Rhesus Neg - water birth/caesarian...

[nadssss]

Hello everyone?does anyone know if being Rhesus negative (and DH being positive) will have any effect on having a water birth ? which is what I would like?

Does anyone know if it makes a caesarian more or less likely? My midwife didn?t seem to know and though MN?ters might know more!

Thanks!

[WhereTheWildThingsWere]

It makes no difference at all, , how far along are you?

[browny]

Definately makes no difference, just like WTWTW said. I'm Rh neg and only had a c/s as my first daughter was in distress, I then had three vbac births (not in water though as I was being continually monitored). I'm almost 34 weeks pregnant now with baby number 5 and hoping for a home birth. Have you had your ant-d yet? .

[nadssss]

Thanks for this ? I am nearly 21 weeks

Really pleased to hear it should have any effect ? I am trying to keep an open mind about the whole birth and accept you don?t know what will happen.

BUT I am really scared of needles (utterly lame I know ? particularly given the pain of birth in comparison etc) so I am really scared about the anti Ds etc and the additional blood tests.

Have to say I really wish my DH was negative too!

[WhereTheWildThingsWere]

I refused anti-D in my second pregnancy, and it wasn't routinely given when I was prgnant the first time round.

Both my babies were Resus-neg, so it would have been completlely unneccerary.

I am not advising you to do the same, before anyone jumps down my throat .

But I would strongly advise that you read up on the subject, before you make a decision, and remember it is your choice.

[mishymoo]

I am Rhesus Neg and had a natural birth with a little help, i.e. ventouse! I had hoped for a water birth but my labour was too quick. It definitely doesn't make any difference being Rhesus Neg! In fact quite a high percentage of woman are (according to my MW)!

[snickersnack]

I refused anti-D second time round as well. dd was rhesus negative and my MIL then told me that dh was as well (he had lots of health problems when younger so she was well aware of his blood group). I came under a lot of pressure from the midwives but they finally agreed to let up if dh had a blood test to prove it. I did then have to deal with the "Oh well, if you're sure he's the father" comments .

I only refused because I was 100% sure it wasn't needed. But it is a blood product, and therefore not totally without risk. Though it's clearly a life saver in many cases - just something I knew wasn't needed.

[nadssss]

did you wtwtw? But if i refuse the anti-D and this baby is positive, won't this put any next baby at risk of my anti bodies?

Can i ask why you declined it? Did you know in advance that your babies were negative?

Thanks so much for your replies

[snickersnack]

What I actually meant to say as well, was that it has no impact on the birth at all. I had an emcs with dd and a VBAC (in the pool for much of the time) with ds. Being rhesus neg was never mentioned

[WhereTheWildThingsWere]

No I knew dp was positive, and I didn't know in advance about my babies, your baby (or rather the cord) is tested for blood group at birth and if either of mine had been positive then I would have accepted the anti-d.

Giving it during pg is a very new thing and really not needed unless you have had a bleed or bad fall.

I refused it because, as snickersnack said, it is a blood product and so not totally without risk and I would only accept it if it was deemed absolutely neccesary, not as a 'just in case'.

[WhereTheWildThingsWere]

Oh, and yes, I too got a lot of flack from the midwives, anyone would think they were on commision from giving out the stuff.

[snickersnack]

Sorry nadsss, cross posted.

If your first baby is rhesus neg, then it may not be a problem second time round - it's the pregnancies that follow a rhesus positive baby, as I understand it (I'd check this with your midwife), though in rare cases it can be an issue with the first rhesus pos pregnancy.

But I think, any pregnancy counts when working out if its the first or second , not just ones resulting in live births - so if you had a miscarriage first then that counts. And you wouldn't necessarily know whether that baby would have been positive or negative. Does that make sense?

In the case of a first baby, although it's unlikely to be an issue if you don't have the anti-D in terms of the health of that first baby, it will have an impact on subsequent pregnances if the baby is rhesus positive. Also, there are things called sensitising events that can happen during pregnancy that may have an impact - if you have a fall for instance, then you'll be given anti-D.

I wouldn't refuse it in a first pregnancy if your partner is rhesus positive. In fact, personally, I wouldn't ever refuse it if my partner was rhesus positive.

[snickersnack]

wtwww, I'm not sure any of the midwives I saw fully understood what I was saying to them. They just kept saying, "yes but if you're rh neg you need the jab". And I kept explaining I didn't because dh was rh neg as well and therefore all our children would be. Problem solved. But I had to actually move away from one midwife who was waving a syringe at me at one point.

[WhereTheWildThingsWere]

snickersnack, they always had the needles ready for me too.

As I said I would never refuse it after a bleed, m/c, or proven Rh-neg baby, but giving it during pg to all Rh-neg women has only been introduced in the last 2 years and it is an unneccersary intervention imo.

