Nov 242012
 
OB at the end of a 2 minute exam: ” Any questions?”
Mother: “Yes, could you tell me my blood type?”
OB, glancing at chart:  “Your blood type is O-, which is a problem.”
Mother: “Why is that a problem?”
OB, backing out of exam room:  “It means your blood could kill your baby, but we’ll worry about that later. See you next month.”
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 November 24, 2012  informed consent, OB, prenatal  Add comments

  30 Responses to ““…Your Blood Could Kill Your Baby, But We’ll Worry About That Later…””

  1. Umm…no you won’t see me next month because you’re fired! Goodbye!

  2. Get your arse back in here and explain yourself. Note to doctor, the next time this conversation comes up you tell the mother than she is O- and then you shut your darn mouth. She can go look up the meaning of having negative blood on WebMD without the intermediate panic. She can also find out if her husband / the baby’s father also might happen to be negative. Either do the job and provide the education or don’t do the job and let her find out on her own. Causing panic is not a good thing. BTW it wouldn’t kill this baby unless she had a blood exchange accident. It would only attack a second baby, so even your lame attempt at education missed the mark.

    • There are some assumptions in your post (some women don’t find out their blood type until subsequent pregnancies). Also, ABO incompatibility is something that can be quite dangerous, and if mom has an O blood type it’s more likely that this will be a problem. That could be what the doctor was talking about here, in which case there is nothing he/she could do and it’s hard to predict it until the baby is blood typed after birth.

      Even so, I don’t disagree with you about the doctor’s tact. Holy cow, this is horrible. If you end a sentence with “It could kill your baby” you had better follow up with information, not “we’ll worry about that later”. I can’t believe anyone would think this was okay, no matter what kind of hurry you’re in! Even if a mom was pushing in the hospital and he/she had 10 minutes to get there a nurse should have been sent in to explain!

      • I’m O- also, and my husband is B+. After doing a LOT of research about Rh and ABO incompatibility and talking to my docs, I learned that its really only a problem for subsequent pregnancies, and even then only if there is blood exchange between mom and baby. If my doctors had said this to me, I would have been freaking out. Especially since the solution to preventing a problem is a simple series of shots (for the Rh factor anyway). And like someone else said, if dad is O- also, then there is not even a problem to begin with.

        • ABO incompatibility and Rh sensitization are two different things. ABO incompatibility can occur with an Rh+ or Rh- mom, most typically with a mother with type O blood and a baby with type A blood. There is no way to prevent it. Rhogam cannot prevent ABO incompatibility.

          • I know they are totally different things, but the root cause of both is essentially the same- incompatible blood types. Since the dad’s blood type isn’t known from the post, OP could potentially have been at risk for both, and the doctor could have been referring to either (though it is likely he was talking about the Rh factor, since a lot of OBs don’t seem to even know all that much about ABO issue). I guess I should have been more clear that I was talking about the Rh issue when referencing the shots, ie Rhogam, as a preventative measure.

          • Yep. My mom is O+ and my dad is A+…I’m A+, first born, and had ABO Incompatibility and had to be hospitalized after birth. I’m lucky in that I didn’t have any lasting issues, but it was an issue for several weeks.

  3. I’m sorry OP! I hope you qickly educated yourself on the situation! And the problem is not always an issue in subsequent pregnancies especially if the previous baby was not born in an overly traumatic fashion *points to zombie baby* see he’s just fine and “shouldn’t have lived”.

  4. Ok, I’m confused here. If a blood exchange happened between mom and baby, if the mom has O- blood, wouldn’t the baby be fine no matter what his blood type is? I thought the danger would be for the mom if the baby had anything but O-??? I’m going by the simplified O- being the universal donor type, meaning anyone can receive it and be just fine.

    • Yes you are correct! O- is the universal doner however we are NOT universal recipients. Being pregnant is kind of like recieving blood and, while our bodies will generally handle baby #1 just fine if baby 1 was Rh + and dad is too if blood from baby 1 mixes with someone’s who’s O- your body has a high chance of rejecting any subsequent Rh+ babies. Rogham can prevent this as well as avoiding extra bleeding (c-section, epesiotomy, severe tearing, etc). According to the general school of thought my youngest “shouldn’t be here” b/c sister and dad are Rh+ but he’s fine :-) Does that help?

      • Yes. I was referring to the OP, trying to figure out how the mom’s blood being O- could potentially kill her baby. My sister also has O- and all four of her children were RH+. I just find it odd sometimes how “random” a blood type can be. I mean, I remember high school Biology and all, but it still amazes me. For instance, my mother was B+, father is A+. I am O+ and my sister is O-. My husband is also O+, so I am pretty sure all of my boys are O+ as well. (I know they have to be O, but it’s unlikely any of them inherited an RH- gene from both their Daddy and me)

        • (Microbiologist and genetics junky here)

          Basically, each person has two halves of their ABO blood type. It’s why people can be AB. Most people are only given one letter, and that’s their dominant type. Blood type A can be AA or AO, B can be BB or BO, O is always OO. So your mom and dad were BO and AO, respectively, and your family just had the luck to have both you and your sister get OO.

