One If by Vaginal, Two If by C (Section): An Argument for Vaginal Delivery for Hemophilia A Carriers with Male Fetuses

Disorders of coagulation such as hemophilia can have profound effects on health and development beginning in the early stages of life, including pregnancy. With regard to mode of delivery planning for hemophilia A carriers bearing affected fetuses, there is little literature to guide practice and there remains little consensus regarding optimal mode of delivery. Importantly, most of the existing literature focuses solely on risk to the fetus without consideration of risk to the mother. We discuss the complex management decisions and present an argument for vaginal delivery as the “default” option, in the absence of strong maternal or fetal indications for cesarean delivery.