Lorraine’s Story

Lorraine Bell found out at 17 weeks pregnant that she and her baby were diagnosed with Rhesus disease, a condition where the mother’s blood destroys her baby’s blood cells. Rhesus disease doesn’t harm the mother; however, it can have devastating effects on the unborn baby - including severe anaemia, jaundice, or even stillbirth - if untreated.

In Lorraine’s case, the doctor’s attempted 14 intrauterine transfusions to save her baby during her pregnancy. In two out of the 10 successful attempts, her baby had a heart attack. 

To learn more about Lorraine’s story and the impact intrauterine blood transfusions have had on both her and her daughter’s life, read on.   

My Anti-D antibodies were created when I gave birth to my son in November 1981. I was immunised at that time to reduce the chance of developing Rhesus antibodies during my pregnancy. However, when my son was born he was severely jaundiced, which was unusual for a first pregnancy. The doctors had concerns that the medication would not work in my case – I was given a medical card to carry with me at all times explaining that I had Anti-D antibodies and always presented this when I would go to donate blood.

In 1993, prior to trying for a second baby, I checked with my GP if the presence of Anti-D would pose a problem. As I had been immunised he believed there would be no cause for concern if I was to go ahead. 

However, at 17 weeks pregnant I felt the need to press for tests to be done as I had a feeling that something was not right. I couldn’t explain what that meant but I had an overwhelming fear that something was wrong with my baby. Despite not being in any of the “Risk Categories”, my doctor thankfully agreed that I should have an AFP test (generally used to determine the baby’s risk of having certain genetic problems).

After getting a sample of my blood taken I was told to go home and I would hear “in around 8 weeks'' that there was nothing to worry about. Mothers with issues would be informed before this 8 week period, and those with no issues would have to wait the full 8 – they were confident that my feeling was no more than that. 

Before lunchtime the following day there was a knock on my door. I opened the door and one of the local midwives passed me a letter telling me that something had shown up in my blood about my Anti-D antibodies, and that I had to go to the Maternity Hospital in Paisley that day and ask for a specific doctor, who would see me immediately. 

When I arrived at the Maternity Hospital in Paisley the doctor told me about Rhesus disease in a bit more detail and how, in extreme cases, hospitals will carry out intrauterine transfusions. This is where they transfuse the foetus with the Universal Donor (O- blood), therefore giving the mothers antibodies nothing to fight against. After explaining this, she gave me the devastating news that there was little hope of my baby surviving due to the extent of antibodies in my blood. The doctor then explained they would consider intrauterine transfusion when a specific blood count gets to 17, and generally around 32 weeks gestation. At the time my count was at 77 and I was only 17 weeks pregnant, but we were lucky that there was an expert in the field working from the Queen Mother’s Maternity Hospital in Glasgow.

I drove to the Queen Mother’s that afternoon with a view to seeing the expert, Dr Alan Cameron.

The next day saw the start of the weekly transfusions to try to save my baby. These involved me being heavily drugged – general anaesthetic is not an option – to ensure I would lie still as the procedure (generally) involves a blood transfusion through the umbilical vein in the placenta. However, given the early stage of my pregnancy and the size of the baby (she was only around 10cm long at this stage) the decision was taken to use an older method of transfusion as this was seen as less stressful to the baby; they would deposit around 5ml of O- blood straight into her stomach. 

Unfortunately, as she was so anaemic at this point, the shock proved too much for her heart and she had the first of two heart attacks. Dr Cameron took the decision to try something he had never tried on such an early pregnancy before, and he injected adrenaline straight into the baby’s heart. Although I was heavily sedated, I was aware of the urgency and subsequent wait in the operating theatre until the heartbeat was heard again.

The following day (Friday), I was sent home and told to return the next Wednesday to have my next transfusion on the Thursday, and that this would be a weekly occurrence for the rest of my pregnancy. I would arrive on Wednesday morning for blood tests and monitoring, receive an intrauterine transfusion on Thursday, and be released Friday afternoon.

Unfortunately the second transfusion had the same outcome as the first and my baby experienced a second heart attack, but again she thankfully pulled through the shock and her heart started beating.

In total there were 14 attempts at transfusion, with 10 of those being successful. As Rhesus disease only affects the baby I didn’t feel any effects other than Leona would be more active, and I would be aware of her moving in the womb, in the couple of days after the transfusion.

At 31 weeks + 4 days, the decision was taken that we had to bring her out, despite being a healthy weight (this was partly because I was being given steroid injections in conjunction with the transfusions, to hopefully help her lungs develop more quickly in case she was to be born early). She was just getting too tired fighting through the anaemia at this point.

Leona was born on the 25th October 1993 by caesarean section. She was a massive 5lbs 10oz considering how early and sick she was, but this was helped by the steroids! She also had an extremely distended liver due to the strain of the Rhesus disease. She had to have an immediate complete blood transfusion, again using O- blood. This took around four hours and she thankfully went through that with no adverse reaction. She was then placed in intensive care under light therapy for that first night. The level of antibodies remaining in her blood meant that she had to undergo another complete blood transfusion three days later, but with continued light therapy, she was out of intensive care and in special care within 10 days. 

Leona is 30 years old this October (2023) and, as the disease is non-transient, she has no ill effects from her time as a rhesus baby. Before I needed blood transfusions for Leona, I was a blood donor as I was aware that I had one of the rarer blood types. However, I had no real idea of the scale of use of donated blood. Like most, I guess I believed it would be used for people needing urgent attention after a potentially horrific accident.

I would like to say that people should consider donating if they are able to do so. It is painless, quick and gives great personal satisfaction. Don’t ever think “it’s just me and my pint of blood, what does it matter?”. The need for blood is far more vast than “just in case of accidents” - you never know when or how you, or your family and friends, will be affected in days/weeks/years to come. And there is juice and biscuits! :)

We’d like to thank Lorraine for taking the time to share her experience with us. Her story reinforces that there are so many reasons why someone might need a blood transfusion, and why more people should donate blood if they can. If Lorraine’s story has inspired you to book your next appointment, follow the link below!

 For more information on Rhesus disease, read on:

Rhesus disease is a medical condition that can occur when a pregnant woman's blood type is Rh-negative (e.g., A-, B-, AB-, or O-) and the baby's blood type is Rh-positive (e.g., A+, B+, AB+, or O+).  

If a pregnant woman is Rh-negative and the baby's father is Rh-positive, there's a chance the baby may inherit the Rh factor from the father. During pregnancy, small amounts of the baby's blood can mix with the mother's blood, especially during childbirth or other medical procedures. When Rh-negative mothers are exposed to Rh-positive blood, their immune system may recognise the Rh+ factor as foreign and develop antibodies (Anti-D antibodies) against it, this in itself won’t be an issue with the first pregnancy that causes the “mix” of blood, the issue could be with subsequent pregnancies where the antibodies can begin to kill off this baby’s red blood cells.  This can result in severe anaemia, other serious health issues for the baby or even stillbirth.

To prevent Rh disease, doctors can give Rh-negative mothers an injection of a medication called anti-D immunoglobulin after potential exposure to Rh-positive blood (e.g., after childbirth, miscarriage, or abortion). This medication helps prevent the mother's immune system from making antibodies against the Rh factor. Rhesus disease only affects the baby. The mother won't experience any symptoms.