-Rh Factor

Updated on January 26, 2010
A.G. asks from Sarasota, FL
5 answers

This is my first child and it's getting close to delivery time and I am very scared. I am a very tiny woman before I got pregant (I was a size 00 and now I am only a 3)and my doctor wants me to have a c- section and I am unsure if that is safe since I have the -Rh factor...can anyone help??

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J.F.

answers from Phoenix on

Join us at the RhNegativeRegistry.com for medical studies, scientific research, patents, information and membership!

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L.C.

answers from Sarasota on

Hi A.,

My neighbor had the -RH factor when she was pregnant and she ended up having a c-section. No problems at all for her or the baby. If your doctor is recommending a c-section and you're not sure, just question why, get details & if you're not satisfied with his/her reasoning, then get a second opinion. You have to be comfortable w/the decision and with the reasons why. But chances are if your doctor is recommending it, then he/she has good reason.

Good luck,
L.

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L.W.

answers from Sarasota on

I was also Rh- and had a C-section with no problems. I received the Rhogram shot at the appropriate time. Hope this helps to reassure you!

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M.O.

answers from Sarasota on

I had a caesarean and -Rh and all was well. I will be doing the same again. The real issue with -Rh is with your second and subsequent children, not the first. And, the risk is not so much in delivery as during pregnancy, etc. However, if you received the Rhogam shot at 28 weeks, you have VERY little to worry about. Furthermore, you can always ask for the Rh immune globulin shot if you are found to be sensitized when you're pregnant the second time. I've included info below to put your mind at ease.

Early in your pregnancy your blood will be tested to determine your blood type and your Rh status — that is, whether you have the Rh (Rhesus) factor, a protein that most people have on the surface of their red blood cells. If you do have the Rh factor, as most people do, your status is Rh-positive. (About 85 percent of Caucasians are Rh-positive, as are 90 to 95 percent of African Americans and 98 to 99 percent of Asian Americans.) If you don't have it, you're Rh-negative, and you'll need to take certain precautions during your pregnancy.

If you're Rh-negative, there's a good chance that your blood is incompatible with your baby's blood, which is likely to be Rh-positive. You probably won't know this for sure until the baby is born, but in most cases you have to assume it, just to be safe.

Being "Rh-incompatible" isn't likely to harm you or your baby during this pregnancy, if it's your first. But if your baby's blood leaks into yours (as it can at certain times during pregnancy and at birth), your immune system will start to produce antibodies against this Rh-positive blood. If that happens, you'll become "Rh-sensitized" — and the next time you're pregnant with an Rh-positive baby, those antibodies may attack your baby's blood. Fortunately, you can avoid becoming Rh-sensitized by getting an injection of a drug called Rh immune globulin whenever there's a chance that your blood has been exposed to your baby's blood.

If you're Rh-negative and you've been pregnant before but didn't get this shot, another routine prenatal blood test will tell you whether you already have the antibodies that attack Rh-positive blood. (You could have them even if you miscarried the baby, had an abortion, or had an ectopic pregnancy.) If you do have the antibodies, it's too late to get the shot, and if your baby is Rh-positive, he's likely to have some problems. If you don't have the antibodies, then the shot will protect you from developing them.

If your baby's father is Rh-positive — as most people are — you have about a 70 percent chance of having an Rh-positive baby. So if you're Rh-negative, it's likely that you and your baby are Rh-incompatible. In fact, your healthcare practitioner will assume you are, just to be safe. There's no harm in getting the Rh immune globulin shot, even if it turns out that it wasn't necessary.

Of course, if your baby's father has been tested and found to be Rh-negative, too, then your baby will also be Rh-negative and you won't need the shot. But if your baby's father is Rh-positive (or you don't know whether he's positive or negative), you won't know your baby's Rh status for sure until his birth unless you have an amniocentesis, a test that examines fetal cells from the amniotic fluid surrounding the baby in your uterus.

On the other hand, if you're Rh-positive and your partner is Rh-negative, you might have an Rh-negative child. Fortunately, there's no need to worry, because it's extremely unlikely that your baby will be exposed to your blood and develop antibodies. It almost always happens the other way around.
Normally during pregnancy, your baby's blood stays separate from yours and very few blood cells cross the placenta. In fact, your blood is not likely to intermingle in any significant way until you give birth. That's why Rh incompatibility is usually not a problem for your first baby: If your blood doesn't mix until you're in labor, the baby will be born before your immune system has a chance to produce enough antibodies to cause problems.

However, you'll need a shot after the birth if your newborn is found to be Rh-positive. If you were exposed to Rh-positive blood during delivery, the shot will prevent your body from making antibodies that could attack an Rh-positive baby's blood during a future pregnancy. (Your delivery team will take a blood sample from your newborn's heel or from his umbilical cord just after he's born to test for several things, including Rh factor, if necessary.) Without treatment, there's about a 15 percent chance that you'll produce antibodies; with treatment, the chance is close to 0 percent.

Since a small number of Rh-negative women (about 2 percent) somehow develop antibodies to their baby's Rh-positive blood during their third trimester, you'll also be given a shot at 28 weeks that covers you until childbirth. And you'll need a shot any other time that your baby's blood might mix with yours, including:
• If you miscarry

• If you have an abortion

• If you have an ectopic pregnancy

• If you have a molar pregnancy

• After an invasive procedure, such as an amniocentesis or chorionic villus sampling (CVS)

• If you have a stillbirth

• If you have an external cephalic version (ECV)

• If you have suffer an injury to your abdomen during pregnancy

• If you have vaginal bleeding

If you find yourself in any of these situations, remind your caregiver that you're Rh-negative, and make sure you get the shot within 72 hours.

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G.P.

answers from Sarasota on

My advice is to listen to what your doctor says but also start doing your own research before you make a decision. I am small, 5 feet tall with small bone structure, and was pressured into a c-section with my first daughter after stalled labor. So, when I found out I was pregnant with my second I started doing lots of research and decided to try for vaginal birth because I discovered that failure to progress in labor can be caused by all sorts of things, not just big baby, small pelvis. But when I got to 38 weeks my doctor changed her mind and pressured me to have the c-section. I am currently pregnant with baby girl number three and unfortunately the doctors won't even give me the option of trying for a vaginal birth even though that is my instinct. So, I guess my point is just to make sure it is what you want to do and what you think is right. Don't do it just because your doctor wants it to be convenient. If you have one c-section, you will have a very hard time finding a doctor that will support trying for a vaginal birth the next time. Read everything you can about c-sections before YOU decide, there is a lot of literature saying that babies grow to the size of the mother and that a true case of CPD is very rare. I don't want to try to persuade you one way or the other but if I had it to do again I would never have given in to the first c-section so easily.

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