Rh Factor

[JoJo1stbub]

I was very upset upon seeing my doctor the other day. It was only the first time I have seen him, and I am not very happy with him.

He was checking my blood test results and said:

"You are AB- blood type. We will give you a shot at 28 weeks and after bub is born".

And that was all he said. No explanation or anything, he didn't even ask what DH blood type was.

I went home and did some research of my own on the net to find out why he would be giving me a shot and what it was.

Not too impressed to find out it contains blood fractions and the stuff they used to make - not sure if same stuff now - used to contain mercury and can harm bub if given while pregnant.

Do doctors think us patients are dumb and don't / wont question what they give us.

Well, I am not saying I am not going to have it, I don't even know DH's blood type yet, but was not impressed at the way the doc handled it.

Oh, and does anyone know anything about eating lots of oranges (the white part particularly) and capsicum during pregnancy to avoid shot if you are Rh-??? Someone told me their mum did that and had 4 perfectly fine children???

Anyways, just thought I would post, as it was on my mind.

[nkenward]

Hi Jo,

Yes it does sound rather strange that your doctor didn't further explain to you the purposes of the anti-D injections. I am Rh negative with blood type O- and my husbands A+. It is very important that you have these injections at the various stages cause if your bubs' blood type is + and something happens to pass your blood into the placenta and vice versa it can cause major problems and can lead to miscarriage.

It has been known that it might not be a problem in the first pregnancy, but you will build a defence to + blood, so if you plan a 2nd baby this will most certainly lead to a miscarriage. This has happened to my husband's first wife, they miscarried their 2nd child.

It is nothing to be concerned about, I had an injection at 28 weeks, 34 weeks and then one after the birth cause bubs was +. If bubs was - then I would not have needed the last one. And when you have so many jabs anyhow with blood tests etc, a couple more isn't going to matter that much.

Please note - this injection is important. If you are able to prove your DH is also -, then take this proof to the doctor and you won't need to have the injection.

[Mummy-2-2]

Please note - this injection is important. If you are able to prove your DH is also -, then take this proof to the doctor and you won't need to have the injection.

Agreed.

I am b- and had a miscarriage at 12 weeks when I didnt know I was pg. I had the normal injections in 2nd pregnancy and am preg with #2 baby now.
I had a fair amount of bleeding in the beginning of this pg and had to have the anti-d every 6 weeks to bring down my antibodies so I didnt abort my bubba. Now am 34 weeks and everything is fine but I dont want to know how everything would have turned out without the injections. I guess some people had a higher amount of antibodies already in their system.

This injection is VERY common in women with a -ve blood group.

[Oscar's mum]

I would really like to encorouge you to have this shot. It is really important for future pregnancies.

If you are not happy about the way the Dr handled the situation please see another Dr, ask them more questions about the anti - D and then weigh up your pro's and con's of having the shot, please do NOT rely (sp)? on what you have read on the internet, it isn't always true.

Please let us know what conclusion you come to.

[hummingbird]

I'm Rh- and my husband is +.

All the previous posts make very valid points which I wholeheartedly agree with.

If you are worried about what the contents of the injection, you should weigh up the negatives against the positives. Like immunisation injections, for me the positives outweigh any negatives.

I agree that your doctor could have gone a little further in explaining your condition and the treatment currently offered - never be afraid to ask lots of questions. Some doctors just seem to forget that many patients like to make an informed decision about what their treatment plan is, often though they get patients that just want the quick fix and aren't interested in the explanation.

[Crazy Monkey]

Hi Jo,

I too am RH negative (blood type O-) and was a little concerned when told I had to have the injections... After doing some research and speak with my OB, I realised it was safe and VERY necessary to have them... As others have mentioned, not having them causes more problems, and if there is a passing of blood from the placenta to your baby, you will harm your baby, more so for your furute pregnancies...

I would definitely recommend having them.. My DS is RH negative so I didn't need the after birth injection....

Good luck

[katesmom]

I also have Rh- blood. The shot is not painful. At least, I didn't think so. Just a little prick and it's over. I had absolutely no side effects. Without it you may miscarry if you try to concieve another child, which may be the furthest thing from your mind right now. I've had two miscarriages and the shot after each time.

