Pregnancy and birth – von Willebrand Disorder
You can have children if you have VWD, even if it is severe, although there is a risk of your child being born with VWD and/or having heavy bleeding during or after labour. Talk to your doctor about your bleeding disorder before becoming pregnant. With proper care, you can have a successful pregnancy and deliver a healthy child.
As soon as you know you are pregnant, contact your haemophilia centre. You should be monitored closely throughout your pregnancy by your obstetrician (doctor specialising in pregnancy and childbirth) under the guidance of your haemophilia centre. The doctors and midwives looking after your pregnancy and delivery must be aware of your VWD. Working together this way will help the doctor who delivers your baby take special safety measures to avoid injury. These measures include not using forceps and vacuum extractions (ventouse suction) to assist in having your baby, if possible.
Pregnancy can cause blood levels of VWF to increase, reducing the likelihood of bleeding complications during pregnancy and delivery. However, this needs to be monitored as women with VWD can have heavy bleeding/haemorrhage after giving birth or have delayed bleeding when the factor levels return to pre-pregnancy levels. This can happen any time, from 24 hours after birth to six weeks after delivery.
It is important for the doctors and midwives looking after you are aware of your VWD, not just for your sake but for your baby’s too. It should be assumed that the baby may have VWD and delivery methods should be as gentle as possible. It is also important that everyone knows about your VWD if you need a caesarean delivery. Women with VWD whose VWF does not rise to normal levels during pregnancy will need specialist assessment and multidisciplinary team management.
If you continue to bleed heavily during the days and weeks after the birth, you should remind your midwife or health visitor about your VWD and seek treatment. Remember that most healthcare professionals may be very unfamiliar with VWD. Always let your haemophilia centre know if you are pregnant or are experiencing bleeding so that they can advise the team looking after you about the risks for you and your baby and how best to care for you both. It is important not to presume your maternity team have contacted your haemophilia team, even if they’re based in the same hospital, as this can sometimes be missed.
More information is available in our Understanding von Willebrand Disorder booklet.