To think it is not necessary to test my blood group in my 2nd pregnancy?

(50 Posts)
ikeaismylocal Wed 02-Apr-14 19:02:14

I gave birth to ds just over a year ago, I'm now pregnant with dc2.

I have really hard to access veins, I had a slightly traumatic time whilst giving birth when the midwives, drs and eventually a specially called in phlebotomist struggled for hours trying to get a cannula into my arm, there was blood everywhere, it was much more distressing than the actual birth.

I had my 1st appointment with my midwife yesterday, she looked at my veins and said she wouldn't be able to get any blood so told me to go to a place where they only take blood tests, she gave me all the papers with the blood tests needed.

The tests were:
the blood test for the neucle scan
Hiv
Hep b/c
Syphilis
3x thyroid tests
german measels immunity
blood group

It was 6 viles of blood, the 1st person couldn't get any veins to word so someone more experienced had to come in, it was horrible, there was enough blood and I now have a very sore arm. I very nearly fainted.

I don't understand why I need to retake all the tests, the blood communicable deseases tests surely only show that I am not infectious right now but I still have another 6 months of pregnancy, I don't know why they can't take my tests from my 1st pregnancy.

The blood group is just stupid, how is there any chance that has changed!?

Another thing that is anoying me is that if I change my name before the birth I will need to get all the tests redone, we are getting married in the summer we were planning on having a double name, but I think I would rather wait than retake all the tests.

AIBU? (probably)

tiredandtiredandtired Wed 02-Apr-14 19:04:58

You don't need to have any tests. None are mandatory. You can refuse consent. You don't even have to see a midwife if you don't want too!

Lazybones12 Wed 02-Apr-14 19:05:34

I asked this question. Had m/c but had bloods done. Few months later on subsequent successful pregnancy the wanted to do again and I was like no pint only done few months ago. I was told ...... Wait for it.... By a lovely midwife.... There was no saying that father the same �� nice!!

stokiemum62 Wed 02-Apr-14 19:13:38

They are not looking for just your group but also an antibody screen. This is routinely done at the booking visit and again at 28 weeks. If you had a blood transfusion after your last delivery or even after a difficult delivery or a normal delivery for that matter, you may have developed an irregular antibody. If you have irregular antibodies the levels and your baby will need close monitoring as this can result in major problems.
The risk is very small the consequences very serious the choice entirely yours. If you are happy to accept the small risk on behalf of your baby don't have the test done.

cherrytree63 Wed 02-Apr-14 19:19:51

In the unfortunate event of you needing a transfqusion it is vital that you receive the correct blood type. They would take another cross match and compare it against your booking bloods. Records must be accurate and up to date.

meditrina Wed 02-Apr-14 19:21:10

You can decline bloods, just as you can decline any other test. But then you must accept anyrsks that arise from not knowing.

Most people would want to know if their rubella immunity had waned, or if their thyroid function had changed, or if they had acquired one of the tested-for diseases. But it's not compulsory to find out.

Soapysuds64 Wed 02-Apr-14 19:22:45

as stoke says, it is the antibody screen that is important. Rhesus antibodies are the main ones, and that is why Rh neg women are routinely given anti D after delivery. But there are plenty of others, and can cause very serious complications in pregnancy.

tiredandtiredandtired Wed 02-Apr-14 19:23:42

Your blood type can't change between pregnancies. And if you have an accident (when not pregnant) they just have to give you a transfusion of universal donor blood till you can be checked if the situation calls for it. So they don't NEED to know your blood group

Musicaltheatremum Wed 02-Apr-14 19:25:28

Believe me they don't do it for fun. Things change and if something did go wrong then they would look pretty stupid for not checking it.

Musicaltheatremum Wed 02-Apr-14 19:26:08

No tired but the antibody status can.

Sidge Wed 02-Apr-14 19:26:20

Changing your surname shouldn't mean getting the bloods redone.

crazykat Wed 02-Apr-14 19:29:11

It's to check the antigens. The German measles one is to check your immunity. I was immune when having DCs 1&2 but not when I had dc3 so needed a fourth MMR after delivery.

It's also possible that HIV / hep b or c can be contracted between pregnancies though obviously unlikely if you're with the same partner.

