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Mary,
Rh factor, or Rh antigen, is a substance present by heredity in the blood of most people. Only 15 percent of us lack Rh factor, or have Rh-negative blood. Years ago, babies often died from what was known as Rh incompatibility, or rhesus disease. Today, we can prevent this from happening. If both you and your husband have Rh-negative blood, then the baby will also have this blood type, and no treatment is needed. If, however, your blood is Rh-negative and your husband’s is Rh-positive, the baby may have Rh-positive blood. In this case, your body could begin producing antibodies to your baby’s red blood cells. If you have never been pregnant before, your baby would be unaffected by these antibodies. They would remain dormant and harmless unless you became pregnant again. Then, if your baby were Rh-positive, the antibodies could cross the placenta and attack the baby’s red blood cells. This could cause anemia and mild to severe jaundice in the baby. To prevent this problem, an Rh-negative mother with an Rh-positive partner receives a shot of Rh immune globulin, or RhoGAM, at 28 weeks of pregnancy and again within 72 hours of giving birth. Rh immune globulin is also given to an Rh-negative woman after a miscarriage, an ectopic pregnancy, or an induced abortion, and at the time of amniocentesis, CVS, or another invasive procedure during pregnancy. A shot of RhoGAM should be considered, too, if an Rh-negative woman experiences any significant bleeding or blunt trauma, such as from a car accident or fall, while she is pregnant. This kind of injury can also cause Rh sensitization.
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A genetic counselor is a specially trained health professional who works with a couple to determine their risk of passing on an inheritable disease to their baby. The counselor thoroughly investigates the personal and family health history and ancestry of both mother and father. He or she helps the couple interpret information about a particular disorder, learn about inheritance patterns and the risks that a disease will recur, and review available options.
Genetic counseling is unnecessary for most couples, but it can be very helpful if you fall into one or more risk categories.
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Hi Tori -
I’m 21 wks pregnant and my doctor called me to tell me that my last ultrasound shows that i have placenta previa. He told me that I need to limit my activities and have no intercourse. Does this mean I have to be on bed rest? Does this mean that I cannot have any stimulation at all with my husband? Can I take bubble baths?
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Hi Lina — Placenta previa occurs when the placenta lies in the lower portion of the uterus, covering or partly covering the cervix. The danger is that when the cervix begins to dilate, the placenta could separate from the uterine wall. The separation could lead to hemorrhage (extremely heavy bleeding) and a reduction in the baby’s blood and oxygen supply.
To prevent possible further bleeding, it is important to limit your activities or to remain on bed rest. It sounds as though your doctor has not placed you on full bedrest at this time but rather has said that you need to slow down your activities, stop working and minimize the possibility of bleeding. If you have an episode of bleeding, it is likely that he will have you go to complete bedrest.
DIfficult as it is, it is important not to have intercourse or place anything inside your vagina. Unfortunately, it also means no orgasms for you as orgasm can cause uterine contractions which in turn can cause bleeding. Taking a bubble bath or a bath of any kind is fine.
Hang in there. Please let me know if other questions come up for you.
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Hi Tori – I am 38 weeks and 4 days pregnant with my second daughter. Is there anything i can do to prepare my cervix more for delivery and/or initiate labor because i’m at the point where i can’t sleep anymore. I have a 15 month old daughter to chase around, and I would like to just have my baby on the outside rather than inside! My doula said primrose oil, and told me to take 1,000mg orally and then insert 1,000mg into my vagina at nght to help soften my cervix and ripen it. I’ve tried castor oil, though it’s been around 10 days since i’ve tried that. Should i try it again? Did i try too early? My baby is dropped, I’m 80% effaced and 2.5-3 cm dialated…my body just needs a PUSH to get going. HELP PLEASE!!!!
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Ah– I feel for you, Brianna. The last weeks of pregnancy can be very challenging. I think in many ways preparing you to “want” labor due to the discomfort of those last moments of pregnancy.
I wish that I had a magic answer. Although primrose oil can soften the cervix it has no bearing on when you will go into labor. Since effacement is the softening of the cervix and your cervix is already 80% effaced, you need no more softening. I’m afraid castor oil is not the magic potion either. Since castor oil stimulates the bowel, if your body is ready to labor, it can get things going. The key is “if your body is ready” which it sounds like yours just isn’t. The real downside of castor oil is that it can really give you cramps and loose stools which is just more unpleasant.
Sex sometimes gets things going due to the prostaglandins in semen but again, only “if your body is ready”. The best possibility is for your practitioner to “strip your membranes” which means that he or she performs a vaginal exam and slightly separates your amniotic sac from the uterine wall. Again, this is an attempt but not a sure thing.
I suspect that your baby just isn’t ready to be born yet. She just may need a little more growing time. If you can, I encourage you to let nature take it’s course, hard as that is. Please let me know when you give birth and how things go. I wish you all the best.
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Hi.. So this is embarrassing, but really kind of worrying me! So I am almost 26 weeks pregnant with my 2nd child and for the past 2-3 weeks I have been itchy with quite a bit of pain and discomfort on the outer part of my vagina.. When I am sitting, squatting, or going to the restroom I also feel a lot of pressure, like the baby is forcing her way out!! I called my doctors office and they told me to try an over the counter medication for yeast infection, but I have gotten no relief!!! Is this something that can be normal in pregnancy or should I be worrying as much as I am??? Thanks!
