• As mothers recount distressing journeys

Medical experts have warned that untreated Rhesus (Rh) incompatibility may endanger both future pregnancies and newborns, calling for stronger awareness campaigns to educate women and young girls on possible complications.

They stressed that early knowledge and proper counselling could help prevent avoidable fear, distress and pregnancy-related complications.

The experts noted that such experiences highlight the need for early screening and appropriate counselling for pregnant women, emphasising that Rh-related risks are largely preventable when properly managed.

The Rh factor is a protein found on red blood cells. Individuals who have it are Rh-positive, while those who do not are Rh-negative. Challenges arise when an Rh-negative mother carries an Rh-positive baby, usually inherited from the father.

In such cases, the mother’s immune system may identify the baby’s blood cells as foreign and produce antibodies against them. While the first pregnancy is often unaffected, subsequent Rh-positive pregnancies may be at risk, as these antibodies can attack the baby’s red blood cells.

The World Health Organisation recommends the use of RhD immunoglobulin (anti-D) for RhD-negative pregnant women to prevent sensitisation, which can lead to haemolytic disease of the newborn. The guideline includes administration at about 28 weeks of pregnancy and within 72 hours after delivery if the baby is Rh-positive.

A gynaecologist at Nnamdi Azikiwe University Teaching Hospital, Dr Stanley Egbogu, told The Guardian that Rh-negative mothers are not inherently at higher risk when proper medical steps are followed.

He noted that complications arise mainly when sensitisation occurs, particularly if the mother’s immune system has already developed antibodies against Rh-positive blood cells.

According to him, timely testing of the baby’s blood group after delivery and administration of anti-D immunoglobulin, commonly called Rhogam, within 72 hours can prevent future complications.

He added that women who receive the injection after childbirth significantly reduce the risk of problems in subsequent pregnancies, while those whose partners are also Rh-negative face no incompatibility risk at all.

Similarly, a consultant obstetrician and gynaecologist at General Hospital Mushin, Dr Muyideen Adelakun, told The Guardian that Rh incompatibility mainly affects the unborn baby, but can also leave lasting psychological distress for mothers.

He explained that in severe cases, the mother’s antibodies may destroy the baby’s red blood cells, leading to conditions such as hydrops fetalis, where fluid accumulates in the baby’s body and survival chances drop significantly.

Adelakun said about half of babies born alive with severe forms of the condition may not survive, but stressed that outcomes improve significantly with early detection and intervention.

He added that even where Rhogam was not administered after a first pregnancy, careful monitoring in subsequent pregnancies can still improve outcomes. In some cases, delivery may be induced early if the baby is stable, or the pregnancy closely managed if complications are detected.

The gynaecologist warned that untreated cases could lead to haemolytic disease of the newborn, brain damage or heart failure, but emphasised that with proper antenatal care, monitoring and timely treatment, Rh-negative mothers can still safely deliver healthy babies.

Meanwhile, mothers who spoke to The Guardian stressed that earlier knowledge and counselling could help prevent avoidable fear, distress and pregnancy-related complications.

Women living with the Rh-negative blood group recounted emotionally draining pregnancy experiences, even as health experts emphasised that most risks are manageable with proper monitoring and timely treatment.

When Florence Ayibe became pregnant with her second child, she expected the journey to be easier than the first. Her first pregnancy had ended in an emergency delivery, but both mother and baby survived. What she did not know was that her Rh-negative blood type could quietly shape her next pregnancy.

During a routine antenatal visit in her fifth month, doctors noticed signs that the baby might be anaemic. Further tests revealed that Ayibe had developed antibodies after her first pregnancy, likely because she did not receive anti-D immunoglobulin in time after delivery. Those antibodies were now attacking the red blood cells of her unborn baby, who was Rh-positive.

“I had never even heard of the Rh factor before, and nobody explained it to me after my first child was born,” she said.

What followed were weeks of fear, hospital visits and constant monitoring. Instead of preparing for a new baby, Ayibe spent sleepless nights searching for answers and hoping for good news. Doctors closely monitored the pregnancy and eventually delivered the baby early to improve the child’s chances.

Her son was born weak and jaundiced, requiring urgent care in a neonatal unit. “I kept blaming myself, but how could I know what no one told me? If I had known earlier, I might have been spared so much fear and sleepless nights. No woman should learn about the Rh factor when her baby is already fighting for life.”

Today, both mother and child are doing well, and Ayibe now shares her story, especially with expectant mothers. She urges them to know their blood group early, ask questions during antenatal care and ensure they receive anti-D injections when needed.

A similar sense of shock marked the experience of Nwadialor Glory (pseudonym), who said she did not expect a routine hospital visit to turn into one of the most frightening moments of her life.

She was in her mid-20s, newly married and working on her undergraduate project when she became pregnant unexpectedly and went to a clinic seeking an abortion.

At first, everything seemed straightforward until the doctor asked for her blood group. She could not recall ever being told she was Rh-negative, but a quick test confirmed it.

What followed, she said, was not judgment but a detailed explanation that changed everything. The doctor told her that because she was Rh-negative, terminating the pregnancy without proper precautions could expose her to Rh-positive foetal blood.

Such exposure could trigger her immune system to produce antibodies that might not affect her immediately but could harm future pregnancies, potentially leading to miscarriage or serious complications.

“I didn’t even understand half of it at first. All I knew was that the risks I thought I understood suddenly had consequences I had never heard about,” she recalled.

Glory said she sat in silence as the implications sank in, that what she assumed was a private decision could affect the children she hopes to have in the future.