You don't have to have them done though if you really object.

bakingtins Wed 02-Apr-14 19:29:21

It drives me mad that they don't employ any common sense when requesting the tests.
I was tested for sickle cell and thalassemia again I am not and never have been in an at risk ethnic group and neither is the father.
But I wanted the blood count done and the antibodies because I have had a transfusion and am prone to anaemia, and I couldn't have some tests and not others...

If the thing about repeating them if you change your name is true that is beyond ridiculous! Surely your NHS patient no remains the same?

Jaeme Wed 02-Apr-14 19:29:33

It depends on the policies of your NHS trust, in ours women's tests from previous pregnancies can be accessed for 5 years so if you were within our trust it wouldn't need to be done again.

ikeaismylocal Wed 02-Apr-14 19:30:41

I had no idea the antibodies could change, thank you for educating me on that! My previous birth was pretty easy (apart from the lack of good veins) but I guess it is better to be safe rather than sorry.

In my last pregnancy I tried to decline a MRSA test, the reaso was that I had to put a swab into the back of my mouth and I was worried it would make me sick. The only reason they wanted me to do the MRSA test was because I am a dirty foreigner, I didn't think the test was neccessary. The midwife said that if I refused the test i would be treated as a contamination patient and it would all be very difficult for me, I'm not sure if it is true but I felt I had to take it.

I did take all the tests, I will bare in mine if I get pregnant again that it is optional to refuse, once I am in a medical enviroment I sort of forget that my body is still my body, I don't have to do what they say!

ikeaismylocal Wed 02-Apr-14 19:32:10

I should have mentioned I'm not in the UK.

Yes, it is the antibody status that's the important one to test for - if you have the antibodies in your blood, it can cause real problems - I found this on a quick google:-

"Rhesus status only matters if you are an RhD-negative mum who is carrying an RhD-positive baby. Your child will have inherited this from her RhD-positive dad.

If some of your baby's blood enters your bloodstream, your immune system may react to the D antigen in your baby's blood. It will be treated as a foreign invader and your body will produce antibodies against it. This is known as a sensitising event.

Sensitising is not usually harmful if it is your first pregnancy. But it can cause problems if you become pregnant again with another RhD-positive baby. The antibodies that your body made in your first pregnancy can cross the placenta and attack the blood cells of your baby.

When your baby's blood cells are attacked, it can cause anaemia. If the anaemia becomes severe, it can lead to life-threatening problems for your baby, such as heart failure and fluid retention.

After she is born, your baby's liver won't be able to cope with the volume of blood cells that need breaking down. She may then become jaundiced, which is called haemolytic disease of the fetus and newborn (HDFN), or haemolytic disease of the newborn (HDN).

In severe cases, HDFN can cause permanent brain damage and neurological problems in your baby, such as cerebral palsy, and physical or speech problems.

Rest assured that, because of routine injections of a substance called anti-D immunoglobulin (anti-D) to guard against the harmful effects of antibodies, HDFN is rare.

http://www.babycentre.co.uk/a568837/what-is-my-rhesus-status-and-how-will-it-affect-my-pregnancy#ixzz2xksgDrCM."

whomadeyougod Wed 02-Apr-14 19:33:03

they got my blood group wrong on the 1st baby , i wasnt given the anti d after , if they cant get a simple thing like that right you worry what else are they doing wrong.

ikeaismylocal Wed 02-Apr-14 19:36:18

I am a little confused, can my blood change from O+ to O-? Or is it just that if my blood was O- they should test for the antibodies in a 2nd pregnancy?

The latter. If you are Rhesus negative, and your first baby is Rhesus positive, and if some of your baby's blood enters your bloodstream, your immune system may react to the D antigen in your baby's blood. It will be treated as a foreign invader and your body will produce antibodies against it. This is known as a sensitising event.

This can be a problem if your second baby is also Rhesus positive and the antibodies you've made get into the baby's blood stream, but if they know you have the antibodies, there's an easy treatment - the routine injections of the anti-D immunoglobulin.

meditrina Wed 02-Apr-14 19:45:17

Some hospitals swab everyone pre-admission for MRSA.

It's nothing to do with nationality, ethnicity, or place of habitual residence. And everything to do with infection control in hospitals. It's particularly important for maternity admissions (because of vulnerability of new borns) but normally done, in those hospitals that test, for every planned admissions.