I'm sorry the dr didn't explain it to you more, but the shot is no big deal really and it prevents so much heartache.

[veve]

I'm not a negative blood type (and am surprised at how many women are affected!! hadn't really thought about it!!!) -

but I read an article in a magazine recently about a lady (who is very old now... but way back before they understood the Rh thing) she had 12 children.. and several of them died (three I think?) ... as the blood crossed the placenta and destroyed the babies red blood count.. I hope I have my facts right... but I am sure I have the story here somewhere ...

very sad story... unless DH is a negative... please look into the injections..

((hugs))
xxx

[JanetF]

Actually evidence based care in the UK (and NZ and a number of other countries with better outcomes than Australia) doesn't promote routine anti-D for Rh- women. They test after the birth and then decide so you're not getting blood products for no reason. So Jo, yes, your doc obviously thinks he's the boss and isn't actually providing you with gold standard health care on an international basis. Recent research has shown that only about 1.5% of women develop the antibodies during pregnancy which means that the other 98.5% are having a blood product (plus the other stuff) for no reason. Why get treated for something you don't have? Women from the UK and NZ are really shocked at the routine policy here since it's been outdated in their ouw countries for some time.
These are much more up-to-date than your doctor who isn't even up with the latest thoughts and research in Australia! See below for more informed studies etc. PM me your email address and I'll send you some articles and other stuff from the best Australian and UK sources.



American College of Obstetricians and Gynecologists (1999)
Prevention of Rh D alloimmunization: clinical
management guidelines for obstetricians and gynecologists.
International Journal of Gynecology and Obstetrics,
Vol 66, No 1, July 1999, pp 63-70.

Bowman JM and Pollock JM (1978)
Rh isoimmunisation during pregnancy: antenatal prophylaxis.
Canadian Medical Association Journal,
1987, 118, pp 623-627.

Coombes R (1999)
Midwives cautioned over risks of using untested blood product.
Nursing Times, Vol 95, No 24, June 16, 1999, p7.

Crowther CA and Keirse MJNC (1999)
Anti-D administration in pregnancy for preventing rhesus alloimmunization. (Cochrane Review)
The Cochrane Library, Issue 4, 1999. Update Software, Oxford.

Gaskin IM (1989)
Rethinking Rhogam
Birth Gazette, Vol 6, No 1, Winter 1989, pp 32-33.

Ghosh S and Murphy WG (1994)
Implementation of the rhesus prevention programme: a prospective study.
Scottish Medical Journal, Vol 39, No 5,
October 1994, pp 147-49.

Gilling-Smith C, Toozs-Hobson P, Potts DJ and others (1998)
Failure to comply with anti-D prophylaxis recommendations in accident and emergency departments.
In Urbaniak SJ (1998)
Proceedings of the Consensus Conference on Anti-D Prophylaxis.
British Journal of Obstetrics and Gynecology,
105, Supplement 18, November 1998, p24.

Herman M, Kjellman H Ljungggren C (1984)
Antenatal prophylaxis of Rh isoimmunisation with 250mg anti-D immunoglobulin.
Acta Obstet Gynecol Scand, 1984, 124, pp 1-15.

Howard HL, Martlew VJ, McFadyn IR and Clarke CA (1997)
Preventing Rhesus D haemolytic disease of the newborn by giving anti-D immunoglobulin: are the guidelines being adequately followed?
British Journal of Obstetrics and Gynaecology,
January 1997, Vol. 194, pp 37-41.

Huchet J, Dallemagne S, Huchet C and others (1987)
The antepartum use of anti-D immunoglobulin in rhesus negative women. Parallel evaluation of fetal blood cells passing through the placenta. The results of a multicentre trial carried out in the region of Paris.
Journal de Gynecologie, d'Obstetrique Biol Reprod (Paris)
1987, No 16, pp 101-111.

Huggon AM and Watson DP (1993)
Use of anti-D in an accident and emergency department.
Archives of Emergency Medicine, Vol 10, No 4,
December 1993, pp 306-09.

