My name is Sara from East Tennessee and at 26 weeks pregnant with my first baby I found out I had Anti-D antibodies. It was the appointment before I would receive the RhoGam shot actually. And I want to say they still gave it to me, not knowing at that point it had already been too late. How did I get sensitized? It’s a mystery that I have been pushing through my head every now and again for over 10 years. I might have been cutting a piece of wood on the table saw when it kicked back a bit and hit my stomach, but that is just a memory, although the only thing I can think of. Not that you even have to have a moment, sometimes it just happens for no reason at all. I didn’t even know what it meant at the time and my OB certainly didn’t explain anything that I remember,  but suddenly I had an appointment with the local high risk office. At 32 weeks I was released back to my OB with everything looking just fine and my OB sort of forgot about it, not another word was spoken, until my 39 week appointment, I asked how all this “sensitization stuff” would affect birth. She looked at my chart and was thinking that the RhoGam had caused my labs to be positive, but in-fact I had the labs before the shot. She looked at me sideways and quickly called for some labs. I was induced that night at midnight, 39 weeks pregnant with my first baby. My titers I had found out earlier that day were 1:16 and no one had been monitoring anything since 32 weeks. I had dreamed of a natural birth, but it ended in a c-section and then 9 days in the NICU with blood sugar issues, a platelet transfusion, and under billi lights. We walked out of the NICU when he was 9 days old and he has been healthy ever since. The pediatrician we were seeing at the time didn’t know anything about it either, thankfully he didn’t need any follow-on care, or we just didn’t know enough to give it to him, but he is almost 10 and thriving.

Fast forward and I went on to have 2 more beautiful babes, both also affected by my positive antibodies. The difference, early on in that pregnancy I had demanded to be at the high risk doctor the entire pregnancy and they listened. So around 9 weeks I was transferred for full care with the MFM and never looked back. The middle had her first IUT at 28 weeks and had 3 total and then was delivered via c-section at 34 weeks. She spent 9 days in the NICU and by the time she was 5 weeks old she had 2 more transfusions. 5 total, 3 inutero and 2 post birth with 2 rounds of IVIG. I really wasn’t done and I consulted with the MFM and they agreed that whatever we wanted to do, they would support 100% of the way. So our little Covid baby came along, which honestly was a whole different ball game. She had both anti-D and Kell at play. She had her first transfusion at 23+6 weeks, which was terrifying. Sitting in the doctors office having a conversation about whether you want the doctors to keep your baby alive should something go wrong, ALONE because of COVID. She went on to have 5 total IUTs and then we delivered at 34 weeks, just like her big sister. She and I spent 21 days in the NICU and by 8 weeks she had 3 post- birth transfusions and 2 rounds of IVIG. Even with the 3^rd baby, nurses in the NICU (they were all born in the same place) didn’t understand alloimmunization, even some of the doctors. I felt I had to be there 24/7 to ensure the appropriate care was given, like not giving a multi with iron, turns out her ferritin was through the roof already.

3 kids

3 sensitized pregnancies (Anti-D and Kell)

8 Intrauterine blood transfusions

11 spinals over 5 years

13 blood transfusions between the girls (THANK YOU blood donors)

39 days in the NICU

A staff of amazing MFM doctors and nurses, and NICU doctors and nurses who supported me and my family through 2 pregnancies.

The most amazing thing was that by 4 months all 3 of my kiddos were meeting their “normal” milestones for a 4-month old and you would have never known they had ever been sick. But getting them to that point was not for the faint of heart, granted I would do it all over again in a heartbeat, I would just maybe do some things very differently to advocate for my own care and my kids. 

My kids are now 10, 8, and 5 and I look at the journey we took to get them here and am in awe some days, the fact that had we not had our amazing team of MFMs for the 2^nd two, things could have turned out very differently.  I also hold on to so much from pregnancy and post birth with them, things I am still trying to admit to myself. I am trying to find ways to heal and I think one important thing I couldn’t have during COVID was a village of support because you just couldn’t have anyone around.  Motherhood is such a wild journey from before you even get pregnant, through pregnancy, and then raising these amazing kids who will go out in the world and make their own impact. I had no idea what all it would entail, but the biggest thing I have learned is the importance of advocating for yourself and your kids health, every step of the way. I am still advocating for my kids health and I don’t think that ever stops.