Rh Factor – The Truth About Rh & Pregnancy
(Rh Factor or Rhogam – click here for an updated post) and for an explanation of what Rh means, click here
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A friend of mine did alot of research regarding the RH Factor, being Rh positive and Rh negative and what that meant for her pregnancy, her baby and her next birth (s). She was 28 weeks pregnant and preparing herself to tell the doctor that she was refusing the RhoGAM shot (and the 36 week shot). She could feel herself being watched by the office staff as she waited for her name to be called, wondering if they were thinking she is a horrible mother by possibly putting her baby in danger or if they wished that they had the confidence to make their own medical decisions when it contradicts the doctors recommendation….
It is her choice to decline the prenatal injections of anti-D immunoglobulin (also named: BayRHo-D, Rhogam, Gamulin Rh, HypRho-D Mini-Dose, and others) and to wait for the baby to be born before deciding to take the RhoGAM shot.
She had thoroughly researched the subject of Rh Factor before making this choice and had the support of her husband. Even though it was a battle explaining it to the doctor and even to her friends, the evidence was well-grounded.
Okay, So What Is Rh- negative Blood?
Everyone is born with a specific blood type.
RH- negative blood is human blood with out the rh factor. You are either born with or without the ‘rh factor’.
If you DO have the rh factor, you are considered Rh+ positive and there is nothing to worry. You have zero need for any RhoGAM or similar shot.
If you are Rh- negative, read on so that you understand what other mothers are talking about when they say they are rh negative.
Here is a good article explaining more about the Rh Factor.
But if you do NOT have the Rh factor in your blood then you are Rh- and it could cause complications. For example, if your blood type is A+ or B+ you are Rh postitive. If you are A- or B- , you are Rh negative. Your Rh- blood recognizes the Rh factor as an intruder to your bloodstream and begins to attack it (form antibodies against it). If your baby is Rh+ and IF your blood mixes with your baby’s blood, then your body could view your baby as a foreign invader and begin attacking the Rh factor in your babies blood.
What Is The Risk?
This all sounds scary, but reading this info will alleviate your fears.
There is only harm if you are Rh negative and your baby is Rh positive AND the baby’s blood mixes with your blood. There are ways to prevent the bloods to mix. You have 72 hours after your baby is born to find out it’s blood type. If the baby has a positive type (and you are negative) only then will you need to make a decision of whether or not to get RhoGAM.
(If you are negative and the baby is negative – you are home free. Nothing to worry about, no need for the RhoGam shot, because your body has accepted the baby’s blood as ‘normal’)
But in reality, the chances your baby’s blood mixing with yours is very slim. During healthy, normal pregnancies, your blood and your baby’s blood do not mix.They flow side by side, separated by a membrane. No antibodies are made by your body as long as there has been no trauma. Trama can be anything from a bad car accident, miscarriage, amniocentesis, direct fall on your belly late in your pregnancy, or chronionic villi sampling (CVS) OR premature umbilical cord clamping. All interventions can cause the baby’s blood to mix with your, that is one of the reasons why natural and intervention free pregnancy and delivery is important. Allow your plancenta to be delivered on it’s own, not torn away from your uterus.
The RhoGam Shot
The RhoGAM shot is very similar to a immunization or vaccination and it may contain thimerosal (same as mercury) which is toxic. RhoGAM puts a small amount of antibody into the mother’s body, attempting to “fool” her body into thinking that the problem has been taken care of. RhoGAM is blood plasma from a donor’s blood and has been cleaned but may still contain viruses and/or bacteria that could cause diseases, rare, but possible. Personally, I think it’s a bit disturbing to have someone else’s blood injected into my body!
Remember, Rhogam must be given within 72 hours of the trauma, when your blood and the babies blood may have mixed. After 72 hours the body will have begun making its own antibodies and the RhoGAM won’t work.
What Are Drawbacks With RhoGAM?
Doctors must admit that the 28 and 36 week dose is simply given at a random. Are they hoping that it may protect some babies even though there is no reason for trauma to have happened at 28 or 36 weeks?
RhoGAM is made from human blood plasma (as are all anti-D preparations.) It’s highly filtered, but it is still a human blood product. Some side effects besides it being someone else’s blood, include swelling and inflammation. Hives and anaphylactic effects are among more severe side effects.
