This pregnancy has been so different from our pregnancy with Knox, even this early on. My belly is already showing, the morning sickness has been almost unbearable and my legs and armpits are covered in the itchiest rash of all time. But the most drastic difference is that this pregnancy has been deemed “high risk” because we found out that I’m now Rh-sensitized. The short story is that my body may attack the baby and there’s nothing we can do to prevent it. The long story follows here.
If you don’t know much about Rhesus (Rh) status, chances are you’re in the 85% of the population who are Rh+ and have nothing to worry about on that front. Rh is an inherited protein found on red blood cells. If your blood has the protein, you’re considered Rh+. If you lack the protein, you’re considered Rh-. Most of the time, your Rh status will effect your life in pretty much zero ways. But if you’re Rh-, your husband is Rh+ and you’re pregnant, it starts to matter a lot more. When an Rh- woman is exposed to Rh+ blood, her body will recognize the Rh protein as something foreign and it can develop antibodies to attack the Rh+ red blood cells. So if you’re Rh- and you’re carrying an Rh+ baby, there’s a possibility you can be exposed to the baby’s blood and become sensitized (develop antibodies against Rh+ blood). To combat this, it’s standard in the US for Rh- negative women to receive two shots of “Rhogam” during pregnancy to help prevent sensitization – one at the end of the second trimester and another right after delivery. According to the (hours and hours) of obsessive online research I’ve done in the past several weeks, the Rhogam shot is effective in 99% of women, meaning they go on to have totally normal, non-sensitized pregnancies for the rest of their lives. I received both of my Rhogam shots while pregnant with Knox, but it seems I was the unlucky 1%.
I went off to our first prenatal appointment feeling on top of the world. It took us 14 months to get pregnant with Knox so we were ecstatic to be expecting our new little one so quickly. Our pregnancy with Knox was as healthy as can be, and (aside from a significantly squishier midsection and chronic lack of sleep) I’m just as healthy now as I was when we got pregnant with Knox, so we expected a gleaming early pregnancy report. I sat down with the nurse, I got my official positive pregnancy test, I listened to the same pregnancy info I’d heard two years prior and I skipped off to have approximately 963 vials of my blood drawn for all of the standard early pregnancy blood tests.
When my blood work came back a few days later, our doctor called with the news that I am Rh sensitized. Which means that my blood now contains antibodies against the Rh protein. Which means that my blood might begin to kill off our baby’s red blood cells. I asked her what we should do to treat this – to prevent this – and she told me there was nothing we could do. Once the antibodies are in your blood, they’re in your blood forever.
We found out more information gradually – that our pregnancy (and any other pregnancy following this one) will be considered high risk and will be closely monitored with frequent blood tests to check my antibody level and frequent ultrasounds to check the baby for signs of anemia. We learned that if the ultrasounds show signs of anemia, our baby will have to receive blood transfusions while still in utero. We read about the damage anemia can do to a developing baby. We learned that to be safe, we will have to deliver the baby at 37 weeks at the latest. And we found out that before 20 weeks, when the baby is too small to receive a transfusion, there’s nothing we can do but hope that the baby stays safe.
I can explain the situation to you as if I’m executing a verbal science quiz, as detached as can be. I can laugh about the absurdity of being that tiny ONE percent. But I’m scared. I’m frustrated. I’m so disappointed. And I feel like my body is betraying me – this body that is supposed to nurture our babies, to protect them, to give them life, and now it may try to take that life away. But I also feel like this baby is strong. This is the baby who has been knocking me out with the worst morning sickness, the baby we watched dance and wiggle for the camera at our 10.5 week ultrasound, the baby who came to us so quickly and surely.
This baby is a fighter. And things are going to turn out well. I can feel it in my soul.