Rh Factor Testing

Rh factor can feel extremely confusing, and I will be honest; it took me a long time to get a general idea of what it is and why testing is crucial. The first thing that you need to know is what the Rh factor is and who it affects. Rh factor is a protein that is found on the surface of red blood cells. Rh factor is inherited; if your blood type is positive, your red blood cells have this Rh protein. If your blood type is negative, then you lack the Rh protein. Although having a negative blood type is not usually a problem for an individual's health, it can cause issues during pregnancy.

Suppose you are Rh negative, and your baby is Rh positive. In that case, it is called "Rh incompatibility." However, the baby's and parent's blood usually do not mix during pregnancy; sometimes, small amounts of the parent's and baby's blood occasionally mix. If the blood mixes, then the parent's body might produce antibodies that would fight against a future baby who is also Rh-positive. So, when the Rh factor is being treated, it is not for the current pregnancy but for any pregnancies after this one. 

When are the times a baby's and parent's blood might mix? 

  • Miscarriage
  • Ectopic pregnancy
  • Abortion
  • Removal of a molar pregnancy
  • Amniocentesis
  • Chorionic villus sampling
  • Cordocentesis
  • Any bleeding during pregnancy
  • An injury or trauma to the abdomen during pregnancy
  • An external manual rotation of a baby in a breech position
  • During childbirth itself

If your next baby is Rh positive, these antibodies your body has begun producing can cross through the placenta and begin to cause damage to the baby's red blood cells, causing anemia. This condition can be life-threatening to a fetus or newborn, so Rh testing and treatment are highly recommended.

But what happens if you decide not to do any Rh treatments this pregnancy because you are unsure that your baby has a positive blood type, know that the chances of this occurring are rare, or for any other reason? If the antibody screen shows that you are already producing antibodies, then an Rh treatment will not help. At this point, the baby will be monitored more closely during pregnancy and might even require a blood transfusion during pregnancy or immediately after birth to save their life. Rh treatment is one of those things that can only be done before the mixing of blood, which is why many pregnant individuals get the treatment during pregnancy and get their newborn's blood type tested immediately postpartum so that they can receive the Rh treatment then as well, if it is needed.

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So, what are these tests, and what can be expected of them? 

The Rh factor test is a blood test usually done at the first appointment during your pregnancy. It is very simple and non-invasive but can be traumatic for individuals who struggle with needles or blood draws. Once the lab processes your results, you will either get back that you are Rh positive or Rh negative. If you are Rh positive, you don’t need to do anything. But if you are Rh-negative, then it might be a good idea to get the RhoGAM shot to help prevent your body from making antibodies. The RhoGAM shot is administered via intermuscular injection into the buttock. Most individuals who receive it would give it a solid one-star review, and I have even heard it dotingly referred to as the “peanut butter shot,” talk about yikes!

Like any medication, there are some common side effects to RhoGAM, including:

  • Injection site reactions
  • Fever
  • Itching
  • Joint/muscle pain
  • Dizziness
  • Headaches
  • Weakness
  • Exhaustion
  • Skin rash
  • Nausea/Vomiting
  • Diarrhea
  • Stomach pain
  • Allergic reactions

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There are also some more severe side-effects like:

  • Pale or yellowed skin
  • Rapid breathing or heart rate
  • Little to no urination, dark-colored urination, or red or pink urine
  • Rapid weight gain
  • Signs of a blood clot
  • Fever, chills, shaking, back pain, unusual weakness.
  • Confusion or shortness of breath

Contact your care provider immediately if you experience any of these side effects. 

RhoGAM is also contraindicated if someone has Immune Globulin A (IgA) deficiency with antibody to IgA or if someone has hemolytic anemia. As with any of your pregnancy, birth, and postpartum choices, getting tested and treated for Rh factor is a very personal decision that only you and your support team together can make. Weighing out the risks and benefits of any given option is the best way to make sure the true consent is being given to your care provider. 

Hospital care providers can always give RhoGAM, and in many areas’ community midwives can also administer the RhoGAM shot. It can provide peace of mind knowing that the testing and treatment for Rh factor are available wherever you choose to give birth.

 

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