Two Rh- parents will have a Rh- baby and there is NO RISK. Pregnant women who are Rh- and whose partners are Rh+ must weigh carefully the risks and the benefits of each RhoGAM injection. If a baby’s blood is attacked by Rh antibodies, the newborn will have Rh disease. This is most likely to happen with the baby coming after a mother is sensitized. According to the March of Dimes almost all babies born with Rh disease will be cured, but it is still a very serious condition requiring a lot of intensive care.
The routine, 28 week injection of RhoGAM is NOT the best way to protect babies from Rh disease. There’s only a slim chance that any major “trauma” will have occurred during the 72 hours before the injection.
Do I Have The Freedom To Refuse RhoGAM?
A woman is free to reject or accept any combination of RhoGAM injections. If a woman chooses not to have RhoGAM, there are steps she can take to make it more likely that her blood and her baby’s do not mix.
An excellent prenatal diet is very helpful for ensuring the placenta and baby are developing well and that all systems interact the way that they were meant to. Drinking plenty of good water, drinking Red Raspberry Leaf tea during your second and third trimester, avoiding refined sugar and eating 60-80 grams of protein daily will make help improve you and your babies health. (there are several online resources for Red Raspberry leaf tea in bulk)
A natural, intervention free birth is the best birth for an Rh- mother wishing to avoid RhoGAM. A completely natural birth gives the lowest risk of maternal and fetal blood mixing.
The third stage of labor is possibly the most vital part of labor to keep natural. Allow the placenta to separate naturally and be born gently. Contractions will help the placenta to shear cleanly off the surface of the uterus and continued contractions will seal off the blood vessels. Allowing the baby to nurse immediately after birth helps your uterus contract and expel the placenta. If the placenta has fully separated, very gentle cord traction may bring it out.
It’s very important to wait for the cord to stop pulsing before it is cut. This allows the blood to flow into the baby’s body. Early clamping and cutting can cause the babies blood to mix with the mother’s blood. If the placenta has been born, then there is no opportunity for the babies blood to get into the mother’s blood – and you are safe.
Check this site out about why it is harmful to save (bank) your babies umbilical cord blood.
In Rh neg women, many people believe that it is the clamping of a pulsing cord that causes the blood of the baby to mix with the mother’s blood, causing sensitization problems. Robert S Mendelsohn, M.D., in his book “How to Have a Healthy Child. . . In Spite of Your Doctor” blames the whole Rh neg problem on too quick clamping of the cord. Especially in Rh neg mothers it is importatnt to wait until the placenta is out before thinking about cord clamping.
Blood can be drawn from the umbilical cord to determine the baby’s blood type.
If the baby is also Rh negative, there is zero need for RhoGAM.
Postpartum RhoGAM decisions can be made after the baby’s blood type is discovered. Seek to have a healthy pregnancy and be fully informed before consenting to having any foreign substance (RhoGAM) injected into your body. Do this for you and your baby’s health.
There now is a new way to determine your baby’s blood type without any invavise procedures. Find out if your baby is Rh positive here. Lenetix® Medical Screening Laboratory, Inc. 174 Mineola Boulevard Mineola, New York 11501 Ph: 516 320-6375
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I have a question… Last year, I gave birth to a stillborn who was Rh+ and I was Rh-. I was told to take RhoGam after giving birth in case mine and the baby’s blood mixed, because it could have made me sick. I accepted it because I hadn’t done any research on it beforehand. Now I’m pregnant again, and I’m not sure if my baby is Rh+ or Rh-. I may be “sensitized” to Rh+ blood, but according to this article, it doesn’t matter unless mine and the baby’s blood mixes, right? Because blood doesn’t mix when the pregnancy and the birth are gone through naturally? If I don’t allow the umbilical cord to be cut early/before I give birth to the placenta, and no harm comes to my stomach, the pregnancy should go smoothly and I should not need RhoGam, correct? Because I don’t want to accept RhoGam now that I know what it is unless I have to.
Sounds right. You took Rhogam after the last birth. This pregnancy should be fine. When the baby is born, test the baby at birth to find out the blood type. If baby is positive, simply take the Rhogam shot. If baby is negative, there won’t be any need for Rhogam.
You won’t need Rhogam until you have another positive blood type baby.
Hugs!