Hughes RG, Craig JL, Murphy WG and others (1994)
Causes and clinical consequences of Rhesus (D) haemolytic disease of the newborn: a study of a Scottish population, 1985-1990.
British Journal of Obstetrics and Gynaecology,
Vol 101, No 4, April 1994, pp 297-300.

Hughes-Jones NC, Ellis M, Ivona J and others (1971)
Anti-D concentrations in mother and child in haemolytic disease of the newborn.
Vox Sang 1971, 124, p 135.

Lee D and Rawlinson VI (1995)
Multicentre trial of antepartum low-dose anti-D immunoglobulin.
Transfusion Medicine, 1995, No 5, pp 15-19.

Mayne S, Parker JH, Dodds SD and others (1997)
Rate of RhD sensitisation before and after implementation of a community based antenatal prophylaxis programme.
British Medical Journal, 315, 13 December 1997, p 1588.

McSweeney E, Kirkham J, Vinall P and others (1998)
An audit of anti-D sensitisation in Yorkshire
British Journal of Obstetrics and Gynaecology,
Vol 105, October 1998, pp 1091-94.

Royal College of Midwives (1999)
Anti-D update.
RCM Midwives Journal,
November 1999 mid-month supplement.

Romm AV (1999)
Rho(D) Immune Globulin: pros, cons, indications and alternatives.
Birth Gazette, Vol 15, No 2, spring 1999, pp 18-21.

Tovey LAD, Townley A, Stevenson B and others (1983)
The Yorkshire antenatal anti-D immunoglobulin trial in primigravidae.
The Lancet, 1983, ii, pp 244-246.

Urbaniak S (1998)
Proceedings of the Consensus Conference on Anti-D Prophylaxis. British Journal of Obstetrics and Gynecology,
105, Supplement 18, November 1998, p24.

Wickham S (2000)
Postnatal Anti-D - Exploring Midwifery Evidence
MIDIRS Midwifery Digest, Vol 9, No 4,
December 2000, pp 520-525.

Wickham S (2001)
Anti-D in Midwifery - Panacea or Paradox?
Butterworth Heinemann, Oxford.

Zipursky A, Israels LG (1967)
The pathogenesis and prevention of Rh immunisation
Canadian Medical Association Journal,
Vol. 97, No. 21, 18 November 1967, pp 1245-1257.

[hummingbird]

As usual Janet F comes through with the goods - love your informative posts.

[mummyto3]

i am O- and DF is B+.This policy of having anti-D shots at 28 and 34 weeks and after bubs is born is only new,as i never had it with the other 2 kids(DD is O- and DS is B-).I didnt even know DF's blood group until my doc told me about the anti D shots.As it is DD#2 is B+ like her dad,so i am glad we found out.If we have another baby it might not survive if i didnt have the needles.

My step sister is a neg blood group and her DH is positive.She never had the anti D shot after her DD was born(who was also positive),and has gone on to have 4 miscarriages in the past 6 yrs.Only now a doctor has told her that it could have something to do with the anti D shot (or rather lack of).So she has had it now,and is hoping to stay pregnant sometime in the near future.

Good luck in whatever you decide :)

[Imogensmum]

I am also rh-, but when i went to have my injection at 28 wks my ob asked me if i really wanted the injection- I told OB that the only reason i was getting it was because my DR recommended it!

OB said that it only gives you something like an extra .5% coverage if no complications (or something along those lines) and that if i where to have a bleed at any stage i would get the shot anyway, plus after birth if bub was a +

So i did a little reading and decided not to have the shot, not for any real reason, but just that i didn't want anything extra if it was absolutely necessary.

Imogen is a +, so after birth i had the shot. Have been assured by Dr and OB that al should be fine if i become pg again, but they will check the antibodies earlier??

I say read all you can, and go with your heart. You will know whats right for you!

