Q: Good evening Dr, your tips are really helpful. I am O NEG while my hubby is O positive. I am AA and he is AS. I had an abortion before we got married though. Right now I am about 38wks pregnant now but my Doc said I should have taken an injection before getting pregnant because our blood groups are incompatible to avoid fresh still birth. I have been so scared. Since on 31st August, I’ve been feeling pains in my abdomen and waist. I don’t know if it is labour.
A: Hello dear, you’re technically ready to deliver and so the pains you’re having may very well be labour. Please visit the hospital to check it out…especially given that you have no experience to compare the pains with.
The fact that you’re AA and your husband is AS, is not really an issue and is not the reason why your doctor talked about ‘incompatibility’. With this genotype, every time you put to bed, you have a 50% chance of having a baby with AS genotype and a 50% chance of having one with AA genotype. The main issue is the Rhesus incompatibility…the fact that your husband is O negative and you’re O positive.
Usually in pregnancy, your blood and your baby’s blood do not mix. However, during the process of delivery (and some procedures during pregnancy), some degree of mixing of mother’s and baby’s blood happens. When this occurs, if your baby is O positive, your body starts to produce antibodies against your baby’s blood….literally. But, because your baby is being delivered or has been delivered, the antibodies have very little time to do any damage to the baby. They can only get rid of the small amount of baby’s red blood cells in your own body. So, baby number 1 is not a problem.
The challenge though is that these antibodies are now waiting for another opportunity to attack foreign blood cells. If you give birth to a baby that is O negative like you, this is not a problem. If, however, the next baby is O positive, those antibodies kick in and start to attack your baby’s red blood cells. It is for this reason that the Rhogam injection is given within 72 hours of delivery to ensure that your body does not mount the regular response of producing antibodies against Rhesus O positive blood. The injection deceives your body into thinking it has already produced antibodies, thereby protecting your baby as the particles of Rhogam cannot cross the placenta.
I hope in your case, that your first pregnancy involved a Rhesus negative baby…in which case the injection you didn’t take wasn’t needed anyway. Whatever be the case, be sure the injection is administered this time.
Don’t beat yourself up over the injection that you didn’t take. It’s past. Let’s focus on the present and be sure to prevent future issues like this. Your doctor already knows what complications are likely to be expected and I trust that he will have the right team in place to handle these as best he can.
I wish you the very best.
Lots of hugs!
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Have a great week, guys 😀