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Fifth disease is caused by a parvovirus B19. The reason is has it’s name is that it is the fifth in a group of six childhood diseases that cause rash and fever. The symptoms of rash and fever are generally mild and frequently go unnoticed. The virus is also known as “slap cheek” due to reddened cheeks that can occur with the rash.
Although it is uncommon to develop fifth disease during pregnancy, a pregnant woman should try to stay clear of anyone who is known to have it. Most women are in fact immune, having been infected as children without having been aware of it.
If a woman is not immune and does contract the virus (such as with your sister) there is a very rare (less than 10%) increased risk of an early miscarriage or a rare form of fetal anemia. It is best that your sister follow her practitioner’s advice in this situation, however, she and her baby are very likely to be unaffected.
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A major blood vessel known as the inferior vena cava runs up your back from your legs. It is responsible for returning blood to your heart. As your uterus and your belly grow, there is increased pressure on this vessel when you are lying flat on your back. You know that you’ve been in this position too long if you have the sensation that your legs are falling asleep or you just feel uncomfortable. As your pregnancy progresses, you will probably be more comfortable lying on your side. This position allows maximum blood flow through your body and to your placenta and baby.
We all move around a great deal while we are sleeping. Please don’t worry if you wake up on your back; this is perfectly normal. Just reposition yourself so that you are comfortable.
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Different women begin to show at different times. When you will start to show depends on your overall body size, your height, your pre-pregnancy weight, and, especially, the length of your midbody. Women with longer midbodies tend to hide their babies longer and look smaller than do other women whose babies are at the same gestational age. Women who have already given birth, as your sister has, tend to show a little earlier in a subsequent pregnancy. How the baby is positioned in the uterus also partly determines how the mother’s body looks.
Most women have at least a little bump by 15 weeks. At first, though, you and your partner may be the only ones to notice your bump. Often, other people don’t recognize that a woman is pregnant until she is about 20 weeks along. Although I am petite, when I was pregnant with Alexander, I did not develop even a bump until 16 weeks. I wore maternity clothes because I was excited, but I really didn’t need them until I was six months along. Try not to be concerned about comments such as “Oh, you look so small!” (People may be asking your sister, “Wow! Is that just one baby in there?”) No one can tell, just by looking at you, what size your baby is.
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Hi Tori! I had a m/c in 9/7/09. I was 11 wks and 4 days pregnant. My question is: is lifting heavy patients (in nsg home) ranging 100 lbs- 300lbs could possibly be the cause of my m/c? I had a previous m/c 2 1/2 yrs ago. I asked my OB if i have any limitation at work now that i am pregnant again and she said none. I didnt have any prob during my pregnancy…no d/c or anything…except when i strain to assist bariatric patients to stand…i would leak little amt of fluid..i know its not urine…it was clear, no odor. didnt pay attn to it until fri 9/6/09 when we assisted a 300lb lady to stand..i leaked more than usual..still not enough to saturate my undies, however, i felt minimal cramping and it lasted overnight. come morning i saw bld when i urinated. then it would stop and then more bld came out when i tried to do anything in standing so i decided to lie down and propped my feet up. After awhile, i felt like i peed and fluid gushed out (saturated my undies) then blood and more blood..with cramps…that got severe as time goes by. went to ER and had a m/c again.
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Hi Maria, I am so sorry that you had a miscarriage in September. Please let me reassure you that absolutely nothing you did caused it to happen. I am so often asked this and it is a completely natural question to wonder.
It is possible that your amniotic sac had a slight tear in it for a time before you miscarried but it was due to there being a problem with the pregnancy itself, not the fact that you lift patients in your work. Our bodies are designed to handle the physical work we do, even during pregnancy. Such things as physical activities, lifting, even emotional upset, do not cause a miscarriage. Often, if a woman has two successive miscarriages her doctor may suggest some additional testing to be sure that there is not a hormonal or physiological cause. You may want to ask your doctor if she thinks you should have any additional testing done.
I wish you all the best in growing your family.
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Josie,
It does sound as though it certainly could be your mucous plug passing. You are about 5 weeks early so you should alert your care provider right away. He or she will ask you if you have been feeling any contractions or cramping and will very likely want to see you.
37 weeks (or 3 weeks before your due date) is really the earliest we like babies to be born. Prior to that their lung development may not be complete and they have not completed their growing. This can result in a longer hospital stay for the baby and some prematurity problems. Please let me know how things are going.
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About Tori Kropp
Known as "the Dear Abby of pregnancy," Tori has been interviewed on national television and radio and in national print publications, including CNN, The Wall Street Journal, New York Post, Washington Times, Atlanta Journal Constitution and Chicago Sun-Times.
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My doctor’s nurse phoned this week to ask if I knew that my blood type was Rh-negative. I had been told this years ago but had forgotten about it. The nurse said that if my husband is also Rh-negative (we will find out this week), I have nothing to worry about. If he is not, I have to receive a shot at 28 weeks. Can you please explain why this is necessary?