I have rhesus anti c. I have no choice about getting a shot and I wish I did. For all the stories about women having rhesus and having healthy babies, there are stories about csections/jaundice/brain damage/foetal demise. I was preparing for a natural/low intervention pregnancy and birth and now I am struggling with the reality that this MAY not happen. I say may because I know nature is unpredictable and I may go through with no rise in antibodies, or signs of distress and get to have my natural birth. But after losing my first child at 29 weeks (the reason I became sensitised) I know shit happens, for no reason. My antibodies may rise, my baby may suffer, I may have to get a csection and my baby may be taken from me and put in NCIU for damage caused. So far in my research and mothers I have talked to with various rhesus conditions (not anti D) at the very least babies are born jaundice, most have had c sections between 30-35 weeks because baby was being harmed, many babies need blood transfusions and weeks in hospital.
If I could get a shot (believe me giving birth to a child who is dead or holding your child as it takes it last breath is far more disturbing than having someone’s blood injected in you) I would.
I agree with being informed so you can make the right choices for yourself and standing up to OB’s to get the care you want (I will be talking to mine next time about delayed umbilical clamping). I see your point about not being sensitised yet and getting the shot after birth, if necessary. But for those who have a sensitised pregnancy make sure you know what happens when things go wrong and there is nothing wrong with being monitored correctly and being prepared for that.
I understand the avoidance of immunisation but for me I would rather a couple of shots than money and monitoring and high chance of a birth that is so removed from what I wanted and the suffering of my child.
My first birth was with an OB and CNMs and I had the 28 week RhoGam. My birth was caesarean and I had the postpartum shot.
For my second birth, I chose to birth at home with a midwife and decided not to worry about RhoGam unless there was reason to think there was blood mixing, as in the case of a car accident or certain birth interventions. I had a lovely, natural, straightforward birth and did not do the postpartum shot. The baby was RH+. Additionally, I asked my doctor to check my antibodies when the baby was 6 months just to be sure nothing had changed, which I thought would be nice information to have in regard to making future child bearing decisions. Nothing had changed in my blood.
My third, fourth, and fifth babies were also born at home, peacefully and without any interference, not done RhoGam during or after the pregnancies, and I have never looked back.
I know that mysterious and unintended things can happen in pregnancy and birth but my opinion is that most of this “blood mixing” business is caused by interventions during pregnancy and birth.
Also, when I was researching RH factors, I discovered there are additional blood factors that are somewhat more rare but can cause the very same problems. Why aren’t we testing and treating and worrying everyone about those as well?
Hi, thanks for the info. I stupidly didn’t search further than ‘Anti-D’ is save. >_< and I had two doses (one at about 30 weeks and the other after birth, a c-section for breech). If I get pregnant again, will I have to have it? Any help would be great, thanks.
Nev
In Australia we only recently started giving Rh at 28 and 26 weeks due to its low supply. You are right it is given as a precaution incase the blood mixes usually due to trauma or unexplained bleeding which we would always give to Rh- women, should they present with such symptoms, but then, there is the unconcealed bleeds behind the placentas, which i guess the medical profession are trying to prevent, which are rare but do happen. The incidence of Isoimmunised baies are not as common as 20 years ago, thanks to anti D. (so as much as i hate medicalisation of birth etc i think this one thing we can thank science for). Having looked after these women and babies they are very sick requiring complete blood transfusions inutero and after birth, which then interferes with bonding, feeding etc, not to mention mobidity and mortality. I definitley agree its not a one fits all as medical births tries to conform everyone to, (ive seen women bullied into anti D even after husbands are known to also be negative with the line just incase his not the real father, which im sure most women are intelligent enough to know who the father is), but can i add in Australia as well as giving the Rh anti D at 28 and 36 weeks we also do blood tests checking for antibodies which may help women make informed choices, pending these results of whether to take the anti D at these gestations. Also for Nancy i would suggest considering the Anti D, as repeat LUSC increases the risks of abnormal placental implantations (previas, etc), more scarring and difficult LUSC increasing the risk of bleeding,(if the baby turns out to be positive), and if you experience any bleeding in pregnancy without knowing the bloodgroup and Jaci you definitley should not of recieved anti D as a positive blood group.
Hi, I am RH- and so is hubby, so this means baby will definitely be RH- also, is that right? Which should mean no complications?