Shannan

[reAllytee]

I am RH O negative & my partner is RH O positive so i had all my injections before bubs was born as well as having one after as bubs is positive like Dad !
There was a thread on here somewhere asking about it all as someone was being induced due to it. So i will somewhat repeat what i had to say there.
You have to count miscarriages, abortions & even blood transfusions as these can all lead to sensitivity. The sensitivity can cause a condition which is called hemolytic disease or hemolytic anemia. It can become severe enough to cause serious illness, jaundice, brain damage or even death in the baby. A mother who is sensitized will be checked during her pregnancy to see if the fetus is developing the condition. Cause once the mother has the condition they can only monitor bubs & then it may be born as normal followed by a blood transfusion for bubs that will replace the diseased blood cells with healthy blood. For more severe cases bubs may be delivered early or given transfusions while in the mums uterus. The anti-d is only for the pregnancy that it is given so that means each pregnancy it has to be given again if there is a chance bubs is positive unless mum has already shown to be sensitive. This is all worst case scenario as usually treatment is given & all is kept is monitored. Of course this isnt always the case.
I would have to say personally i wanted to get it done for the sake of my baby & my future bubs. Its a shame your doctor handled this so badly so as one of the other girls was saying i would possibly consider seeing another doctor if you dont feel comfortable with him. I always knew my blood group so growing up i knew i would encounter some problems when falling pregnant as both my parents being this group never had to worry but it was talked about.
I was lucky to have midwives who talked to me about it & then when i saw the doctor at the antenatal clinic they also went into details about it to which i agreed it was a good thing for bubs. I had to sign a waver as it is a blood product but then i thought the benefits far outweighed the risks. There are risks in immunisations but again they are far outweighed by the benefits.
I guess the thing is for you to make an informed decision & go from there.

[mum2four]

Please have your DH tested, if he is neg then great, if not, please, please, please get the shot! I wish they had a shot for the antibodies I have, but since mine is rare it's not worth their money:mad:
I would never wish an antibody pregnancy on anyone! You have the opportunity to avoid it by having a simple injection, your lucky!
I have 2 antibodies, and both cause the same problems in bub that RH disease does.
Let me just tell you a little of what you can expect in furure pgcies if your baby is + and you develope antibodies.
Regular (as in every 3-4 weeks) blood tests, extensive ultrasound regularly (mine were every 3 weeks and I was lucky) where they measure the blood flow through your babies brain, if baby starts to become anemic then you can expect you baby to need full blood transfusions whilst still in utero, early delivery (anytime after 34 weeks) which means nicu, possibly regular blood transfusions for your baby once he/she is born. In very severe cases if not caught early enough, you may even suffer the worst possible scenarion, that being babies death, permanent disability or brain damage.
Don't mean to scare you, But I am faced with this with my pregnancy, and if a little scaring helps another to decide to have a shot to prevent it, then i'm willing to tell it as it is.

I hope your DH is - and you have nothing to worry about!

[Kaileysmum]

Hi,

I am A neg, and i had 2 injections (Anti-D) while I was pregnant and then when dd was born they tested her cord blood to see if she was a positive or neg blood group, as she was positive they gave me another Anti-d. Its not for this baby it is for the next one, as if you get positive blood in your system your body develop anti bodies to fight it, so if you got pregnant with another baby and it was positive it would fight against it, if you have the shots it stops you forming these Anti bodies, so you and all your babys will be fine. You should ask your ob or midwife for information as my midwife gave me a litlle book explaining it. Or you could google it, its called 'Rh Incompatibility'. I hope this makes sence and helps. Its nothing to worry about, as long as you have the shots, or if your partner is a negitive blood group too.

E;)

[Oscar's mum]

JoJo1stbub what decision have you made? :confused:

[JoJo1stbub]

Hey,

Thanks for all the info guys, has been great help. I have not decided yet, but I haven't been able to get DH to the doc's to get his blood type tested yet either. We have been kinda busy, but I am gonna try and get hime down there this week. I just really hope he is - then i don't even have to make any decision about it.

But if he is + we will talk about it and decide together.

Oh, I would love to change my DR, except there are not many doc's where I live and he is the only one who delivers at the hospital I am going to, so, I gotta stick with him.

But yes, I will make sure I ask him lots of questions next time. I did try last time to ask some questions, but he really just wants to get you out and the next patient in, and he does become a bit rude.

I am going for my first proper scan on 9th Jan, can't wait for that. The doc gave me a quick one the other week, when I was 12 weeks. I didn't need it, and wasn't prepared for it, but he got a new machine and wanted to practise on it. I got to see the bub's head and it was moving around a fair bit, but DH wasn't there to see it (was a bit disappointed) But he will be with me for my proper one.

