm seeing what the MFM says.

 

[petitpas]

If there is a family history of clotting, you are over 35 or overweight then you can really push for injections. Otherwise, maybe you have to put your trust in your doctors and stop the aspirin. It has done a great job in getting you to where you are. Things work differently at different stages in your pregnancy so if aspirin was what kept your baby going through the first trimester and lowered your risk of pre-eclampsia until now then maybe it's done its job and you can let it go now. You seem to be very well cared for, have regular checkups, right? You are in control, too, because you can feel your baby's movements and you can go get checked out if you feel 'off' in any way. If your baby was born now it would probably do well.
I totally understand your fear. With my son, which was my sixth pregnancy after five losses, I was put on steroids and progesterone during the first trimester. I was quite anxious when I was told to stop them but after a few days my baby still had a heartbeat and I started to relax. With this baby I couldn't wait to get off them Every medicine has its timing and it looks like at this point the aspirin might do more harm than good in your case.

I'm sorry you don't have access to a midwife. I take it you're not in the UK Still, you seem to have lots of people looking after you. Maybe they can advise if there is a counsellor or someone you can talk to in order to deal with your anxiety

 

[autumnx]

If there is a family history of clotting, you are over 35 or overweight then you can really push for injections. Otherwise, maybe you have to put your trust in your doctors and stop the aspirin. It has done a great job in getting you to where you are. Things work differently at different stages in your pregnancy so if aspirin was what kept your baby going through the first trimester and lowered your risk of pre-eclampsia until now then maybe it's done its job and you can let it go now. You seem to be very well cared for, have regular checkups, right? You are in control, too, because you can feel your baby's movements and you can go get checked out if you feel 'off' in any way. If your baby was born now it would probably do well.
I totally understand your fear. With my son, which was my sixth pregnancy after five losses, I was put on steroids and progesterone during the first trimester. I was quite anxious when I was told to stop them but after a few days my baby still had a heartbeat and I started to relax. With this baby I couldn't wait to get off them Every medicine has its timing and it looks like at this point the aspirin might do more harm than good in your case.

I'm sorry you don't have access to a midwife. I take it you're not in the UK Still, you seem to have lots of people looking after you. Maybe they can advise if there is a counsellor or someone you can talk to in order to deal with your anxiety

Thank you. Her information was very conflicting. I talked to an mfm prior to her and he said there was zero risk besides an epidural. Not anything else she said. I'm going to talk with them again next week and then if they say I need to then I will I guess. I just heard that factor v leiden is most dangerous third trimester. Not first.

 

[Dinah93]

I was on 75mg aspirin in my first pregnancy and 150mg the second one and I had a spinal both times. I did have some bleeding issues the second time but not from the anaesthetic.

 

[autumnx]

I was on 75mg aspirin in my first pregnancy and 150mg the second one and I had a spinal both times. I did have some bleeding issues the second time but not from the anaesthetic.

Were you advised to come off of it? I don't get why I am told to when I've read that a lot of women like yourself are on it straight through.