A Rhesus Negative Mums!

[Expectantmum]

Wondered if could give me some advice/set my mind at rest. I am 30, 22 weeks pg and have just found out that my blood group in A Rhesus Negative, which means I have to have the Anti D (I think thats what the midwife called it) jabs over the next few months. Can I hear from any other women who experienced the same and just set my mind at rest and maybe put into some terminology I might understand .

Thank you!

I'm Rhesus Neg. and have had the Anti D with all 3 pg's. Now on number 4 and have to do the same thing again. I have never actually thought of it as a problem, just a literal pain in the arse having to have the injections!

Don't worry - it's fine.

kinki - you have every right to refuse anti-D if you want. Your DH can make an appointment with the GP to get his blood grouped checked (sometimes they chanrge). In my area the midwife is actually able to send a sample from the husband off to find out. Alternatively, get him to give blood if he is suitable, however the blood transfusion service do not want people to donate just once to find out group - preferably they would like you to continue to donate which is a good thing.

The NICE guidelines state that if the partner is known to be Rh neg then there is no need for anti-D.

I agree kinki, that the midwife has no right to infer the baby might not be your partners. It is up to you to base your decision on the facts you have.

If I knew my partner was Rh neg there is no way I would have anti-D. I think all Rh neg women should know their partners blood group.

MrsJetson - the injection is not th eissue - it is exposing a baby in the womb to an unnecessary blood product that we truly don't know the effects of.

NICE guidemace for the public

Print this off and show your midwife - it says if partner is known to be negative no need for anti-D

It's interesting that the guidance says that Mears - perhaps our surgery needs to read it! Strangely enough, if DH and I hadn't insisted he had his blood checked, I would have declined Anti-D for the wrong reasons, thinking he was -ve when in fact he turned out to be +ve. I wonder how many other women might be in the same position. As it was, at least I could make a properly informed choice (which as I said was not to have it).

It makes me really angry actually that women out there with Rh -ve partners are being given Anti-D, the risks of which I don't think are well enough understood yet, when there is actually no need for it at all.

I agree with you Twinklemegan.

Thanks for the information and the NICE link. It's given me impetus to find out if I really need it. I think we'll make a formal request to find out dh's blood group. I only want to decline the anti-d if I know he's -ive as well. Mind you, having said that, this is probably my last pregnancy, in which case I wouldn't need it for that reason either.

The thing is Kinki, it is so so unlikely that you would have a sensitising event during your pregnancy and not know about it. Any bump or fall and you can go and have Anti-D. That was my reasoning. As I said, when DS's cord blood was tested and he was Rh +ve, THEN I agreed to have the Anti-D, when DS could no longer be affected by it (although this is probably my first and last pregnancy).
Anyhow, best of luck with what you decide in any case, and good luck with your drs surgery.

Well there we go then - I wasn't told any of the information!! It was a case of you have to have this on this date and there you go - he did do a lot of scaremongering actually - so we did it!

We didn't know any better - just trusted what the Doc said.

Thank you Mears for so graciously pointing this out to me.

I contacted my midwife today about needing the second dose of Anti-D and she said I didn't need it because they give double at 28 weeks.....Oh well. I DO know dh is rhD+ because dd is + though.

This is something i still don't really understand.

I'm rhesus neg. After dd1, had the shot. During my second pg, i wasn't offered any further injections, but had my antibody levels checked and was always fine.

When dd2 was born, her bilirubin levels were so high she was whipped off to scbu and kept under the lights for days - we were told it was rhesus disease.

I still wasn't given a further shot, and i questioned this, - but was told it's still present in my blood so not needed.

When we were discharged i was told by the consultant that further pregnancies would be risky due to the severity of the reaction, and another baby may need a transfusion through the cord during pg. (which has totally put me off any more babies.)

All this, and only ever one injection. Dont' understand why others seem to have so many more.

Scroll further down and 'Mears Explains It All' Sounds like you have the anti-D antigens now so you will have them forever. The Anti-D prophylaxis is to mop up any blood from baby entering your system and prevent the antigens from being produced in the first place. Since you've got the antigens, there is no point in you having the anti-D.

I did read that, but am still struggling to understand. So why did i make antigens if i'd had the anti-d? Why didnt' it work in the first place?

Boco - there is something not adding up here. If your baby was treated for jaundice due to rhesus disease, then you would have had rising antibodies during your pregnancy. Are you sure your antibodies were checked? It is not the first time that tests have not been done or followed up.

I would ask your GP to find out for you exactly what happened during your last pregnancy - it is important to know.

It may well be that the anti-D you were given after your first pregnacy was not enough and that you developed antibodies which would not be detected at the beginning of your pregnancy but would show up as the pregnancy developed.

If you didn't show any up during your pregnancy it could be that you developed them at the end of your second pregnancy. I developed mine at 36 weeks. I had had a pain about 34 weeks but my GP had dismissed it, so so did I. It must have been that I had a small bleed behind the placenta then and that is what caused antibodies to form. DS2 was under phototherapy for 5 days as a precaution, not because he was actually jaundiced.

My third and fourth babies were severly jaundiced.

Antibodies must have been detected in your blood post delivery and that is why you were not given anti-D as there is no point then.