Oh yeah, also, my sis-in-law (DH bro's wife) had her baby the other day. Little boy, 8pound 1. Little cuttie too. Is her 3rd, and had him by c-section, lost a lot of blood, but I think is doing ok now.

;)

[loobeelu]

I have only had the shots after the baby is born, they dont bother with the in pregnancy ones here (NZ) I think the routine pregnancy blood tests tell the docs whether you have any antibodies developed or not (you could have them from your miscarriage, I had to have shots after a miscarriage) which would give you more information to decide on whether or not to have the shots during the pregnancy, I think the ones after the baby is born are no-brainers, if the baby is positive then for the health of future babies the shot is worth having IMHO.

Your doc sounds a bit of a worry, he should respect your need for answers, if he is like this now how is he going to be when you are in labour and in need of reassurance and explanations? Are there any midwives around there you can consult who will actually listen to you and give you the time you need? If not perhaps you could employ a doula to be your advocate in labour.

[♥Heaven Sent♥]

Like many of you i am RH- being o- .When i was pregnant i had no choice i had to have it about 5 times while pregant i had bleeding at 5-6weeks and had it ,and had a couple of accidents with my belly being bumped and my levels were down so i had it routinely when my levels were down.I am so glad i did as i had an A+ baby.I am now pregnant again and i had the needle after i had bubs I think its best for you and bubs to get the needle if you start to bleed or the bubs is found RH+ wen born.

[SweetDreams]

Jo,

Was going to ask if we had the same Dr but from the sounds of it we don't! (I know nothing of an u/s machine!!). Sounds more like one of the ones on Grevillea Street. I hope it's not one from the shopping centre!! :eek:

Anyhoo, I have an u/s on 6/1. Where do you go to Gladstone or Rocky?

Cheers :)

[JanetF]

Sandra here in Australia we have a crap healthcare system with none of the midwifery you have in NZ. I hope you've finished having babies because coming here is going to be a rude shock to your system. Every Kiwi I know has nearly died of shock at how primitive things are. So don't say you weren't warned ;) :o

[lisak78]

It is amazing how many people are RH -. I had never heard of it before I became pregnant. Sounds like all doctors are a little vague when it comes to describing these shots to us.

I walked out stressing. I found all of my information on the internet and it's amazing how many people I speak to have it.

I am quite happy to have my shots if it means that bubs is all ok.

Also is there a policy that women only get a 18 week ultrasound now? Is this the only one that we get? I live in QLD.

Lisa

[JellyBean06]

It's very important to have. My Mum is O- and I am B+. They never gave her injections and she ended up having two blood transfusions, bleeding out and almost dying! Sounds extreme, but even she says she would take the jabs over all that fuss any day! :o

[Funkychicken]

I'm also Rh- and when I was carrying our first DS 7 years ago it was a routine check of babys bloodtype AFTER the birth and a shot given of Anti-D then, which I had as DS is O+. With my recent pregnancy, I had the two shots during and another afterwards as DS2 is also A+.
History shows what happened prior to the discovery of Neg and Pos blood groups and the word Rhesus comes from the Rhesus monkies that were used to discover this info. Prior to that many Neg women were told to stop after 2 babies as the risks to future babies and themselves were great and many babies did die as a result. We may live in a world filled with all sorts of crazy stuff but sometimes science comes up trumps!

[Funkychicken]

Sandra here in Australia we have a crap healthcare system with none of the midwifery you have in NZ. I hope you've finished having babies because coming here is going to be a rude shock to your system. Every Kiwi I know has nearly died of shock at how primitive things are. So don't say you weren't warned ;) :o
I have friends who have moved here from Holland and would agree wholeheartedly about the system here-compared to theirs. Having said that, I had a great pregnancy through the midwifery care program recently. They were very open and followed my lead a lot of the time. I only saw a GYN once and that was for the hospital referral. Iactually think we are blessed by the fact we can make our own choices about our pregnancy care here in Aus. We can decide if we want the whole DR thing or just midwives or shared or homebirth or hospital. We choose how to give birth, what position we want to do this in, how we want to manage pain, do we want showers, baths, who we want to have at the birth, if we want to come after after delivering etc...you get the picture.
There are countries which have none of this-at least we are constantly improving such things as midwifery especially when you compare it to our parents experiences!