          Rh factor functions the same way. Rh- people have the genes for Rh-/Rh- while Rh+ people can be Rh+/Rh+ or Rh-/Rh-. Since your sister is Rh-, both your parents must be Rh+/Rh- and you have a 50% chance to be Rh+/Rh-.

      • I get it. I am going to claim “Mommy Brain” and blame the almost 3mo sleeping next to me for my brain going blank there for a bit.

      • Ok, I seriously know nothing about blood. I am A+ and hubby is O-. So am I to assume we would never have this problem? No idea what bloodtype my son is. Any link to teach me the basics in simple terms? I look it up and I might as well be reading Greek.

        • yes thats right, in very simple terms,what happens is if the baby’s positive blood mixes with the mothers negative blood then the mothers blood will form antibodies against the foreign object, generally not a problem in the current pregnancy but in later pregnancies where the baby’s blood is positive, if there is another bleed leading to the their blood mixing, the mothers blood will recognise the new baby’s blood as that foreign object and attack it, its not always fatal depending on when the bleed is but it can have serious consequences. if the baby’s blood is also negative then there is no issue. if you have are RH positive then you dont have to worry :)

  5. This was me. This was my first pregnancy. I went into a total panic at the end of the exam. I also had HG so I threw up in the office, the parking lot, and for quite some time when I made it home. After a scary 25 minute drive home,I spend hours researching on the internet trying to figure out why it would be a problem.

    My hubby has O+ blood so ABO incombatibility wasn’t a problem but I didn’t know that yet.

    My children both survived my poisonous blood ;) despite this doctor’s fearmongering. They both have O- blood also.

  6. First post didn’t work. This is me.

    Went into a total panic when I left the doctor’s office. I also had HG so I threw up several times before I made it home 25 minutes later.

    I spent several hours on the internet trying to figure out how my blood was going to kill my baby. (I did find out that Type O negative was a grunge band from NYC.)

    Hubby is O+ so ABO incompatibility is not a problem. Both my children survived my blood type seeing as they are both O- as well.

  7. A- here and both my boys (A+ and O+) are alive and well thanks doc, as long as you receive an anti D shot within 72 hours of a suspected internal bleed all should be well, i personally got the routine shots through pregnancy as my husband is a known positive and id rather not risk future pregnancies.

  8. I have always been relieved I’m O+ so I don’t have to put up with this crap. I had my 1st OB (who I did not stay with) sit there *holding my chart in her hand* start to give me the speil about how horrible rh complications can be and how I *must* get checked. I interupted her and informed her I was O+. She stared at me, clearly trying to reorganize the lecture she had been about to give, and then said ‘ok’ and then proceeded on with the next utterly ridiculous lecture she was going to give (about how important prenatal testing was so I could abort if there was anything wrong!!)

  9. I am going to give the doctor the benefit of any possible doubt, so I will assume that

    1. This was a case of concern about ABO incompatability where there is nothing that can be done until the baby is born.

    2. The doctor absolutely knew that the father’s blood type was AB.

    3. The doctor did not know the blood type of the fetus so there was some doubt as to whether ABO incompatability was even a possibility.

    4. There was some test scheduled at a future date that would let them know the fetus’s blood type so that they could get a better sense of whether ABO incompatibilty was a potential issue.

    Even if all these things are true, there is no excuse for making this comment. Either keep your mouth shut or take the time to educate. Dropping a bombshell and walking out is never, ever, EVER okay.

  10. This was me. I went into a total panic when he left the room. I was a first time Mom and vaguely remembered reading something about rh and ABO incapability. I threw up several times on the way to my car. It took me 25 minutes to drive home and I was crying the whole way. I spent the rest of the afternoon researching it. (fun fact: there’s a grunge band called Type O negative)

    My hubby has O+ blood so ABO was not a problem. Both my kids ended up with O- blood also so they’re miraculously not dead.

  11. I’ve tried posting three times.it won’t let me post.

    • Okay now it works.
      This was my first pregnancy. I got really panicky when he left the room and threw up dental tones on the way home. Spent the rest of the afternoon researching why I had poisonous blood. It really freaked me out. My daughter also has o- blood so she’s not dead. Neither is her younger sister. Ugh.

  12. So you just tell the mother that she might inadvertently kill her baby and then you LEAVE!?!?

    Ex-plain! Ex-plain!! EX-PLAIN!!!

  13. Oh. my. I cannot even imagine telling that to a mom. When is “Your blood might kill your baby” ever the right sentence to end an exam with?? OB must have been on crack that day.

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