Anti-D injections

[Ca Plane Pour Moi]

OK, another row with my DH about this, so I want to know if I'm over-reacting and incredibly argumentative right now.

I received in the post an appointment for my first anti-D injection, plus told I'd be given another one pre-birth and one post-birth if the baby is Rh+. I don't want any injections! I haven't so much as bumped my tummy in recent weeks (whether holding a rather heavy basin against my hips and stomach at 5-8w pg will do anything is another matter, and a bit too late now) and IF I had done, I would have gone to the midwife and requested this. Because I do know that I could have problems with the next baby if I don't.

I'm not wanting to argue with everything or cause problems, but do I really need to be given products from someone else's blood? OK, I know the chance of an infection from this is so small it's not worth considering, but I just don't want this done! I am having the GD test anyway, so what's the harm in another needle, says my DH, and I should stop thinking that the midwives want to hurt me. I know they don't, and I'm fine with any injection I need to be given (I've had a lot over the years), I just don't see the need for this one right now. Post-birth then yes, if Liebs is Rh+ I'll have this without question, but right now I see no need.

Am I being stupid about this? I know that 20 years ago women weren't given pre-birth routine injections and those women went on to have other babies (my aunt is one case in point) so why do we need it now?

[Lukesmum]

Hi Ryn,

I didn't have or was never requested to have the anti -d injection during my pregnancy until about 36 weeks when I had slight bleeding. I was then told it may be a good idea to have one. If this didn't happen I would not of been given the injection until after the birth and finding that the bub is +. This is my secong pregnancy and bub # 1 was +. For this pregnancy I have not had any injection has they have found no antibodies in my blood - therefore no need to. I think I have a blood test again at 28 weeks and will not have injection unless antibodies have formed.

Gosh what a woffle. I hope I make sense. Unless you have had a fall or had bleeding, even if Liebs is + I don't think you need to have the injection. If you are having the blood tests they will show if you need it.

[Twin Sister]

Oh wow I'd never even heard of Anti-D injections (I'm Rh + though so I guess that's why)

I was just doing a lot of reading on it though and I agree with Lukesmum that unless you have a fall or bleeding, I don't think you really NEED to have the injection right now. I'm so paranoid though that in your situation I probably would.

[Visitor7]

I'm A- & DH is A+ and I had the blood test at 28 & 32 weeks which showed no antibodies. DD is A+ so after giving birth I had the injection.

[Muppity]

Is there a specific reason that they want you to have one (like blood test results) or is it just routine in the UK?

I would say don't have it unless there is some obvious need as I am with you on not using other people's blood products unless there is a real reason.

Trust in your own instinct.

[Ca Plane Pour Moi]

This is blinking routine! I'm so annoyed about that! But DH thinks I'm overreacting (as he does about everything babywise these days... personally, I thought it was normal to be excited over buying a cot, but no, that's not).

I'll give them a call on Monday and cancel it. That way I have the weekend to find the bit of paper with the number on... failing that, I'll just call the ward on Monday and they should be the right people.

[Ozziehoffy]

What exactly is it for anyway?? I've never been told and I don't need to have it...but yeah, don't even know what it's for

[Ca Plane Pour Moi]

It's because I'm Rh- and thus can make antibodies against Rh+ blood should I come into contact with it. IF the baby is Rh+ and IF the mother/baby barrier breaks down and IF the next baby is Rh+, then I could reject the next pregnancy. BUT the injection has to be given within 3 days of the blood mixing, so giving me a set date means exactly diddly squat because what happens if there's a problem a week before the routine injection? I know, I ask for an emergancy one, but why bother with the routine ones? It seems really stupid to me.

[blackbird]

I had my first one a couple of weeks ago. I had mixed feelings about it but decided to go ahead as I'm likely to have a few other things to deal with post-birth. If you don't feel comfortable and your antibody tests are neg, then I'd say don't do it and deal with the situation when Liebling arrives. You're obviously informed enough to be able to make your own decisions about this sort of stuff!!

Is your DH 'normally' like this (have seen some of your other posts) or might this be him completely freaking out about the whole event? Mine behaved like this about me wanting to have children (he was scared of it all) and for the first 9-12 months of TTC but then settled down again. Maybe he needs some support of his own as well as learning how to better support you.

