What are the Risks of Rh Incompatibility?

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  • Written By: J. Beam
  • Edited By: Niki Foster
  • Last Modified Date: 25 August 2018
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Rh incompatibility poses a very low risk to mother or baby with a first-time pregnancy. The risks of Rh incompatibility increase significantly with subsequent pregnancies, however, especially if the mother is not aware of the condition. Babies affected by Rh incompatibility may suffer mild to severe symptoms ranging from jaundice to hearing loss to retardation, seizures, or death. Rh incompatibility occurs in only a small percentage of pregnant women and happens only when the mother has an Rh-negative blood type and the fetus develops an Rh-positive blood type. The odds of a fetus developing an Rh-positive blood type are 50% when an Rh-negative mother conceives with an Rh-positive partner.

The risk of Rh incompatibility can be assessed with a simple blood test that is administered routinely as part of prenatal care. In a first pregnancy, Rh incompatibility rarely affects the baby, but can affect subsequent pregnancies if the mother’s blood develops antibodies against the Rh-positive proteins. If this happens, then any subsequent conceptions can be affected as the antibodies may work to destroy the red blood cells in any Rh-positive fetus she may carry.

Complications from Rh incompatibility are preventable with proper prenatal care. When a mother is found to be Rh-negative, then the possibility of Rh incompatibility exists. To prevent complications, the mother is given a series of injections called Rh immune-globulin, which function as a vaccine to prevent the mother from developing the antibodies that could harm a future fetus.


If doctors learn that a woman has already developed Rh antibodies, they will closely monitor the pregnancy and can proceed with an exchange transfusion treatment if necessary. An exchange transfusion is a special type of blood transfusion that prevents damage to the developing fetus’s blood cells. Since the development of Rh immune-globulin injections, exchange transfusions are rarely necessary in women who have sought proper prenatal care beginning with their first pregnancy.

Though complications with Rh incompatibility are rare, the development of Rh disease can be dangerous for a developing fetus and newborn, posing a risk for jaundice, anemia, brain damage, and even death. There is no need to take this risk, and it can be avoided by seeing an obstetrician to determine your Rh factor as soon as you think you might be pregnant.


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Post 3

I have had three children. I gave birth to my first child overseas not being aware of the problem and therefore, was not given the injections. My second child needed a blood transfusion. My third child was under the lights for ten days, but thank god they are all healthy children now. I am planning for a firth and am scared. Any suggestions?

Post 2

I too had a first pregnancy where my daughter was rh incompatible and did have two blood exchange transfusions. The NICU had to shut down for an emergency meeting as no one had ever seen this in a first time seemingly healthy pregnancy/ birth and it caught them off guard.

I did have the RH shots and was under the care of great ob doctors. I am insulted that this article sites "There is no need to take this risk, and it can be avoided by seeing an obstetrician to determine your Rh factor as soon as you think you might be pregnant."

Post 1

Our *first* baby had severe complications due to the fact that I am RH negative and my husband is RH positive ... but I was unaware of this incompatibility till *after* our baby was born. She had severe jaundice, and was put in a Special Care Unit. Her bilirubin levels went up so high that the specialists were just a couple of hours away from attempting a "complete blood exchange". Thankfully, her levels started to subside just before this procedure was done. The specialist said he had *never* seen this in a *first* time pregnancy ... only usually in a 4th or 5th. He advised us not to have any more children as the risks would be too high. Over the next

11 years, we had 6 more children, all of whom were RH Positive like their father. I had the Anti D needle for the next three, then I refused it after that, when I found out it was derived from blood. Our 7 children have all grown up healthy young adults now. After this terrible experience, I would *never* say to any pregnant woman, that RH Neg incompatibilities can't happen in a first pregnancy, because I have firsthand experience that it *does*. It also may be of interest that I also had severe Toxemia and baby had to be delivered 10 days early. Afterward delivery, my hemoglobin dropped to just 4 (probably due to bloodloss during a difficult, forcep/suction birth) and they really had to work hard to bring it up to a safe level, over the next couple of weeks. I am unaware of why I developed the Toxemia, as I never had any such complications with the subsequent 6 births. While this case might be a rarity, it still *did* happen, and we *both* nearly died!

Thank-you for allowing me this post.

Kind regards,


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