When You Are On Lovanox an Induction is Often Recommended… Why?
A Closer Look at Safety and Timing
Today, I had a wonderful conversation with a client of mine and she mentioned her team had told her IF she were to take Lovanox, she would be switched to Heparin a month before her due date and an induction would be recommended. Whenever I hear blanket statements like this, I know I need to know more.
So I did a deep dive for you.
Nothing in this blog is to be considered medical advice, I am a doctor of bodies (physical therapy) I am NOT an MD.
If you’ve been prescribed Lovenox (enoxaparin), you’ve likely been told about the importance of carefully managing your labor and delivery. Lovenox is a blood thinner, typically prescribed to prevent blood clots, especially during pregnancy when certain risk factors increase clotting concerns. While this medication is essential for your health, it does come with some added considerations for your birth plan. One common recommendation is that those on Lovenox be induced rather than waiting for spontaneous labor to begin on its own.
But why is induction recommended, and is it always the safer option? Let’s dive into what you need to know if you’re managing your pregnancy with Lovenox.
Why Induction Might Be Safer on Lovenox
Lovenox works to thin your blood and reduce the risk of developing dangerous clots, but during labor and delivery, having thinner blood can increase your risk of bleeding. Timing is everything when it comes to balancing the need for Lovenox and reducing the risk of hemorrhage during birth.
Here are the primary reasons induction may be considered safer for those taking Lovenox:
1. Managing Bleeding Risks
One of the biggest concerns with blood thinners is the risk of excessive bleeding during childbirth. Because Lovenox affects your body’s ability to clot, if labor starts suddenly and you’ve recently taken a dose, there may be an increased risk of heavy bleeding, especially if you need interventions such as a C-section or assisted delivery (e.g., forceps or vacuum).
Induction allows for better control over when labor begins, so your care team can stop Lovenox with enough time for it to clear from your system before you go into labor. This minimizes the risk of bleeding complications during birth.
2. Epidural Considerations
Many people opt for an epidural during labor, which is a form of pain relief delivered via injection into the spine. However, having Lovenox in your system can increase the risk of bleeding around the spinal cord, a rare but serious complication called a spinal hematoma.
To safely receive an epidural, there’s a specific window of time where it’s safest to avoid Lovenox. If you’re induced, your healthcare team can better coordinate the timing of your last dose and ensure you have the option of an epidural if that’s part of your birth plan.
3. Avoiding Unpredictable Labor
Waiting for spontaneous labor can feel like a game of chance. Labor could start at any time—day or night—potentially catching you by surprise if you’ve recently taken your medication. Induction gives you and your medical team more control, helping to prevent the start of labor when Lovenox is still active in your system, which could complicate your ability to safely proceed with a vaginal delivery or a C-section.
Is Induction Always Necessary?
While induction is commonly recommended for those on Lovenox, it’s not an absolute must for everyone. The decision depends on various factors, including your specific dosage, medical history, and how well your body is tolerating the medication.
Some people, particularly those on lower doses of Lovenox, may be able to wait for spontaneous labor if carefully monitored. Your healthcare team will consider your clotting risk, the timing of your last dose, and how labor is progressing before making recommendations. It’s always a good idea to talk to your provider early on about your preferences for labor and delivery and to have a plan in place.
What to Discuss with Your Provider
If you’re on Lovenox, here are a few key questions to ask your provider as you prepare for delivery:
When should I stop taking Lovenox before labor? Your provider will give you a timeline for when to stop taking Lovenox leading up to your induction or estimated due date. This is important to ensure that the medication has time to leave your system before delivery.
What happens if I go into labor before my scheduled induction? In the event that labor begins spontaneously, your care team will adjust your treatment plan accordingly. It’s important to know what steps they will take to manage your care safely.
What are my options for pain relief? If you’re hoping to have an epidural during labor, your provider will help time your last dose of Lovenox so that it’s safe to proceed with that option.
What are the signs I need to go to the hospital immediately? While inductions are typically scheduled, you should also be aware of any emergency symptoms, such as heavy bleeding or signs of clotting, that would require immediate attention.
The Bottom Line
If you’re on Lovenox, induction is often recommended to provide a safer, more controlled environment for your delivery. By carefully timing when you stop taking your medication and starting labor in a more predictable manner, you can reduce the risks associated with bleeding or complications from pain relief methods like epidurals.
That said, every pregnancy is unique, and induction might not be necessary for everyone on Lovenox. Having an open conversation with your provider will help you feel confident and prepared, whether you’re planning for an induction or waiting for your little one to arrive on their own terms.
Love,
Emily
