Nice one I didn’t realise it could be so good! Love this analysis.
The big issues with Aspirin might not be the evidence, but the reluctance of us clinicians here and fears of how patients might respond if something goes wrong when they are on. This stuff might just not be a big deal in many contexts though.
1. Safety of NSAIDS in general durign pregnancy and Aspirin specifically still hasn’t been cleared after all these years. “Do no harm” as a principle can stand stronger than a benefit/harm analysis espeically in something like pregnancy.
2. Bleeding. We’re all terrified of this. And if someone gets a miscarriage on aspirin (even unrelated) they are going to ask if its related. Same with PPH.
I think getting this past clinicians might be harder than the program. I actually think this program wouldn’t be that hard to do and could be implemented for WAY less than $32 per woman. I’m low-key excited about this actually
I think if this was lodged squarely into national guidelines that would make it easier. Or maybe it is already and us doctors are still ignoring it :(.
Thanks, Nick, I’m always grateful for your insights! :)
Great points. Even with a clear WHO recommendation (and WHO tends to be pretty cautious), clinicians could be reasonably hesitant about risks based on everything else they know about NSAIDs and bleeding.
If the simple and clear clinical protocols are in place, there’d still be implementation work to do to change minds on the frontlines. This should be added the “Recommendations” as an area to dig into more.
Nice one I didn’t realise it could be so good! Love this analysis.
The big issues with Aspirin might not be the evidence, but the reluctance of us clinicians here and fears of how patients might respond if something goes wrong when they are on. This stuff might just not be a big deal in many contexts though.
1. Safety of NSAIDS in general durign pregnancy and Aspirin specifically still hasn’t been cleared after all these years. “Do no harm” as a principle can stand stronger than a benefit/harm analysis espeically in something like pregnancy.
2. Bleeding. We’re all terrified of this. And if someone gets a miscarriage on aspirin (even unrelated) they are going to ask if its related. Same with PPH.
I think getting this past clinicians might be harder than the program. I actually think this program wouldn’t be that hard to do and could be implemented for WAY less than $32 per woman. I’m low-key excited about this actually
I think if this was lodged squarely into national guidelines that would make it easier. Or maybe it is already and us doctors are still ignoring it :(.
Thanks, Nick, I’m always grateful for your insights! :)
Great points. Even with a clear WHO recommendation (and WHO tends to be pretty cautious), clinicians could be reasonably hesitant about risks based on everything else they know about NSAIDs and bleeding.
If the simple and clear clinical protocols are in place, there’d still be implementation work to do to change minds on the frontlines. This should be added the “Recommendations” as an area to dig into more.