How ITP affected my pregnancy and birth plan

Pregnancy is full of numbers, especially when you’re living with immune thrombocytopenia (ITP). And for someone who doesn’t enjoy math, that’s not ideal.

There are the usual questions: How many weeks along are you? At what percentile is the baby measuring? How many days until you’re due? The list goes on.

But throughout my two pregnancies, there was another number sitting quietly in the back of my mind: my platelet count.

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Aug. 21, 2026 Columns by Daisy Souster

Struggling with anxiety from a childhood ITP diagnosis

I was diagnosed with ITP at 8 years old, so platelet counts have been part of my vocabulary for as long as I can remember. By the time I became pregnant at 26, I was already familiar with waiting for the results of a complete blood count and immediately scanning the page, looking for one particular number.

Pregnancy, however, gave that number a whole new significance, and it brought a new wave of fear to overcome.

Suddenly, my platelet count didn’t just tell me how my ITP was behaving; it also informed conversations about labor, delivery, and what kind of pain relief might be available to me. This was extremely scary, especially during my first pregnancy.

For most expectant mums, creating a birth plan might mean thinking about whether they want a water birth, what music they want playing, or whether they would like an epidural as an option.

ITP brings another question: What are my platelets doing right now?

Creating a birth plan with ITP

ITP causes the immune system to mistakenly attack platelets, the cell fragments that help with blood clotting. Pregnancy is also associated with a drop in platelet counts, though this tends to be more severe in women with ITP. As a result, those with a history of the condition may require additional monitoring during pregnancy and delivery. This was definitely the case for me, even though my platelet count had been stable for eight years.

When it comes to delivery, the recommended minimum platelet count may vary depending on the type of delivery and whether an epidural is needed. Doctors may also consider whether the mother’s platelet count is stable or falling, and take her bleeding history and other individual circumstances into account.

For somebody without ITP, these recommendations might look like simple medical figures. But for somebody who has spent much of their life watching their platelet count, they can feel much bigger and scarier.

Many pregnant women may be able to request an epidural if labor becomes particularly painful. But if your platelet count is too low, neuraxial anesthesia may not be appropriate due to concerns about bleeding around the spine. That means something as personal as your preferred form of pain relief may depend on the result of a blood test.

Having ITP doesn’t automatically mean that someone will need a cesarean section. Medical guidance recommends determining the mode of delivery based on obstetric reasons, not ITP alone. Babies born to mothers with ITP may also have their platelet levels checked after birth because maternal antibodies can cross the placenta and affect the baby’s platelets.

Taking back control

Daisy Souster is pictured seven months pregnant with her second child. (Courtesy of Daisy Souster)

But beyond the clinical guidance, there is an emotional side to pregnancy with ITP that numbers don’t really capture.

Pregnancy already asks you to surrender a certain amount of control. You can write the most detailed birth plan imaginable, but babies aren’t particularly well known for reading them. Adding ITP to that equation reminded me that my body might make some decisions for me.

That’s why, for women living with conditions such as ITP, birth planning should involve more than simply discussing what we would ideally like to happen. We need opportunities to talk through the alternatives, too: What happens if my platelet count drops? What pain relief would be available to me? What would change if I need to deliver via C-section? What monitoring might my baby need?

Those conversations don’t necessarily take away the uncertainty, but they can give some control back.

Because when you’ve spent years reducing your health to a platelet count, pregnancy is an important reminder of something else: You are far more than a blood test result. And so is your birth story.

Note: Bleeding Disorders News is strictly a news and information website about the syndrome. It does not provide medical advice, diagnosis, or treatment. This content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. Never disregard professional medical advice or delay in seeking it because of something you have read on this website. The opinions expressed in this column are not those of Bleeding Disorders News or its parent company, Bionews, and are intended to spark discussion about issues pertaining to bleeding disorders.