According to a study shared at this year’s International Stroke Conference, the risk of blood clots for new moms is twice as high as researchers previously thought. During pregnancy blood and platelet clotting factors increase, peaking at and near the time of delivery. Standard medical practice is minimize clotting risks for new moms for approximately six weeks after birth when they are 10.8 times more likely to suffer a blood clot than normal. This new study found that, new moms are still at risk for weeks seven through twelve after delivery, with their clotting risk 2.2 times more likely than normal. All of these numbers are even higher for women with additional clotting risks such as clotting disorders or a history of clots.
Between thirteen and eighteen weeks postpartum, new moms were shown to be 1.4 times more likely to get a blood clot but the researchers deemed this rise as non-significant. Between weeks 19-24, the chance of suffering a clot returned to normal. Less than one in 10 thousand women suffer postpartum blood clots in the six to twelve weeks after delivery. The research was headed by an assistant professor at Weill Cornell Medical College in New York.
Blood clots are one of the most common causes of strokes and one of the easiest medical diagnoses to prevent if there are no abnormal risk factors in play. According to the Mayo Clinic, “blood clots have many causes but can be boiled down to anything which prevents blood from circulating normally or clotting properly.”
In most cases, both blood clots and strokes are two of the most preventable life-threatening diseases. Over 90 percent of strokes can be prevented by changing personal habits to decrease the risk factors which include poor diet, lack of exercise, obesity (particularly in the abdomen), smoking and high blood pressure. Blood clot risk factors include injury or surgery, long periods of sitting, obesity, smoking, cancer, pregnancy, bowel diseases that are inflammatory, birth control pills, extended bed rest, heart failure or a history of blood clots. There are a few blood clot risk factors that cannot be controlled: inheriting a clotting disorder or having a family history of blood clots, receiving a pacemaker or catheter in a vein, being over 60 years of age and being a tall man – there has been no increased risk linked to tall women.
Risk factors like inherited clotting disorders or previous blood clot history can make blood clot prevention more challenging in pregnancy and for the new mother, which is why the findings announced at the stroke conference are so important. High risk obstetrician, Dr. Tamerou Asrat, recommends that pregnant women with these risk factors “drink at least 90 ounces of water each day, engage in routine exercise, wear compression hose whenever they sit for the duration of the pregnancy and inject medication that will prevent the formation of a blood clot.” Additionally he recommends that these women be closely monitored by their obstetrician.
The medication used most often for pregnant women to prevent clotting is Lovenox. The recommended dose is injected in the abdomen once a day during the first trimester and twice a day for the second and third trimesters. It is customary for a pregnant women with a high clotting risk to switch to Heparin approximately 34 weeks into her pregnancy. This is because, while Lovenox takes up to 12 hours to leave the body, Heparin can leave the body in three or four hours. Additionally, in the case of an early delivery, medical professional have medication that will reverse the effects of Heparin and there is no comparable medication that works on Lovenox at this time. These high risk women are switched back to Lovenox after the delivery and instructed to continue the shots for six weeks. In light of this new study, that window of time might soon be extended.
All new mothers can adopt certain prevention behaviors to lower their blood clot risk in the crucial 12 weeks post-delivery. They can avoid sitting for long hours without moving unless they wear compression stockings. Drinking extra water to avoid dehydration is a must, especially for nursing mothers. An easy formula for new moms to calculate their necessary water intake is to divide their weight by two and drink that number of ounces of water. All new moms are also encouraged to resume exercise as soon as possible, although that can be traumatic for women who had their babies by Caesarean section. Increasing foods such as ginger, fish oils, garlic, peppermint, flax seeds and cinnamon will help decrease the risk since these are platelet de-aggregating foods. Finally, it is recommended that new moms consider moderating their intake of foods that are high in Vitamin K, which thickens the blood, in the window of time where their clotting risk is increased.
These findings at the stroke conference will likely change the medical protocol for the critical weeks post delivery when new moms are at higher risk for developing a blood clot, especially now that doctors know the window of time is twice as long. However, anyone can get a blood clot, so these behaviors are recommended for all.
By Jenny Hansen