I lost a baby years ago to man I don’t whether was negative or positive – could I be sensitised, and would this have any impact?
Thanks so much for your help!
Correct, if both parents are RH- (negative), everyone is good and no need to medicate.
I am Rh neg and my husband is Rh pos. With my 1st child I had 1 shot during pregnancy and none after because my son is also neg (so it was not needed). With my 2nd I refused during pregnancy (easy w/ midwives) and she was also neg. With my 3rd (back at the Dr.’s this time) I refused, and the nurse said I couldn’t refuse… no one ever had. I said yes I can, your just not going to put that needle in me. So she went and talked to the Dr.’s who said I had to sign that I was refusing it. Fine with me!
Carina – awesome! Thanks for sharing your story.
Was your third also negative?
Thank you a lot this answer will help me a lot in the future.
Hi i just find out i,m Rh – and i,m thinking having babys soon,so can i have Rhogam shot before being pregnant?
That’s a good question… I’m guessing they will still want you to have one or two Rhogam shots while you are pregnant, even if you get one now.
Remember, that the shot is not for this pregnancy, it for the antibodies that ‘may’ be creatimg during this pregnancy that ‘may’ affect future pregnancies. If it were me, I’d just wait until after the baby is born, test the cord blood immediately and if the baby is rh+, then you can get the shot so that your second pregnancy goes well.
So far as I understand the shot only stays effective in your body for 6 weeks (hence 28 and 34 weeks…then presuming baby is born at 40 weeks). So having it before pregnancy is pointless. Having it if you’ve had a bleed in pregnancy is probably far more important than the prophylactic dose.
Something else the article doesn’t mention – and as far as I understand it now preg with my 3rd – is that even if your blood does mix with a + baby’s blood, that baby isn’t at risk at all. Its your next pregnancy that your baby could be at risk, but only if the baby is + blood group.
Hayley – yes, exactly! Thanks for your comment!
I’m a -ve mother and my hubby is +ve. I had a rhogam shot after my 1st delivery, and was told this will protect my next pregnancy. I later had a miscarriage whiles in my 4th week but did not visit the clinic for an advice. I am currently 25 weeks pregant and not quiet sure if my baby is safe or not. I have been told i will be given a shot in 28weeks and also at 34 weeks. I am a bit confused after reading this article and not sure what to do. How safe will my baby and I be after the rhogam shots? Please advice
The rhogam shot they give you at 28 and 34 weeks is for a future pregnancy, not the current pregnancy. It sounds like this baby is fine, your body has accepted the pregnancy. If you do not want the Rhogam shot, then simply refuse it while pregnant. Have a blood type test for the baby done at birth and if the baby is positive (because you are negative) – then at that time you can get the rhogam shot to protect the next pregnancy.
Does that help?
Yes very helpful. Thank You
This is the best explanation of this that I have found on the web so far – thank you. I am going to have to go “head-to-head” with my OB on this in a few weeks as I am due for my Rhogam on October 15th but don’t want it. I terminated 3 pregnancies several years ago and recieved the shot at the time of the terminations because I am Rh-. My husband is Rh+. I simply do not want the shot – would I have built up the anitbodies from the previous shots? It is my intention to stand my ground and only get this shot after the birth is the baby is indeed Rh+. This is most likely the only child I will be able to have – miracle baby at age 42. My OB is quite a forceful person and I am concerned that he will refuse care if I don’t want the shot so I want to have my facts straight when I discuss this with him.
Is this a good plan in your opinion?
Thank You!
Correct – if this was my pregnancy, I would wait to get the shot after birth. If I knew that I wasn’t going to have anymore children, then there essentially isn’t a need to get the shot at all. Rhogam protects you against the next potential rh negative pregnancy. From what I understand, it doesn’t have anything to do with the present pregnancy.
Thanks for commenting! Keep us informed with updates
And there is NOTHING wrong with changing doctors during pregnancy. You can terminate him just as easy
Congrats on being pregnant in your forties! My mother had 4 healthy pregnancies and deliveries in her 40′s.
