Download and print the checklist [PDF –664 KB]
Checklist for blood clot risk
Determine your risk when pregnant or in the 3 months just after delivery
Check the box next to any risks that might apply to you and share this information with your doctor or healthcare provider.
Blood clot risks associated with pregnancy
- Prolonged immobility due to bed rest during pregnancy or recovery after delivery
- Delivery of a baby by C-section
- A previous blood clot, a family history of blood clots, or a genetic blood clotting disorder
- Pregnancy at age 35 or older
- Certain pregnancy conditions and complications, such as pregnancy with multiple babies or the use of fertility treatments involving hormones
Other risk factors for blood clots
- Smoking
- Overweight or obesity
- Sitting too long, such as traveling for more than four hours, especially with legs crossed
- Long-term diseases, such as heart and lung conditions, or diabetes