Coumadin, clotting disorders and contraception — oh my!
I saw my hematologist last week and he reminded me of something that I can’t believe I’d forgotten about: that the whole Coumadin issue is going to be on the table again as soon as the baby’s born.
For those of you who missed the fun last time (some highlights here and here), just a few weeks after I came to agree with Catholic teaching on birth control I developed a blood clot whose treatment requires a medicine that is completely incompatible with getting pregnant — if you conceive while you’re on it it is very likely that the child would have severe birth defects, if it lived at all. It’s so urgent to prevent pregnancy while on this drug that many doctors counsel women to consider tubal ligation before they start on it. Not what you want to deal with when you’ve been trying to live by Church teaching for all of two weeks.
Anyhoo…it turns out that the clot was caused by a clotting disorder called Factor II (similar to the more common Factor V) which I miraculously inherited from both parents. The odds of that are about one in a zillion. It makes me wonder if my parents are telling me the real story behind how they met (“the truth is, Jen, we were at a family reunion…”). Especially that I have both copies of this gene, any kind of high estrogen state is risky and requires preventative blood thinners, hence the shots in the stomach every day during pregnancy.
What I had forgotten all about, however, is that breastfeeding also puts me in the risk category, and the shots I take now, while safe for pregnancy, are not safe for breastfeeding. Coumadin (also called Warfarin) is what I should take for while I’m breastfeeding…but Coumadin is incompatible with becoming pregnant.
So, I’m back to that dilemma where my options are:
- Breastfeed, take Coumadin, disregard Church teaching and use contraception;
- Breastfeed, take Coumadin, practice NFP very carefully;
- Don’t breastfeed, in which case I wouldn’t need Coumadin;
- Breastfeed, take Coumadin, and practice abstinence until weaning (which would probably mean weaning fairly early);
- Breastfeed, don’t take Coumadin, and accept the risk of a another DVT or pulmonary embolism (which are really dangerous, often fatal, and generally something you want to avoid);
- Pray that there’s some alternative I haven’t thought of!
After a lot of prayer and consideration, the first two are out.
I really would never consider the first option. Not only has Catholic teaching on birth control gone from something I accepted on a purely intellectual level to become a personal, heartfelt belief, but there’s also the very compelling point that was originally pointed out to me by commentors here on this site: no form of contraception is 100% effective. You can’t count on anything but abstinence to completely avoid pregnancy — and at least with NFP it’s likely that you’d be aware of a pregnancy sooner and therefore could discontinue the medication immediately and mitigate the damage. So it’s not like using contraception is the perfect, worry-free answer while taking an FDA Category X drug.
And after a lot of prayer and thinking I decided that option #2 is just not worth the risk. Even if I practiced NFP conservatively and the risk were small, the prospect of conceiving a child who would be severely harmed by a drug I was taking that I knew full well caused birth defects is just not something I can have on the table. It’s not worth taking even a slight chance.
That leaves me with options 3-6, and a lot to think about. Frankly, I’m really holding out hope for #6.
So why am I writing a post about all this?
First of all, my commentors are always so full of good advice that I thought it would be interesting to hear what others have to say.
But the main reason I write this post is just to get it out there in case my story is helpful to anyone else. I’ve intentionally written it in a Google-friendly way and welcome emails from anyone else who faces a similar dilemma, even if you’re reading this months or years after I originally wrote it. Back when I first faced this issue one of the most difficult parts of it was the lack of support and resources that were compatible with Catholic teaching.
So anyway, I have a lot to think about in these coming weeks. Although, with my new philosophy on worrying, I’m probably not going to think about it all that much. I’m going to pray for guidance and just see how I feel about it after the baby arrives, and trust that God will clearly lead me down the right path. Everything that happened last time only brought me closer to God and deepened my faith, so I believe that the only thing I really have to do is prayerfully seek God’s will, and trust.