[snickersnack]

I agree, and wish I'd realised when pg with dd that I didn't need it, I didn't have to have it and I was able to say I didn't want it.

[Romney]

I hate needles but had it anyway. I didn't think it was worth taking the very likely risk of what it can do in a second pregnancy against the really tiny risk of having an injection. Just think of the amount of intervention required if my antibodies did start attacking my baby! Ick! (not to mention the poor baby would have a poor chance of living of course)

I would have got DH to have a blood test, but I think he is worse than me about them!

[WhereTheWildThingsWere]

It not the tiny risk of having an injection Romney, it's being injected with a blood plasma product and the risks that that carries that worried me.

To me it's something you only have if you have a proven need.

[mazzystar]

I think its just a case of weighing up the relative risks. Look into it and I think so long as its clear that you are making an informed decision most decent hcps will respect that.

Personally I accepted the routine injection both times, ds was rh neg like me but dd is rh +. It did mean I had a couple of extra midwifery appts at the hospital and was able to use these to talk about some other stuff.

It won't interfere with any other aspect of your pg or birth.

[AmandaN]

Hi Nadsss - snickersnack is right - the risk basically lies in the possibility of the mixing of blood between you and your baby, which wouldn't normally happen apart from possibly during the birthing process. At this point if your immune system is exposed to the Rh positive protein then you may start producing antibodies to this, which next time round (i.e if you get pregnant again with another Rh +ve child) might end up being more problematic. Essentially the difference between you being rhesus negative and your baby being rhesus positive, means that your baby has a protein on the outside of it's red blood cells that you don't have on yours.

(I know a little bit about this as used to test mums serum samples for risk of haemolytic disease of the newborn many years ago)

If your baby is rhesus negative then there is no way you would run a risk of developing antibodies to something that isn't there - so definitely no point having the anti-D.

Sometimes midwives and other medics like to make out as if they know more than you rather than admit that they are not always experts. They can sometimes assume that cos you're the patient how could you possibly know anything, but is worth getting informed and being able to challenge them - you often find that when you ask them specific scientific questions about this sort of thing they actually don't understand it properly themselves!

As for water birth - can's see any reason at all why you should be restricted due to being rhesus negative - I guess they may want to be extra vigilant re any possibility of tearing - and not sure (having not yet even had my baby!) on how they go about this if you are in the pool, but don't see why it should stand in the way :-)

[HeathersMummy]

Hi. Just to offer a different point of view. I'm RH Neg and DH is RH Pos, our DD is the same as her Dad RH Pos. It didn't effect my birth with her - it ended up forceps and episiotomy.
Unfortunately, our health authority do not offer Anti-D injections at any time either after birth or during pregnancy. I'm now 26 weeks pregnant with DC2 and I'm going for fortnightly blood tests as I have developed Anti-D and Anti-C antibodies which are now gradually on the rise. They're going to monitor my bloods every 2 weeks for the duration of my pregnancy and I'm getting additional scans to check on the baby's progress. I would give anything to have been able to get Anti-D injections. Would save me from the blood tests, but more importantly from the worry of how things are going to go.

[Scotia]

WTWTW, it isn't only in the last 2 years that they have been administering anti-D duing pregnancy. My friend's dd is almos 12 and she had the injections during pregancy, as did I five years ago. We are in Scotland though so it may be different for different health authorities.

HeathersMummy, I'm shocked you weren't offered anti-D after your dd's birth.

[HeathersMummy]

Hi Scotia. I'm in North Lanarkshire and asked my midwife for Anti-D when I was first booked in. She said it wasn't available and double checked my hospital notes as I shouldn't have had it after DD's birth (according to their policy). Defo not had it, or going to get it .

[nadssss]

This is so interesting ? thank you all for your replies. Given my Dh is def positive, and to be on the safe side in case of a fall say, I will have the injections (and stop moaning).

Heathersmum ? I am so so sorry you can?t get them ? that is completely shocking.

[WhereTheWildThingsWere]

Scotia, yes I think maybe it is just England, I know it is given routinely in the US.

I am shocked at anyone not being offered anti-d after delivering a positive baby.

[MadBadandDangeroustoKnow]

Am Rhesus neg and had a c-section but that was coincidental. C-section was due to failure to progress and cephalo-pelvic disproportion - blood group had nothing to do with it.

[Scotia]

HeathersMummy, I'm really shocked by that policy. I've got 4 adult girls, all Rh+, so I had anti-D after each of their births. I don't understand why a health board would refuse an injection that (I was under the impression) is essential to preven problems like you are facing in this pregnany.

Yes WTWTW, different authorities then.

I'm due my preventative anti-D at my next ante-natal appointment, and I probably will go ahead because I have had Rh+ babies before (although my ds is R-), but I can understand those who are against it in first pregnancies, or whose babies have been Rh-.