[BellyBelly]

Rhesus Negative in Pregnancy

This is a pet peeve of mine. I am rhesus negative and my Ob I used for both births (a very experienced IVF and infertility specialist so he's going to be conservative with this stuff) never bothered with giving me any as I had no bleeding in pregnancy. Instead of the injections he gave me a blood test to check for antibodies forming, of which there were none. The baby's blood circulation is separate to that of the mother. Unless there is reason to believe the blood may have mixed, e.g. though bleeding in pregnancy, if you have had an amnio, after a miscarriage or termination... then you need it. You need it within 72 hours to prevent the antibodies forming. So if you hadn't had any of those, 1. how likely is it that is that the blood is going to mix and 2. how will you know when it happens and when to have the injection in time for 72 hours of the blood mixing?! Its ridiculous! It's a blood product, so its not without risk also. You might like to read Sara Wickham's book which is in my article above... we fall for the old trick that it doesnt matter, its to be sure... but are we introducing an element of risk which we may not need? The pharmaceutical companies get richer...

[blackbird]

I would normally be anti this sort of thing for those reasons you mentioned Kelly. My OB told me that there is new evidence that there is/can be a mixing of blood without an amnio etc which was a factor in my decision. I think we should be informed as much as possible about any sort of procedure so we can make up our minds about what we want 'done' to us and you are soo fantastic at providing info!!

[Ca Plane Pour Moi]

Yes, blood may mix, but when? Is it at 28w and 34w, when I have my scheduled injections? Why that time scale? It's just stupid. I don't even brake hard when I drive! I was so angry when I got this through the post (also, I am not Ms Smith, I am Mrs Smith - GET IT RIGHT. How many times do I have to say I'm married?) but my DH is completely not interested in anything pregnancy related so just assumes what's being done is normal and correct, and that I shoudn't argue with people who know "best".

[BellyBelly]

Thanks I do try, but always learning!

Even if the study he quoted is true - they wont catch blood mixing in 72 hours if you have no reason to suspect it, which would defeat the purpose... it's all a stab in the dark. I wouldnt think it would be common though, as many rh- women do give birth without problems. I had the anti-d after my two were born and also after my first preg before Marisa. Oh the decisions!

[Ozziehoffy]

Oh ok, I think I get it. I know I'm RH positive which is why I know I don't need it...but just never knew what it was all about. Thanks. Ryn, good luck with working it out with DH.

[Michelle71]

Ryn - is your DH Rh + or -??? My Dh is Rh -ve too so I have refused Anti-D. I know who the father is, I know his blood group (and mine - both negative), therefore I don't need it.

And maybe your DH is having a mini meltdown over this process. Some men are chicken like that

[chelleg]

Ryn - is your DH Rh + or -???

I was gonna ask exactly the same question. Obviously if DH is also Rh -ve then there is no need for Anti-D at any stage, nor will there be a need to take cord blood for group and coombes, or your blood for a Kleihauer after your birth.

[Ca Plane Pour Moi]

DH is A+ and I'm A- (genotype A-, O-). I don't know DH's genotype so it's a wait and see to find out if the baby is positive or negative, group A or O! It's jolly exciting, but the safe money would be on Liebling being A+, like Daddy. I don't know what blood groups PiL are either, so can't figure out my risks that way.

I think I'll just cancel and not tell DH I'm cancelling. Well, he wouldn't be coming to these anyway and won't think to ask how it went even if he remembered.

[sunbeam koala]

Hi Ryn,

Here in Denmark it isn't standard practise to administer Anti D prior to birth. I was terribly worried about this during my first pregnancy as it is standard practise in Australia and UK (so it seems). I am RH-.

The practise here is to test baby's blood type after birth and if baby is not RH-, then you get the Anti D. As it happens Al is also the same blood type, so it wasn't necessary.

Just so you know, it is not a standard medical procedure in other countries. (Also no test for Strep B here either). they do do blood tests for antibodies etc..Maybe Australia and UK err on the side of caution...

ps Denmark is definately not a country who likes to support drug companies, it is very difficult to get a script of bloody anything unless you're pretty close to death it seems.