Thanks so much for the quick response – the only thing I worry about is the instance of our baby being Rh+ and the blood somehow mixing the birth process, right? In this instance it could be troublesome but from what my research tells me, the chances of this are very, very slim (less than 1% chance). I am going to have to be adamant that the cord is not clamped too early and that they allow proper time for the placenta to do it’s job…I wish I went with a midwife
. Here in Canada it’s one or the other – you can’t have both but you can have a doula and an OB so I am going to go that route, too. Thanks again for your help, if you heard the story of how I got pregnant you would understand why it’s so important to take matters into you own hands. 4 specialists told me I was in early menopause and had absolutely no hope of concieving…story is long but took charge of myself and concieved naturally quite by surpise after doing alot of digging and research and using Traditional Chinese Medicine…but that’s for another day, don’t want to take this too off track.
Thanks again, will let you know how this all shakes down.
Mary
My blood is (-) and my husband’s is (+). I have 2 children and first was (+) and 2nd was (-). I had a c-sect. with the first b/c he wouldn’t clear my pelvis and it was a LONG labor. I tried v-bac for my 2nd but he also was born via c-section b/c my water was broken and labor was not starting (4 days later). So, more than likely, we’ll have another c-section for the rest of our children. Will this increase or decrease the risk of the blood mixing? Would you recommend the shot if the baby is (+) even if the baby is born via c-section?
Thanks for your response!
I’m guessing that yes, c-section would increase your chances of the blood mixing. (A friend’s baby was just born via c-section and the doctors accidentally, nicked with the knife, the baby’s forehead – that would cause mixing…) If it were me, I’d wait if possible for the placenta to be ‘born’ (out) before cutting the cord. That would help in preventing mixing. Blood type the baby at birth to see if you need the rhogam shot. Remember you only need rhogam if the baby is rh positive and you are rh negative. Blessings!
There is also a new test that can determine the baby’s blood type via a maternal blood draw. It is not covered by insurance but is not terribly expensive. I opted for Rhogham prenatally even tho I am the least interventiony person out there. Amazingly I did turn out to be carrying a negative baby from my positive husband!
I do think it was a crime that Rhogham used to contain Mercury, but today, I would rather avoid a future high risk pregnancy & possible cesarean delivery than Rhogham were I to be carrying a positive baby.
I love that we can be informed before making a decision. Seems like so many decision are made out of fear in the doctor’s office…without all the information.
If it was my baby, I would wait ’till baby is born and then get the rhogam shot within 72 hours of delivery if I had a rh positive baby. That way I am not getting a shot containing human blood while pregnant. That just disturbs me…
Thanks for commenting!
Hi – I am a young woman in my very late 20s and I have started to contemplate the idea of becoming a mother one day. I am RH negative and I was sensitized during a failed pregnancy in my very early 20s. At the time, I refused the Rho-Gram shot although it was heavily pushed and it seemed to the nurses and medical staff that I was making an unsound emotional decision, which would come back to haunt me if in the future I would become pregnant again. Based on your experience, how will being RH-sensitized effect any future pregnancies? I understand best case scenario being negative blood type father, but if the father has a positive blood type? Thanks.
Yes, a Rh negative father would be ideal. From my experience…one of three things will happen. 1. You will get pregnant, have a normal pregnancy, and a healthy baby and never know that there was any ‘problem or doubt’ haunting you. 2. You will miscarry until you conceive with an rh negative baby that is compatible with you. 3. You will have a rh positive baby, carry it to term or almost to term and then it can be treated after it’s born just like other babies are treated within hours of birth that are rh positive with negative moms.
question: is it confirmed with tests that you have been sensitized? also, I have read some crazy testimonies where the mother’s blood type went from negative to positive. It sounds crazy, but crazy (miraculous) things still happen. Babies in of themselves are a miracle.
Blessings!
I am Rh- and found out during my third pregnancy that i was sensitized. We proceeded to have my blood tested every week and then closer to the end of my pregnancy, every few days. My antibody levels began to rise and I got a call from my doctor on Thanksgiving morning that she wanted me to come in and be induced because the antibody level had reached the point where problems can start. I was planning a homebirth so my midwife came and induced me at home by breaking my water. My labor came on fast and was FAR from the gentle births i was used to. I retained placenta which had to be manually removed – but my baby was perfectly healthy. I never could accept that I was “done” – it just didn’t feel right, despite the risks. three years later i was pregnant again. This time, my midwife agreed with me that we needed to keep this pregnancy as stress free as possible for me, and so we decided to do independant lab testing – no doctors involved. My antibody titer count never even got high enough to count! Genetic science already determined that all our babies would be rh+ but we figured there was some mistake somewhere and this baby must be rh- …but she turned out to be Rh+! The risk is “supposed” to be higher with each subsequent sensitized pregnancy, the antibody count rising faster. But we proved that theory wrong in this case. I can only attribute this to my strong faith and my non-fear based care. I don’t want to be arrogant or ignorant – i did a LOT of research. The March of Dimes information really helped me understand what i was dealing with, though i was left with a lot of questions still. Anyway, my advice to other sensitized rh- mothers-to-be is to not be afraid. focus on nutrition and avoid all iterventions. Also, always delay cord clamping so baby has all her rightful blood. We already know that cord blood has stem cells – who knows what else may be in there designed just for baby’s individual needs?
