How long after a cesarean section should you start postpartum anticoagulation?

Postpartum anticoagulation is typically initiated 6-12 hours after a cesarean section, particularly for women who are at increased risk of venous thromboembolism (VTE). This timing allows the patient to be appropriately monitored in the immediate postoperative period for bleeding and other complications, while also beginning to reduce the risk of thromboembolic events.

Starting anticoagulation earlier than 6 hours may increase the risk of hemorrhage if the surgical site is still vulnerable, whereas delaying beyond 12 hours may allow the risk of VTE to rise significantly. The balance between preventing blood clots and managing bleeding risks is critical in the postpartum period, especially after cesarean delivery, where there may be additional risks.

The standard practice considers both the timing of anticoagulation initiation and the clinical status of the patient, making 6-12 hours the optimal window for intervention. This approach is supported by guidelines that prioritize patient safety while effectively managing thromboembolic risk.