AnyoneforTurps Wed 02-Apr-14 19:45:33

It's not just rhesus or blood groups - there are a host of blood factors & antibodies that can change over time. Blood has to be matched carefully to avoid transfusion reactions which can be fatal.

Unmatched O negative blood can be given in an emergency but it is not anywhere near as safe as properly matched blood and, as it is always in short supply, there is also a risk that there might not be enough available when you needed it - a good-going obstetric haemorrhage can require 12 or more units of blood.

YANBU to ask whether you need the tests - you should always ask why tests are being done - it's your body smile. But the mw is definitely NBU to want to do the tests again.

candycrushhater Wed 02-Apr-14 19:50:20

I am Rhesus negative and DC1 was positive. When pregnant with DC2 it was noticed after taking second lot of bloods that I had started developing antibodies. In my case I had both anti-c and anti-d. I was not given the anti-d immunisation as it was determined not to be worth while because of the other antibodies I had. The levels of antibodies in my blood were very closely monitored for the duration of my pregnancy with lots of blood tests. When DC2 was born he was quite poorly, but the drs were expecting it, he was treated and made a full recovery in a few weeks.
I really feel for you as giving blood for tests sounds pretty horrific, but it is absolutely worth it.

ikeaismylocal Wed 02-Apr-14 19:58:45

It's nothing to do with nationality, ethnicity, or place of habitual residence. And everything to do with infection control in hospitals. It's particularly important for maternity admissions (because of vulnerability of new borns) but normally done, in those hospitals that test, for every planned admissions.

It was because I had been in a foreign dr's surgery. I am English but I live in Sweden, I had been to the Dr with dp as he has tonsilitis when we were visiting my family and that was enough for them to want to test me for MRSA, they don't test people unless they have been in a dr's surgery or hospital in a different country, it doesn't matter that I wasn't a patient, purely walking in the door made me high risk.

I pointed out that my dp had had MRSA (picked up in a Swedish hospital) so why would visiting an English Dr's surgery be more dangerous than being treated in a Swedish hospital. They had no answer.

Soapysuds64 Wed 02-Apr-14 20:00:08

No, your blood group doesn't change.

Your blood cells have antigens on them, but you can form antibodies during delivery or if you have a bleed during pregnancy, as the baby's blood mixes with the mother's. The most common antibody is rhesus D, but there are also rhesus C, c, E, e, Kell, JKa, Jkb, Fya, Fyb..... the list goes on, and this is why rhesus positive as well as rhesus negative women are tested (although rhesus negative women are tested more, because anti rhesus D is by far the most common).

Transfusion labs up and down the country group and screen a lot of antenatal samples everyday - most are ok, but sometimes antibodies are found, which are investigated further and pregnancies monitored more closely. The antibodies (not the blood cells) pass through the placenta into the baby, and can attack the baby's blood. Babies with HDN (i.e. mothers having high levels of rhesus antibodies) are given exchange transfusions shortly after birth, where all the baby's blood (with mothers antibodies) is replaced, and possibly intra-uterine transfusions.

If you need a caesarian, you are likely to have another blood group and screen in case you need a transfusion.

Whomadeyougod - are you sure they grouped you incorrectly, or did you just not get anti-D?

Don't know if that makes it clearer... might make it my specialist subject in Mastermind (and also looking for a job back in Transfusion just now....)

redspottydress Wed 02-Apr-14 20:02:35

Yes I developed 2 relatively rare antibodies in my second pregnancy despite never having had a blood transfusion. I declined the sender on rubella and Hiv test though.

itsmeitscathy Wed 02-Apr-14 20:04:44

Why on earth is it such a big deal? It ensures that you get the correct blood type (which, very rarely, can change if you have a donor BMT for example, as unlikely as this may be) and it's one extra vial. It checks the anti bodies and presumably reduces scope for human error.

So yes, you're being unreasonable. Stick your hands under warm water before getting blood taken though, that might help.

meditrina Wed 02-Apr-14 20:06:52

Sorry IKEA - I'm guilty of assuming everyone's in UK and using NHS.

whomadeyougod Wed 02-Apr-14 20:16:50

soap yes they got blood group wrong and didnt get anti d , it wasnt till i had 2nd dd they noticed the mistake.

uselessidiot Wed 02-Apr-14 20:18:51

It will be partly to cover themselves. Imagine, god forbid, they'd made a mistake the first time and you needed a transfusion. They'd be in a lot of trouble for relying on an old test. The transfusion people have very tight guidelines.

