Information for Women

Pregnancy and Childbirth

With proper care, most women with von Willebrand disease (VWD) can have a successful pregnancy and deliver a healthy child. A woman who has VWD should be monitored closely throughout her pregnancy by her doctors.

It is important for a woman’s health care providers to be aware that she has VWD so that plans can be made for a safe delivery. If a woman is receiving care at a hemophilia treatment center, those doctors and nurses should be involved and work closely with the doctor who is delivering the woman’s baby. Working together in this way will help the doctor who is delivering the baby take special safety measures to avoid injury. These safety measures include not using forceps or a vacuum extractor to assist in the delivery of the baby, if possible.

After Delivery

Women with VWD are at risk for serious bleeding after delivery. During any pregnancy, the body makes higher amounts of clotting factors to prevent bleeding. However, the high levels of clotting factors during pregnancy drop back to lower levels after delivery. If the woman has low levels of clotting factor, then she can bleed after delivery or surgery (for example, following a Cesarean section). Some women have bleeding from the birth canal that lasts a long time. This is called postpartum hemorrhage and can require treatment to stop the bleeding.

Tips

To reduce the chances of having problems during pregnancy and after delivery, a woman with VWD should:

• Talk to her doctor about her bleeding disorder before becoming pregnant.
  
  
• Think about seeing a doctor who specializes in high-risk pregnancies and a hospital that has a hematologist (a doctor who specializes in bleeding disorders) on staff for prenatal care and delivery.
  
  
• Talk to her doctor before having any prenatal tests or medical procedures (for example, amniocentesis) to find out whether anything needs to be done to prevent serious blood loss.
  
  
• Have blood tests done during her third trimester to measure the levels of VWF and factor VIII in her blood to help plan for delivery.
  
  
• Meet with an anesthesiologist (a doctor who specializes in giving patients medicines for pain relief) to review her options for pain medicine and to discuss taking medicine to lower her risk of bleeding.