Amazing story! Thank you SO much for sharing. Blessing to you and yours!
I went to the doctor at 6 wks pregnant because I was having light bleeding with no cramping. The nurse gave me the RhoGam shot but I am not Rh-. They did the ultrasound and the baby was the right size as well as the sack. A couple of hours later I had a miscarriage. Could the shot have caused that because I am not Rh-?
Rhogam for ‘light bleeding’? I wonder why she gave Rhogam? or why the doctor okayed it? From what I understand, Rhogam is ONLY for rh negative people. I am sorry to hear of your loss. Let us know if you find any info from your doctor as to why they gave you that shot. Did they do anything else besides give you the shot while you were at the office? Blessings.
The nurse gave the rhogam shot to me without the doctor’s okay. When I asked the doctor why she gave rhogam to me, the doctor said that she shouldn’t have given it to me and the nurse said that she gave it to me because she assumed that I needed it. Basically the nurse was not doing her job correctly. I almost think that the nurse thought I was a different patient.
I have a question… I never really looked up on the RhoGam shot untill the past few weeks… I had my daughter 11-24-09 and she was stillborn… I was 37 1/2 weeks I had a clot in my umbilical cord… I have a clotting disorder… My fiance is rh+ and Im rh- and I chose to get the shot not knowing how much risk is involved… Well now its 5 mths later and Im pregnant with my 2nd child and the rhogam from my daughter is still in my system… Dr’s dont know why and cant explain what it could do to the baby… And I cant find nething online about it can you please help…
Thanks for reading my post and commenting. I’d love to help if possible. What is your specific question reqarding the Rhogam shot or the baby? Is there a specific name for the clotting disorder you have?
Hi there – I just found out my Grandmother was Rh- and my husband & I have been trying to get pregnant for the last 2 years… I have no idea what I am – could this be a factor in fertility? Do you know how the Rh- is inherited?
thanks!
I doubt the Rh factor is preventing you from being able to get pregnant…especially if you haven’t had any children. (It’s simple to get your blood type – just do the ‘eldoncard’ blood type at home.) 2 yrs is quite awhile to go without getting pregnant. Have you read the book, “Taking Charge Of Your Fertility”? It’s on my recommended reading list. It’s a MUST read. You might want to look into using some natural progesterone cream (find it at a health food store or online). There is quite abit of info on the women’s need for progesterone… google the phrase ‘progesterone fertility’ or ‘progesterone luteal phase’ or ‘progesterone pregnancy’ etc.
I had a client who became sensitized during her first pregnancy before she could get Rhogam, despite not having any trauma that you describe. She birthed that baby preterm, and he spent 2 weeks in the NICU. Her next pregnancy was with twins, and it was a very high risk pregnancy since she was sensitized. She ended up having a cesarean birth at 28 weeks, and obviously those babies spent a lot of time in the NICU.
I’m all for avoiding unnecessary interventions…but sometimes interventions are necessary.
Is there a chance she could have been sensitized before even becoming pregnant? Amazing she was able to get pregnant again without miscarrying! And with twins. So, I’m assuming the single birth and the twins were both rh positive?
thank you for posting. i’m very relieved. i’m pregnant and have ab- blood and was worried about the shot. but i just found out that the father has 0-, so i’m extremely relieved. thanks.
Thanks for commenting. I am glad you found out that your husband is also rh negative. Blessings to you and this new little one.
A very interesting article. I had never really understood the whole Rh factor before. Thanks for posting!
I’m glad we both have positive blood types so we don’t have to worry about whether our babies have the Rh Factor. Are you A+?