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This week, we provide more information about Anti-D. We cover topics like baby movements, your sleeping position, and the tests and treatments available for your baby after birth.
Part 1: Things that are relevant to your pregnancy now
A blood test in early pregnancy gives us important information about your blood type. As well as your blood group, it tells us if you’re Rh positive or Rh negative.
Rh refers to a protein on the surface of red blood cells. If your blood cells have this protein, you’re Rh positive. If they don't, you’re Rh negative.
Most people are Rh positive. If you’re Rh negative and your baby is Rh positive, your body may produce antibodies that fight against your baby’s blood. This could cause them to develop anaemia (low red blood cells) and jaundice (yellow skin and eyes).
This can be managed by testing your blood again later in the pregnancy and receiving an Anti-D (Rh immunoglobin) injection at 28 and 34 weeks.
Before you receive an Anti-D injection, you must give your informed verbal permission or consent. Your doctor or midwife will:
- explain why the Anti-D injection is recommended
- tell you when you’ll receive the Anti-D injections, both during your pregnancy and after your baby is born
- discuss what the treatment involves
- describe the risks and benefits of having the injection, as well as the risks or consequences if you choose not to get it
- give you a chance to ask questions
- use written information or diagrams to help you understand treatment.
Anti-D may also be recommended for other medical reasons during pregnancy. Your doctor or midwife will discuss this with you if necessary.
Part 2: Things you may want to consider
By now, you’re probably quite familiar with your baby’s movements. Whether it’s light flutters, a swish, a roll, or stronger kicks and punches, these are all signs that your baby is well. Paying attention to your baby’s movements is a simple thing you can do to help keep them safe and healthy. Regular movements are a good sign of wellbeing.
Your baby will continue to move during pregnancy, changing positions and stretching. How often they move varies from baby to baby. They’ll also have periods of being awake and asleep. These movements continue throughout your pregnancy.
It’s a myth that babies’ movements slow down or become weaker towards the end of pregnancy. When a baby is unwell, they may try to save energy by reducing their movements. This may be the first sign of a problem and can occur at any time in a pregnancy.
How will you know if a quiet time is normal or too long?
From 28 weeks onward, you should feel your baby move regularly every day, regardless of where your placenta is located. Babies keep moving every day until they’re born. Feeling regular movements is a sign that your baby is healthy.
If your baby is unusually quiet at a time when they are normally active, it might be a sign that your baby is becoming unwell. It’s easier to feel your baby’s movements when you’re sitting quietly or lying on your side.
Please go to the Women’s Emergency Care department immediately if you notice a change in your baby’s movements that worries you. Don’t wait until the next day or your next hospital appointment. You know your baby best - it’s your body and your baby, so trust your instincts.
For more information, visit The Centre of Research Excellence in Stillbirth website - Movements matter
The Women’s Emergency Care department is located on the Lower Ground Floor, near our carpark entrance on Flemington Road.
Sleeping can become difficult when you’re pregnant because of things like heartburn, nausea, your growing baby, and the need to use the toilet more.
Finding a comfortable sleeping position can also be challenging.
But it’s important not to sleep on your back or stomach. Research shows that sleeping on your side from 28 weeks can reduce your risk of stillbirth by half compared to sleeping on your back.
Try to start sleeping on your side from 28 weeks. You can sleep on your left or right side – both are fine.
Sleeping on your side:
- helps maintain good blood flow to your uterus and oxygen supply to your baby
- prevents slow or sluggish blood supply to your body
- makes breathing easier
- reduces the risk of gut and tummy problems
- decreases pressure on your growing breasts.
Don't panic if you accidentally roll onto your front or back while sleeping. Simply roll back onto your side and go back to sleep.
Here are some tips to help you get comfortable in bed:
- place a small pillow or rolled handtowel under your belly to relieve pressure on your upper side or back. It will also help prevent you from rolling onto your stomach
- use a pillow between your knees
- consider buying an extra-long pregnancy pillow
- position a pillow behind your back to stay on your side and avoid rolling onto your back.
If you’re experiencing shortness of breath or heartburn, try these tips:
- use pillows to raise your head in bed
- have someone put a rolled-up blanket under the head of your mattress
- raise the top end of your bed.
For more information, visit The Centre of Research Excellence in Stillbirth website – Side Sleeping.
Your baby continues to grow and develop until 39 to 40 weeks. Research shows that every week your baby stays inside you improves their short and long-term health and development.