[Goosie22]

You have probably found this definition(or one similar) its very basic and written in normal lingo so its easy to read I thought I would post this to clarify for later readers:)

Definition:
Rh incompatibility develops when there is a difference in Rh blood type of the pregnant mother (Rh negative) and that of the foetus (Rh positive). Subsequently, anti-Rh positive antibodies form. (See also ABO incompatibility.)

Causes, incidence, and risk factors:
During pregnancy, red blood cells from the foetal circulation leak into the maternal circulation. If the mother is Rh negative, her system will not tolerate the presence of Rh positive cells. Her immune system treats the Rh positive foetal cells as if they were a disease and makes antibodies against the foetal blood cells. These anti-Rh positive antibodies move through the placenta into the foetus where they destroy the foetus' circulating red blood cells. First-born infants are often not affected as it takes time for the mother to develop antibodies against the foetal blood.

Rh incompatibility may cause symptoms ranging from very mild to death of the newborn. In its mildest form, Rh incompatibility causes hemolysis (destruction of the red blood cells) with the release of free haemoglobin into the circulation. Haemoglobin is converted into bilirubin, which causes an infant to become jaundiced. The jaundice of Rh incompatibility may range from mild to very high levels.

Hydrops foetalis is a severe form of Rh incompatibility where massive foetal red blood cell destruction (a result of the Rh incompatibility) causes a severe anaemia resulting in foetal heart failure, total body swelling, respiratory distress (if the infant has been delivered), and circulatory collapse. Hydrops foetalis often results in death of the infant shortly before or after delivery.

Its taken from http://ekhmedical.com.au/html/default.asp

[SMBT]

I started bleeding in my pregnancy with DS at 9 weeks, they checked my blood type and found that I was RH-. Had to have the shot then incase bub was +. Started bleeding again at 15 weeks but little DS was fine. When DS was born he was 0- so didn't have to have another shot. Then when I was pregnant with DD I had to have 3 shots while I was pregnant at different intervals, apparently it was some new schedule that was brought in. Again my DD was 0- so didn't have to have another one after the birth. Basically I had a lot of shots for nothing, as both my children are the same blood type as me. Ouch! But worth doing if means bubbies will be ok!

[uptheduff]

I'm o-, and both my son's are o- aswell. My mother in law is o-, so i'm pretty sure that dh is o- too. When i was pregnant with ds2, i asked my dr if i could get dh tested so that i possibly did not have to have the jags. She told me that it's not as easy as that, there are many many factors that need to be taken into consideration. Not quite sure what that meant, don't know much about it, but maybe if mum and dad are -, there is still a small chance you could have a + baby? Or maybe she was just doubting that dh was the father lol!

Anyway, i had ds1 in the UK, and they do not give anti-d to mothers pregnant for teh first time, unless they have antibodies present. I'm pretty sure they do give it to mothers if it is not the first pregnancy, or if there was bleeding in the first, or first baby was +, etc.

[reAllytee]

She told me that it's not as easy as that, there are many many factors that need to be taken into consideration. Not quite sure what that meant, don't know much about it, but maybe if mum and dad are -, there is still a small chance you could have a + baby? Or maybe she was just doubting that dh was the father lol!

Anyway, i had ds1 in the UK, and they do not give anti-d to mothers pregnant for teh first time, unless they have antibodies present. I'm pretty sure they do give it to mothers if it is not the first pregnancy, or if there was bleeding in the first, or first baby was +, etc.

If you have a negative & a negative you can only have a negative :)
Thats why i hate my parents LOL they were lucky they didnt have to worry about any of it both being RH O negative so it meant they produced all RH O negative girls they even quite rudely (jks) said "oh well thats the girls problem when they have babies" LOL :rolleyes:
Yes there are factors involved due to any misscarriages, blood tranfusions or previous babies but if you are tested for the antibodies & have none present with a negative partner like yourself then that should be a green light saying you dont need to have the anti d so i would look into that more if i was you !
Good luck :)