I remember they checked back over my results and said that the last blood test had been at 34 or 36 weeks (can't remember which) and there were no problems detected at that point, they said that it must have happened in the last few weeks of pregnancy - i delivered at 42 weeks and was induced. She was jaundiced but not severely - she was also under the phototherapy lamp for 5 days, but didn't have the blood transfusion although it was planned for each day, then they'd say they could leave it for another few hours as her levels were no longer rising.

Boco - you sound as though you are one of the women who has been 'silently sensitised' - that is something has happened during your pregnancy which has allowed fetal cells into your circulation. In my case I had a pain that was ignored. What should have happened with me is that I should have been given anti-D when I complained of the pain and that would have stopped me from developing the antibodies.

In your case, the antibodies could have been prevented if you had been offered and accepted routine anti-D injections at 28 weeks and 34 weeks of pregnancy.

Did you have any unexplained pain or bleeding during your second pregnancy?

I don't remember any unexplained pain or bleeding - had a lousy pg all round with lots of sickness and tiredness, and some scares about the size and movements of the baby, but nothing I can think of.

I'd read about the 2 routine injections and checked with my gp and midwife, but they had not introduced them in our area so couldn't offer them to me - which is pretty bad really - if this could have been prevented but wasn't.

Thank you for all this information, you've explained more than the gp and the midwife did after the birth!

Boco - when I developed my antibodies, my consultant arranged for my husband blood group to be checked in more depth to see whether he would only father Rhesus positive babies or whether he could father positive or negative.

He tested as homozygous positive which meant that we knew from the outset that any babies I had would be Rhusus positive, which meant I was totally prepared for the baby baing delivered early.

DS3 is 16 years old and was delivered just over 35 weeks. He needed help with breathing initially and was treated under phototherapy for about a week. At 6 weeks old he needed a blood transfusion because he had become anaemic. That was because he still had my antibodies in his system destroying jhis red blood cells.

My fourth child, DD1, was born at 37 weeks and she needed 3 exchange transfusions after her her birth where the blood is changed with Rhesus negative to reduce the antibodies. She was on folic acid supplements till 16 weeks and had her blood monitored weekly then fortnightly. She did n't need any further transfusions.

If you decide to have another baby then your pregnancy would be monitored closely with regular scans and antibody testing. In my last 2 pregnancies the antibodies did not start to rise until after 30 weeks.

Mears that all sounds quite frightening. To be honest if it wasn't for the rhesus thing i may have wanted another baby, but i found the birth and the days afterwards really stressful, and don't think i could do it again. I think i'd spend my pregnancy in a state of total panic! How did you manage to handle it all?

I had a reaction to the induction drug and the birth was awful, very frightening. I went from 3cm dilated to holding dd2 in 14 minutes.

Also, i found it so stressful that in the days she was in scbu, i was only allowed to breastfeed her every 4 hours, and wasn't allowed cuddles in between. I was in shock after the birth and spent the first few days howling next to her in scbu (slightly embarrasingly)

I hated it because they kept telling me she was going to be dehydrated and her sodium levels were getting too low, so they wanted to give her formula - and i was arguing that i'd just bf her more, as i wanted to - but they said i couldn't as she had to be under the light. I found them cup feeding her with out my permission and felt completely powerless to do anything - they spoke to me like i was being a silly girl and kept sending me away.

Anyway, luckily breastfeeding was fine once we got home, and she was fine, but it took me ages to stop feeling bad about it all. Maybe i'm a bit of a wimp? I'd certainly find the early deliveries and bloodtransfusions really scary.

Sorry i'm waffling, - but thanks for all the info.

That is a real shame about the feeding. When DD was admitted to SCBU I was asked whether it was OK to give formula - I said 'no way'. The midwife said what if she needs it? I said she will not and if she needs extra fluids she can have a drip. As it turns out she needed to have the exchange transfusions so had a drip anyway and wasn't actually allowed out to feed during that time. I just expressed during the first couple of days which meant I had milk stored for when she started feeding. In fact I sent loads of milk home with DH when I had DS3 because he wasn't able to feed for the first week because he needed support with his breathing.

Once DD started feeding she was fed 3 hourly and she actually didn't demand feeds any more often than that.

4 hourly feeds is ridiculous for a jaundiced baby. They need milk in to help get rid of the jaundice as well as the phototherapy.

I am a midwife myself so was used to all the equipment in special care - my DH was a bit phased by it all though.

Things have moved on though since I had my babies - there is much more information obtained by scanning. I don't think DS3 would have been delivered as early if that pregnancy was now.

I am afraid I am a very broody person and knew I wanted 4 babies. I knew that the technology could help look after my babies. I decided not to chnace it after baby number 4 though and got sterilised. Knowing that your baby is going to be in SCBU is different than being unprepared for it. Gives you a chance to discuss with staff what you want done regarding feeding too. You always have to remember that it is your baby not theirs!

Sorry to hear about your experience Boco, and thanks for all the information about rhesus negative Mears. Ever heard about the single dose job my hospital is doing?

No I haven't JennsterSS - seems pointless to only give one if it is going to be given antenatally. One injection will not last longer than 6 weeks.

That's what I thought just giving more of it (as I was told) won't make it last any longer. Anyway. Unless I have a silent sensitisation which I have learnt from you is very rare, then I'm not going to worry.