Anti-D injection

All rhesus negative women having a surgical abortion or medical abortion over 10 weeks’ gestation are offered an anti-D injection.

As well as the main blood groups (A, B, AB or O) there is a second factor called rhesus (RhD). People who are RhD positive have a substance called D antigen on their red blood cells. People who are RhD negative do not have the D antigen on their red blood cells.

Whether someone is RhD positive or negative is inherited from both parents. If the father of the pregnancy is RhD positive, then there is a chance that the fetus will also be RhD positive even if you are RhD negative.

If at any stage of pregnancy there is the mixing of your RhD negative blood with that of the fetus which may be RhD positive, your body’s defence mechanism, called the immune system, may form antibodies against the D antigen. These ‘anti-D’ antibodies attack red blood cells with the D antigen on them.

This mixing of blood can happen at various stages of pregnancy, including abortion. Because the antibodies stay in your system, this could harm future babies if they are RhD
positive.

What does the anti-D injection do?

It ‘mops up’ any D antigen that may have been carried across from the fetus to your blood supply at the time of the abortion. The idea is to neutralise the D antigen from the fetus before it causes your body to produce its own natural anti-D antibodies.

What might happen if I don’t have the anti-D injection?

If you do not have the anti-D injection, it is possible that you will produce anti-D antibodies. If you become pregnant again and the baby is rhesus positive, the anti-D antibodies might enter the baby’s circulation and attack its blood. If this were to happen it would make the baby ill, either in the womb or after it is born. This is called haemolytic disease of the newborn, which is a very serious condition.

Do I have to have the anti-D injection?

Ultimately, it is your decision whether to have the injection. However, it is strongly recommended that you do. However, it is strongly recommended that you do, especially if you wish to have children at any time in the future.

Is it safe?

Anti-D injections have been in use for over 40 years and there are no known serious side effects. At worst, some women experience short-term rashes or flu-like symptoms, but these are very uncommon. Anti-D is a blood product made from a part of the blood called plasma that is collected from donors. The production of anti-D immunoglobulin is very strictly controlled to ensure that the chance of a known virus being passed from the donor to the person receiving the anti-D is extremely low indeed.