Managed Third Stage and Rhesus Status - Advice Please!

[AliP]

Hi - just after some advice/experiences.
At my NCT class last night i was told that i was better not having a managed third stage if i was rhesus negative. Has anyone else heard this & can you give me any advice/point me to a good web site. None of the books i have have said anything about this.
I have already had my first Anti-D injection so not sure what the problem is.

any thoughts any fellow mumsnetters! PS this is baby no 1!

Mears,thanks for the information. I assume that my dh is RH- since we didn't have any problems when dd was born, but I may find out about him getting his blood checked as a precaution.
To be perfectly honest I don't feel very comfortable about having RH blood given to me on the off chance that I might need it. I would much rather wait until after the birth to see if I'd need it.
Is it possible to say that I don't want the anti d injections at 28 weeks and 34 weeks, or will they over rule my objection since these are the new guidlines?
My pregnancy with dd went very well, to well some people say giving the delivery I had but hey ho. I know that another pregnancy could be totally different but I'm not very keen on needles as it is and if possible I'd rather avoid these extra injections if I could.
I haven't yet looked at the web site that you gave the address for but will do it later when I have more time.

Mears - thanks for all the information and the website. I shall go and have a look at the NICE stuff - forewarned is forearmed!

BTW, sorry to hear you had such a difficult time during your 3rd pregnancy - it must have been an anxious few weeks for you. IIRC you went on to have a fourth. Did you have to receive rhesus prophylaxis throughout that pregnancy?

Linnet - if your dd is Rh- it does not necessarily mean your dh is. There are 2 types of Rh gene, Rh+ and Rh-. Rh+ is dominant over RH-. Everyone has 2 Rh genes. If a person has one Rh+ gene and one Rh- gene, then their blood type will be Rh+ (because the Rh+ gene is dominant). If they have 2 Rh- genes then their blood type is Rh-. And 2 Rh+ genes make an Rh+ blood type. Your dh could therefore have Rh+ blood but have an Rh- gene. He could have passed on this Rh- gene to your dd. Alternatively, he could have Rh- blood (as you do) in which case he would have 2 Rh- genes.

Mears - sorry, I've just re-read your post and see it was your last pregnancy where your baby needed transfusions. I've been on the wine I'm afraid

Linnet - yes you could refuse injections if you want. Get your dh's blood group checked. If he is RhNeg then you will never need anti-D as long as he is the father of your babies. I believe the injections should be given if there is an indication such as bleeding, pain etc.

Gingernut - once you develop antibodies you are not given anti-d prophylaxis because the damage is already done.
Ds no.2 got phototherapy for a few days after birth. Ds no.3 required was delivered almost 5 weeks early because of rising antibodies and he needed a blood transfusion aged 6 weeks because my antibodies made him anaemic eventually. My last dd was 3 weeks early and needed 3 exchange transusions. She was bright orange at 1 hour old.
I subsequently got sterilised as each pregnancy gets worse. With my dh's blood group we could only have RhPos babes

Hi everyone, me again. Having talked over the RH- situation with dh he has said that he is more than happy to have his blood tested to see if he is rh- or +. To be honest since he's actually agreed to this next baby he has confessed that he is worried about things going wrong. I think he's thinking along the lines of we've managed one healthy child will we manage it again.
Does anyone know if we should discuss this with our GP first or should we just go ahead and set up an appointment for blood to be taken by a nurse and explain that we want it checked for the rh factor? And does anyone know if we would have to pay for this blood test since we are asking for it to be done and it's not a medical necessity?
thanks gingernut for explaining about the rh gene. I realised after I'd replied that there could still be a chance, I was thinking back to genetics lessons in biology and realised that without actually knowing his blood type there could still be a chance. silly me.
thank you to everyone for your help and advice, this is a great website and I'm so glad I've found you all.

Linnet - he could kill 2 birds with one stone and become a blood donor That way he will find out his blood group for nothing and will be helping out the low blood stocks in the NHS.

Alternatively you could ask the GP to do it because you want to know if you will require prophylactic anti-D. If you don't you will be saving the NHS money.
If the GP won't do it (can't think why not though), The hospital can do it at an antenatal visit. That was where they took my DH's blood. He already knew his blood group through donating but they wanted to know the chances of our babies being rhesus positive because of my antibodies. The test showed he was homozygous positive - see gingernuts posting below - which means we can only have rhesus positive babies. Heterozygous means that the father may have positive or negative babies. That will not be helpful to you though so just the blood group and rhesus factor is enough. Let us know how you get on.

Glad to see that I got such a lively discussion going and sorry i've been away over the weekend (no Mumsnet for 3 days!)
Even since the publcication of the NICE guidelines not all hospitals have yet adopted them and I had to request the prophalactic anti-D (and take copy of guidelines with me!). I wanted it as I have had a previous miscarriage when no anti-D was administered (despite my GP questioning the hospital!).

Thanks for all your advice

Mears - thanks so much for all your input, it's very much appreciated

AliP - out of interest, do you know your DP's blood group? If he is RhNeg you do not need anti-D anyway.

yes we were both blood doners (well at least he is still going) and he is rhesus positive (A i think) whilst i am b-ve.

Thanks for all the advice

You're welcome AliP

Just out of interest Am I right in thinking that if dh went along and donated a pint of blood they will be able to tell him if he is rh neg/pos? I know they can tell you what blood type you are i.e a,b etc but don't know about the rh factor. If not we'll go to the dr anyway and get them to check.

Yes Linnet they tell you your rhesus factor. You are given a card with your group and rhesus factor on it. In fact when you are O negative you are begged to come back. O negative blood can be given to people with any blood group, so it is vital for emergency situations where blood is needed when the person's blood group is not known or if they have run out stock of the known group.