Public health experts are urging all pregnant women to get early blood tests to detect a potentially life-threatening condition known as Rh incompatibility, a mismatch between the mother’s and baby’s blood types that can have deadly consequences if left untreated.
Molumaela Lepeli, a PhD candidate, public health specialist, and practicing midwife, emphasizes that this condition is entirely preventable with routine antenatal care. He advises every pregnant woman to have her blood group tested as soon as she visits a clinic, so healthcare providers can check for the presence of the RhD (Rhesus) antigen, a protein found on the surface of red blood cells.
To understand the risk, it helps to know a basic fact about blood types. If your blood has the Rh protein, you are Rh-positive. If your blood lacks this protein, you are Rh-negative.
Problems occur when a woman with Rh-negative blood becomes pregnant with a baby who has Rh-positive blood, a trait usually inherited from the father. In this situation, the mother’s immune system may view the baby’s Rh-positive red blood cells as foreign invaders, similar to how it would react to a virus or bacteria.
The real danger often emerges in a second or later pregnancy, Lepeli explains.
During the first pregnancy with an Rh-positive baby, the mother’s immune system may be exposed to the baby’s blood, especially during delivery or if there is any bleeding. This first contact usually does not harm the baby. However, the mother’s body “remembers” the Rh protein and produces antibodies against it.
In a subsequent pregnancy with another Rh-positive baby, those pre-existing antibodies can cross the placenta and attack the baby’s red blood cells. This immune attack destroys the baby’s blood cells, leading to a serious condition called haemolytic disease of the newborn (HDN), also known as Rh disease.
Babies with Rh disease can develop severe anaemia (too few healthy red blood cells), which can compromise oxygen supply to vital organs and jaundice (yellowing of the skin and eyes), caused by the rapid breakdown of red blood cells.
In its most severe forms, Rh disease can lead to brain damage, heart failure, or even stillbirth.
Fortunately, Rh incompatibility is easily managed when caught early.
Lepeli explains that if a mother is Rh-negative, she is given one or two injections of a medication called anti-D immunoglobulin during pregnancy. This injection works like a shield. It clears any Rh-positive fetal blood cells from the mother’s bloodstream before her immune system can recognise them and start making antibodies.
The injection is typically given at around 28 weeks of pregnancy. It is safe, effective, and may cause only mild side effects such as a rash or flu-like symptoms, which usually resolve quickly.
Babies diagnosed with Rh disease are closely monitored throughout pregnancy. After birth, treatment depends on the severity.
Mild cases may be treated with special blue lights (phototherapy) to reduce jaundice.
Severe cases may require a blood transfusion to replace the damaged red blood cells with healthy ones.
“All pregnant women must attend the clinic as soon as they realise they are pregnant and keep up with all appointments,” Lepeli stresses. “This simple step saves lives.”
While no formal study has been conducted on Rh incompatibility in Lesotho, Lepeli notes that in his years as a midwife, he has encountered many cases in the country, underscoring that this is not a rare problem.
A study in Nigeria found that while most women knew their own blood type (69 percent) and their partner’s (66.8 percent), fewer than half understood that Rh incompatibility could lead to miscarriage or premature birth. More than half knew that Rh-negative mothers need the protective injection, but many mistakenly believed it should only be given after delivery, too late to prevent the immune response in that pregnancy.
The study concluded that although awareness exists, there are still significant gaps in understanding that require more public education.
Summary
- Public health experts are urging all pregnant women to get early blood tests to detect a potentially life-threatening condition known as Rh incompatibility, a mismatch between the mother’s and baby’s blood types that can have deadly consequences if left untreated.
- He advises every pregnant woman to have her blood group tested as soon as she visits a clinic, so healthcare providers can check for the presence of the RhD (Rhesus) antigen, a protein found on the surface of red blood cells.
- While no formal study has been conducted on Rh incompatibility in Lesotho, Lepeli notes that in his years as a midwife, he has encountered many cases in the country, underscoring that this is not a rare problem.
Ntsoaki Motaung is an award-winning health journalist from Lesotho, specializing in community health stories with a focus on sexual and reproductive health and rights, as well as HIV. She has contributed to platforms like “Be in the KNOW,” highlighting issues such as the exclusion of people with disabilities from HIV prevention efforts in Lesotho.
In addition to her journalism, Ntsoaki serves as the Country Coordinator for the Regional Media Action Plan Support Network (REMAPSEN). She is also a 2023 CPHIA Journalism Fellow.