For uncomplicated pregnancies, it’s usually best for you and your baby to wait for labour to start on its own and as close to your due date as possible.
In some cases, a planned birth before your due date may be safer. A planned birth is when you give birth at a specific time, either through an induction of labour or, less commonly, a caesarean section. Sometimes babies need to be born earlier to reduce the chance of complications, especially if you or your baby are unwell or have conditions that increase your risk of stillbirth.
Deciding between a planned birth or waiting for your baby to be born is not always easy. Your midwife or doctor will discuss the benefits and risks of both options with you, answer your questions, and support you in making your decision.
The chance of stillbirth and other major complications is generally very low. Your midwife or doctor will explain your risk of stillbirth, discuss the timing of your baby’s birth, and if you or your baby need closer monitoring.
For more information:
- talk with your doctor or midwife
- visit the following websites:
- Every Week Counts
- Let’s Talk about Timing of Birth - The Centre of Research Excellence in Stillbirth
Part 3: Tests and treatment for your baby after their birth
After your baby is born, you’ll be asked if you want your baby to have several tests. You have the right to agree, ask for more information, or refuse.
Here is some information to help you decide. You can also ask your healthcare team for more information about these tests at any time.
The Apgar score assesses your baby’s overall condition, including breathing, heart rate, and colour. This is done at 1 minute and 5 minutes after birth. The Apgar score tells your carers how well your baby has adjusted from life inside your uterus to life outside.
Babies with a lower Apgar score may need extra care.
For more information about the Apgar score, visit the Pregnancy Birth and Baby website.
Vitamin K helps the blood clot and prevents bleeding.
We recommend giving babies a single dose of vitamin K by injection within a few hours of birth, because newborns may have low vitamin K levels during their first 8 days.
For more information on vitamin K, visit the Better Health Channel.
Hepatitis B is a liver disease caused by a virus. It spreads through infected blood and other body fluids like saliva. We recommend immunising babies soon after birth and during infancy. The hepatitis B vaccine will be offered to your baby before you leave the hospital. More vaccinations are given over the next 4 years to complete the immunisation.
If you are hepatitis B positive, we suggest that your baby be given another injection in the hospital called hepatitis B immunoglobulin. This gives your baby immediate protection from hepatitis B.
For more information, read our fact sheet hepatitis B immunisation: the birth dose and your baby
After your baby is born, we suggest weighing them, usually after their first breastfeed. By then, your baby may already have passed urine (wee), and meconium (their first poo). They will be weighed again on Day 2 either in hospital or when our midwife visits you at home.
It’s common for babies to lose some weight during this time but still remain healthy. The midwife will inform you of any weight loss and if any treatment is needed. Most babies take about 7 to 10 days to return to their birth weight. This is normal.
This routine health check is offered to your baby soon after birth. Some babies are born with a hearing loss that could affect their speech and language skills. Hearing loss may not be obvious in the first few weeks, but a hearing test can detect it. You’ll get the results as soon as the test is completed.
Ongoing hearing tests will also be part of your care in the community through your local Maternal and Child Health Nurse.
For more information about the Victorian Infant Hearing Screen program, visit The Royal Children’s Hospital ;website.
The Newborn Neonatal Screening Test is recommended for all babies in Victoria. A blood sample is taken from your baby’s heel and sent to a specialist laboratory. The sample is then tested for very rare, serious diseases. In most cases, if any diseases are found, they can be treated, allowing your baby to grow and develop normally.
This test screens for:
- congenital hypothyroidism
- cystic fibrosis
- amino acid disorders such as phenylketonuria (PKU)
- fatty acid oxidation disorders
- other rare metabolic disorders.
How is the test performed?
When your baby is between 48 and 72 hours old, a midwife will prick your baby’s heel and collect 4 small spots of blood on a blotting card. If the results are normal, you will not be contacted.
For more than 99 out of every 100 babies, the test results are normal.
If your baby is found to have a medical condition, you’ll be contacted, and your baby will be referred to a specialist for tests and treatment.
Visit the Victorian Clinical Genetics Services (VCGS) website for more information about the Newborn Screening Test.
Vitamin D supports a baby’s growth and helps their bones develop. It is recommended to give your baby vitamin D from birth until they are 12 months old, or as advised by your doctor.
For more information, read see our fact sheet vitamin D supplements for babies.
We hope you have found the information interesting.
If you have any health concerns please talk to one of your health care professionals – midwife, General Practitioner (GP), hospital doctor, etc.
There will be more to read and learn next week, in week 28. Stay safe and well.