Rh Sensitized

We have high-risk pregnancies and here is a medical explanation of why. I've tried to explain it a million times, but this post contains excerpts from an article online (I have put words and phrases in bold that apply to our situation):

"If you're Rh-negative, you'll need to take certain precautions and there's a good chance that your blood is incompatible with your baby's blood, which is likely to be Rh-positive. 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. He would probably develop Rh disease (hemolytic disease). Your antibodies would cross the placenta and attack the Rh factor in your baby's Rh-positive blood as if it's a foreign substance, destroying his red blood cells and causing anemia. The disease can cause problems ranging from severe newborn jaundice to brain damage or, in extreme cases, even miscarriage or stillbirth.

Once you're sensitized, you have the antibodies forever. And you produce more with each pregnancy, so the risk of Rh disease is worse for each subsequent baby. While health care providers try to screen and treat as many women as they can reach, about 5,000 babies still develop Rh disease in the United States every year.

The good news is that doctors are finding new ways to save babies who develop Rh disease. Your practitioner can monitor your levels of antibodies and keep tabs on your baby's condition during the pregnancy to see whether he's developing the disease. They may check on the condition of your baby's red blood cells using Doppler ultrasound or amniocentesis.

If he's doing well, you might be able to carry him to term without complications. After birth, he may be given an "exchange transfusion" to replace his diseased Rh-positive red blood cells with healthy Rh-negative cells. This stabilizes the level of red blood cells and minimizes further damage by antibodies circulating in his bloodstream. Over time these Rh-negative blood cells will die off and all your baby's red blood cells will be Rh-positive again, but by that time, the attacking antibodies will be gone.

If your baby's in distress, he might be delivered early or given transfusions through the umbilical cord. The survival rate for babies who receive a transfusion while in utero is as high as 80 to 100 percent, unless they have hydrops (a complication caused by severe anemia), in which case the chances of survival are about 40 to 70 percent."

[Babycenter.com article reviewed by the Babycenter Medical Advisory Board] http://www.babycenter.com/0_blood-test-for-rh-status-and-antibody-screen_1480.bc

When I was pregnant with Porter we found out at about 30 weeks (this was summer 2008) that there was a problem. I had just had routine blood work done and the gestational diabetes test done. On my next regular prenatal visit I was asked about three times if this was my first pregnancy...if I was SURE this was my first pregnancy...positive it was...or if I had ever had a blood transfusion before. I started to think they thought I was stupid. They knew the answers to those questions; I told them and it was all in my file. Later found out it was the fact that they were surprised and puzzled to find the antibodies in my blood. I've never had a blood transfusion so the only way they can guess I became sensitized is I was pregnant at some point and never knew (apparently that is very common), thus never got the shot which prevents the antibodies that cause all the problems. I remember that morning I received a call from the actual doctor (not a nurse or receptionist like normal) after having additional blood work done. He explained what was going on and used a lot of medical terms I didn't understand, but scary words stood out to me such as "anemic", "stillborn", "premature", "miscarriage". I cried and because Aaron didn't work that morning, we went on a bike ride and my knees hit Porter in the womb the whole time. That was therapeutic (the bike ride, not the jostled fetus). My doctor told me less than one percent of women are sensitized, meaning it's rare.

With Porter I was visiting the Maternal-Fetal medicine office 2-3 times a week for non-stress tests and Doppler ultrasounds with the perinatologist until he was born at 35 weeks. "Maternal-Fetal medicine is the branch of obstetrics that focuses on the medical and surgical management of high-risk pregnancies. Management includes monitoring and treatment including comprehensive ultrasound, genetic amniocentesis, and fetal surgery or treatment." Thankfully Porter was fine and looked great the whole time and just happened to come early all on his own. He was 4 lbs 14 oz and spent almost two weeks in the NICU for severe jaundice (blame goes to the antibodies that were attacking his blood which his body just couldn't fight very quickly by itself) and low-birth weight. After he came home he still needed to be under bili-lights and even used an oxygen tank in an attempt to help his weak little body.

During the pregnancy we were sent by the perinatologist to a genetics counselor and were told the risks in future pregnancies and were given our other options (that were emphasized by all medical personnel we had spoken to): adoption, sperm donation (with a negative blood type), or no more children. One thing my OB told me at one point that I appreciated (after feeling very much discouraged to have more biological children) was that it was our decision; no one could tell us what to do or not do and their job was to just treat us. I gave a hardy amen to that. Thankfully we don't put all of our faith into medical science but instead into our Heavenly Father and His power. We definitely take medical knowledge into consideration through the decision-making process, but in the end depend on personal revelation and the hope for miracles.

What hurts the most through all of this is the fact that my body should be a shelter, a safe haven, a place of protection, and a peaceful, secure environment for my babies to grow and develop. Instead it is a "hazardous environment" (according to the perinatologist) for my babies. They tested Aaron's blood to see if he was heterozygous positive or homozygous positive. If it was heterozygous then we would only have a 50% chance of a high-risk pregnancy and 50% chance normal pregnancy with an A-negative baby. Unfortunately I married bad blood (ha ha) and he is homozygous; thus 100% of our babies will have a positive blood type and be at risk. So there you have it.