Onsera3 Wed 02-Apr-14 20:25:49

Very glad PFB is a rhesus neg like me!

I can see why you're frustrated. I felt like a pincushion by the time DS was born. Blood tests blood tests to check hormone level TTC, blood tests fertility clinic, IVF injections and sometimes daily blood tests, sometimes midwife and ob taking blood tests for same things during the pregnancy, anti D tests and jabs. My midwife was so bad at taking bloods I nearly passed out once or twice despite being a pro with needles by that time.

It sounds like it's really horrible for you poor thing.

Frustrating that they might repeat things too. But I guess we are lucky to have access to this healthcare. 80 years ago they didn't know about this blood type problem and my grand mother said in hindsight she was suspicious rhesus disease had taken the life of her newborn sibling.

WestieMamma Wed 02-Apr-14 20:28:57

I had the MRSA test when expecting DS. In Sweden it's done if you have had surgery or given birth in a hospital abroad, not for visiting a GP. You midwife sounds rather over enthusiastic.

As a complete aside, Swedish naming laws forbid double barrelling surnames. You can add the other surname as an extra middle name but they only allow doubl barrel names if they pre-existed moving to Sweden (and then only because one of the European courts said they had to.)

Mumoftwoyoungkids Wed 02-Apr-14 20:30:56

My rubella immunity wore off between pregnancies. Apparently it's quite common!

Chunderella Wed 02-Apr-14 20:37:50

It is, but there's nothing much you can do if you find out your rubella immunity has waned once you're pregnant, is there?

MissYamabuki Wed 02-Apr-14 20:54:49

Am with you ikea!

Booking appt with this.pregnancy:
Midwife: we need to take your bloods to find out your blood group
Me: it's not changed since my.last pregnancy
Mw: <blank stare>
Me: it's a rhneg, had antid during 1st pregnancy, DD is rhesus neg too so.no sensitisation etc
<Look it up on mynotes ffs>
Blood was taken. During next visit midwife announces importantly:
your blood group is a rhesus neg, you will need to have antid.

A waste of time and resources in my case

ikeaismylocal Wed 02-Apr-14 20:55:58

The test that I really wanted was chicken pox immunity, my dm can't remeber if I have had it or not, if I am not immune I will get ds vaccinated. I have to meet with a Dr to discuss this as it could be too expensive (I don't expect them to pay for the vaccination, just the test to see if I am immune).

westie Possibly different areas have different rules, I have 2 friends who had to also have the MRSA test due to visiting UK hospitals, we all had different midwives in different parts of the city. Ds has a double last name just without the hyphen, both my last name and dp's last name are his official last names (on prescriptions, official letters and on his passport) he also has 2 middle names which are not on his prescriptions and official letters.

MiaowTheCat Wed 02-Apr-14 21:12:21

I queried this (I've got an 11 month gap between my kids) and got the sheepish look from the midwife of "oh, I can't find your results anywhere on the system from last pregnancy so let's just add in that one to the bloods I'm doing since I'm jabbing you anyway"

She sounds crap saying that but my MW was lovely really.

BeyondTheSea Wed 02-Apr-14 21:17:47

I developed anti bodies in my 2nd pregnancy and had a complicated delivery. Such a small inconvenience having blood taken but the risks if you don't could be enormous.

herethereandeverywhere Wed 02-Apr-14 21:25:44

I got funny things in my blood between my 1st and 2nd pregnancies - it was the antibodies thing but not Anti-D. I think it was Anti-M (but I might be getting mixed up with M and Ms confused)

I hadn't had a blood transfusion previously either but they said it can sometimes be triggered by a virus and it wasn't one of the most serious ones, like anti-D.

It did mean *lots more blood tests - don't know why *I had to carry a special emergency card *I wasn't eligible for a MLU birth as I wasn't low risk - no worries there I wanted a CS! *I couldnt have something like express match/emergency matched blood and I needed mine properly matched in case I had a funny reaction (sorry, bad explanation)

Sixgeese Wed 02-Apr-14 21:29:58

I had a plasma transfusion after a secondary PPH after DC1 was born, and my lovely boring O+ blood now has an abnormal antibody in it. This isn't saying that it comes from the transfusion, but that was they only thing that changed.

