Hospitals across the U.S. have been giving anticoagulants to nearly all women who give birth by caesarean section to prevent fatal blood clots since the practice was recommended in Obstetrics & Gynecology in 2016. However, many doctors are now questioning this recommendation due to potential conflicts of interest and safety concerns.
Blood clots are a common cause of death during pregnancy and childbirth in the U.S., contributing to poor maternal mortality rates compared with other developed countries. The American College of Obstetricians and Gynecologists (ACOG), which publishes Obstetrics & Gynecology, advises giving anticoagulants to women with a history of blood clots, or those who have risk factors for developing them. However, critics argue that overusing blood thinners can dangerously increase postpartum bleeding, and that current available data does not justify this advice.
In addition, the group of physicians who developed this recommendation were found to be part of the National Partnership for Maternal Safety, an organization that receives funding from companies that manufacture blood thinners. Initially, the article did not disclose this detail, but included a correction in a later issue mentioning the funding without identifying the specific companies.
The journal is expected to publish the companies’ names in a letter from nearly 50 physicians in late October.