Doctors push back on advice to give women blood thinners after C-sections

Doctors are criticizing a recent recommendation from medical experts to give blood-thinning drugs to women who give birth via cesarean section, warning the advice is not only stained by its ties to drugmakers, but possibly unsafe, according to a new Wall Street Journal report.

Since 2016, when the medical journal Obstetrics & Gynecology published the recommendation from the National Partnership for Maternal Safety, hospitals have begun distributing blood thinners to women in order to prevent fatal blood clots, which pose a dangerous risk to women who give birth by C-Section, according to the Centers for Disease Control and Prevention.

Nearly one-third of births in the U.S. are by C-Section, meaning roughly 1.3 million women a year would be placed on blood thinners, according to the Lown Institute, a nonprofit based in Massachusetts. But in a separate editorial that accompanied the article, two obstetricians warned that broadly distributing blood thinners “not justified by the available data, and has the very real potential of doing more harm than good.” Following the recommendation, they said, would cost $130 million and could result in severe bleeding in thousands of women.

Dr. Adam Urato, chief of maternal-fetal medicine at MetroWest Medical Center in Massachusetts, was one of the doctors who raised concerns about the new recommendation, and the pressure to implement it. When he investigated the organization, he discovered that NPMS, operating under the auspices of a group of prominent physicians, actually had significant ties to pharmaceutical companies, some of which made blood thinners. The 2016 recommendation did not disclose this conflict of interest.

“It’s an uncontrolled experiment on women who just [had] a baby,” Shannon Brownlee, Lown Institute senior vice president, said.

Authors of the article defend the recommendation, saying the advice is safe and effective, the Journal reported.

Three years after the recommendation first ran, Obstetrics & Gynecology published a correction; however, it did not name any of the companies that are linked to NPMS, nor did it appear in the online version. According to the Journal, the company names will appear on Thursday in the official publication of the American College of Obstetricians and Gynecologists, when it publishes a letter from nearly 50 physicians.

“It is imperative that obstetric providers, pregnant women, and the public be informed that the National Partnership is funded by three companies that manufacture or sell anticoagulants—companies who would directly benefit financially from the approach they recommend,” the draft letter said.