My DC2 and DC3 were both meant to have their cord blood tested to check that the abnormal antibody wasn't going to effect them, which was forgotten after DC2's delivery (I was a little busy at the time and reminded them too late, despite it being written all over my notes), so she had to have 4 months of blood tests starting day after her birth.

traininthedistance Wed 02-Apr-14 21:33:52

I'm sure I read somewhere that it is technically possible in rare cases for blood type to change....must be extremely unlikely though!

It isn't only the antigens; they keep the blood and if necessary can use it to check various immunities which may well have changed between pregnancies and which they may need a baseline for for the new pregnancy.

eg. I was exposed to slapped cheek at just the wrong stage in pregnancy for slapped cheek and my GP arranged for my booking bloods to be tested for slapped cheek immunity (thankfully I was immune - and they were amazingly quick doing it: as the blood was already on ice as it were the surgery rang me with the results the next day so I didn't have to worry about it).

traininthedistance Wed 02-Apr-14 21:40:28

Antibodies not antigens! Gah must sleep.

Soapysuds64 Wed 02-Apr-14 22:28:15

herethere - yes, there is anti M - which is why all women are tested, not just those who are rhesus negative (at risk of developing anti D)

MissYamabuki - being rh -ve and having a rh -ve baby doesn't mean you can't develop any of the other antibodies that cause HDN!

Endymion Sat 05-Apr-14 11:29:21

I was A rh-. Now I am A rh- with anti-D and anti-c antibodies. Meant ds2 (third child) was severely anaemic post-natally and required a transfusion, despite my having had all the anti-D jabs ante and post-natally.

Have a card to carry in case I need an urgent transfusion in the future. Would also mean that a fourth pregnancy would be high-risk.

winklewoman Sat 05-Apr-14 11:53:20

I too have the 'urgent transfusion' card, in fact three, all different from three pregnancies.

1 RH neg
2 RH pos but with, presumably, strange antibodies needing card
3 RH neg when giving, RH Pos when receiving (or the other way round)

I have always found this puzzling but DSs were fine.

Yddraigoldragon Sat 05-Apr-14 12:10:52

I always struggle with blood taken from the arm, I am pretty sure my veins see the needle coming and hide..
So now, I always state very firmly that if blood needs to be taken it comes from the back of my hand.

I am always told that it hurts more, I think having half a dozen holes poked in my elbow is likely to hurt more!

There seems to be an issue of professional competency, as I am in fact doubting their ability to find the vein in my arm. I though am confident after many blood tests that it is a better way.

Classic phrase is I do NOT consent for you to take blood from my arm - at that point they use my hand or I do not have the test done.

And it is worth noting that using my hand they have never failed to achieve the correct amount of blood first time and with little pain.

Simples..

Whathaveiforgottentoday Sat 05-Apr-14 13:39:58

If you are rhesus negative you would need Anti D's with every pregnancy as its when the child is rhesus positive that there is a problem. It wouldn't matter if your 1st child is Rh - because the 2nd one may be rh +.

The only way you could be sure if you knew your DH was rh- too and even then, the midwife would still test you as they don't trust your word that your DH is definitely the father. Don't take offense as they treat everybody like this as its easier (rates of cuckoldry vary from around 1% - 5% of the population depending on where and how its been studied).

Also you may have been infected inbetween pregnancies and immunity levels can wane, sometimes mistakes have been made, results lost etc. In in all, its probably easier to just retest for everything.

MargeSimpson Sat 05-Apr-14 14:05:21

Is it worth putting emla on 1 hour before tests to help with the pain, and holding a heated wheatbag or hot water bottle on your arms to help your veins be as prominent as they can.

Sixgeese Sat 05-Apr-14 15:50:03

My abnormal antibody is anti s, people look at me as if I am confused as I also have the unrelated blood clotting condition of Protein S Deficiency. At least having the same letter makes it easy to remember. If I need blood they would have to bike it in from a central London blood bank.

VivaLeBeaver Sat 05-Apr-14 17:41:48

Like others have said not only can you develop odd antibodies but you can change between a positive and a negative for the rhesus status. Rare but it happens.

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