One of the greatest aim of an expectant mother is to carry her nine months pregnancy and to deliver successfully, a healthy baby with zero complication. Most women after the first baby dream of delivering another baby without any complications. However, such dreams and hopes of motherhood are shattered and leave most women in pain, self-anger while others are ridiculed by their relations or society. Awula Naa of Chorkor, a suburb of Accra said “I was ridiculed by the society. I was told I was not a complete woman because I am not capable of delivering a baby and bringing it home. These comments shattered my dreams of becoming a mother of many children”.
There are lot of programs instituted by the World Health Organisation through the Ghana Health Service to curb such complications. Programs such as Ante Natal Care (ANC) and Post Natal Care (PNC) delivery are very important for any pregnant woman. Attending to such care delivery system minimises or helps the midwives’ or paediatrician rule out any pregnancy related complications. However, some women in Ghana are unaware of such programs as a result fall prey to some pregnancy related complications. “I have not heard of any programs instituted by the government to look into this complications and where our health centre is located is far. Due to the poor nature of our road, I usually prefer delivering at home” Said Beatrice Nyamekye in the Central Region.
Aside the fact that most women are unaware of ANC or PNC, certain factors prevents most women from going for ANC or PNC. “I know I am supposed to go for ANC at least once every month but our road is not good. I get too tired and some do not get any transport back. I have decided to do that once every three months”. Said Grace Bonti, an expectant mother. One of such complications most women fall prey to is the physiology of rhesus immunization.
Most expectant women understand that knowing their blood group is paramount to delivering successfully without any complication but do not know the importance of the ‘rhesus’ factor. The Rhesus (Rh) factor is part of the human blood systems and is the second important human blood group system after the ABO blood group system. The Rhesus factor is an antigen that surrounds the red blood cell. It is present in about 85% of humans which makes them test positive while those who do not have it are negative. The knowledge of the rhesus group factor in pregnancy is important because it may cause rhesus incompatibility also called the rhesus disease. Rhesus incompatibility occurs when a person with Rh negative blood group is exposed to Rh positive blood group thereby producing rhesus antibodies to fight against any rhesus positive blood group reintroduced into the blood. Therefore, a pregnant woman with the Rh negative can be sensitized by her Rh positive baby if there is bleeding from baby to mother at any point during the pregnancy from an induced or spontaneous abortion, trauma, early separation of the placenta, invasive obstetric procedures and even through a normal delivery.
A baby inherits its Rhesus blood group system from either from the mother or father. Babies who have the same Rh factor with their mothers do not affect their mothers when their blood gets into contact with their mothers blood. This includes women with Rh positive but carries a baby with Rh negative blood system. However, the biggest concern is when Rh negative mother carrying her first Rh positive baby. As baby’s blood is exposed to mother either through birth or an abortion, antibodies will be formed in a mother within 3 days after delivery. If no medical intervention is done then the mother becomes permanently immune against any Rh positive baby she will carry for the rest of her life. The first Rh positive baby lives but the next either becomes a miscarriage or the baby is born with severe jaundice immediately after birth as a result of mother’s Rh antibodies destroying the red blood cell of the baby.
Rh negative women who undergoes unsafe abortion (as defined by the laws of Ghana) may have the next babies to be at higher risk of the rhesus disease because less precautions are taken, no laboratory investigations are done and more over it is not supervised by a qualified health personnel. This can make the woman to live in a guilt of being punished.
Advanced knowledge in blood grouping systems lead to the discovery of RhoGam which is a medication given to Rh negative mothers to prevent the formation of antibodies in her. Immediately after delivery blood tests are run on mother for the presence of antibodies and on the baby to know it’s Rhesus factor. If baby is negative as her mother than no treatment is required but if the baby is positive, RhoGam is given to mother within the first 3 days after delivery. This test is to be done for every baby the Rh negative mother delivers. For Rh negative woman who undergoes an abortion would be given the same treatment within 3 days. Now, RhoGam is not only after birth but at 28 week of pregnancy in case there could be any little bleeding that may not be noticed.
The best way to deal with issue is for both partners are to test for their blood group and Rhesus factor so that if the mother is at risk, partners can plan and prepare for before conception and the birth of their children. Regular visits to the antenatal clinic and attending scheduled dated for postnatal clinic. Moreover, don’t hesitate to go to registered health facility for a safe abortion.