- Courtney Yeager’s antibodies started attacking her son when Yaeger was pregnant.
- The doctors gave the fetus blood transfusions in the umbilical cord.
- The stress of the situation contributed to Yaeger’s postpartum depression.
This narrated essay is based on a conversation with Courtney Yaeger. It has been edited for length and clarity.
I work as a radiology assistant, so I am close to many pregnant ultrasounds. I also have a negative blood type. In school I learned how this can cause complications during pregnancy. I tucked this information away, thinking I might have to come back to it one day.
Of course I did. During my first pregnancy, the doctors explained that I was at risk Rh incompatibility. The condition meant my body was able to make antibodies that attacked the fetus’s red blood cells. My medical team gave me a drug called RhoGAM that stopped my body from making these antibodies, and my first son was born without complications.
During the second pregnancy, things got more difficult. I started producing more antibodies and the medication was not as effective. I had blood tests and ultrasounds every two weeks during the second half of my pregnancy until my second son was born without complications.
Unfortunately, Rh incompatibility often worsens with subsequent pregnancies. When I got pregnant with my third son, Beau, things got very scary.
Beau needed a blood transfusion at 23 weeks pregnant
Right away with Beau, my doctors Fetal care center Yale New Haven Children’s Hospital started measuring the antibody level in my blood. After week 16 I had a level that could be dangerous for the fetus. That’s when we started ultrasound examinations twice a week.
During the ultrasound, the technician examined a blood vessel in Beau’s brain. The way the blood flowed through the area could indicate if he was anemic. Anemia, or a low red blood cell count, can cause his organs to shut down. It can be fatal for the baby.
At 23 weeks, the doctors delivered bad news: Beau was anemic. He would need a blood transfusion before he was born.
I had to be prepared for the risk of an emergency C-section
I went straight from the polyclinic to the maternity ward of the hospital. There, the doctors explained that the procedure would take place in the operating room because there was a risk that I would need an emergency C-section if something went wrong.
A neonatal group that specializes in premature babies spoke to me. But I knew that if Beau was born at 23 weeks, he wouldn’t make it. We decided to do the blood transfusion knowing it was heavy but we had no choice. He couldn’t wait.
The procedure can be done under general anesthesia or with an epidural. I chose the epidural because if I needed a C-section, I would at least be able to see my baby born.
After the anesthesia was administered, I lay on my back in the operating room while the doctors inserted a needle through my abdomen into the amniotic sac at the point where Beau’s umbilical cord joined the placenta. Once there, they delivered the blood donation that saved Beau’s life before it even started.
I looked and felt good between procedures
Each transfusion protected Beau from anemia for two weeks. I needed six procedures, an epidural each time. I usually went home after the procedures, but twice I had to stay overnight in the hospital for observation. Between appointments, I looked and felt fine, making it difficult for friends and family to understand how serious the situation was.
Doctors explained that at 34 weeks of pregnancy, the procedure became more risky than premature delivery. I had my last blood transfusion at 33 weeks and was induced at 35 weeks.
Even though I had already had six epidurals, I wanted Beau to have an unmedicated birth like I had with my previous two pregnancies. My high risk team was amazing and helped me work with the midwives to make it possible. The calm, serene birth that I had dreamed of in the midst of so much trauma was everything to me.
Beau needed 3 more blood transfusions after birth
Unfortunately, the birth was not the end of Beau’s health concerns. She had to spend six days in the neonatal intensive care unit because she developed severe jaundice, another complication of Rh incompatibility. I couldn’t hold or nurse him for four days.
When Beau was three weeks old, I noticed he was very pale, which could indicate anemia. Sure enough, he needed a blood transfusion. Because he had received so many blood transfusions as a fetus, his body had come to rely on donated blood and not produce enough red blood cells on its own. Beau required two additional blood transfusions, but after five months he was stable and healthy.
That’s when all the emotions of the past eight months hit me like a ton of bricks. Beau was finally healthy, but I experienced postpartum depression and anxiety. I was able to stand up for myself, just like I had for Beau, and get the help I needed. Today Beau is a busy 18 month old and we are both happy and healthy.
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