Anti-D information: getting started

Many people visit this website looking for Anti-D information.

Anti-D is the name of a medicine made from blood that is offered to rhesus negative women who may have been exposed to rhesus positive blood.

It’s known as RhoGAM® in the USA. 

Anti-D is given in the hope of preventing them from making antibodies which may cause problems for future babies. 

It doesn’t benefit the baby they are currently pregnant with.

I am the author of two books about Anti-D. The first was published in 2001, and things have moved on since then. So in 2021 I published a brand new and updated book on this topic, Anti-D Explained.

Anti-D Explained explains the issues fully and clearly. I take you on a journey through the evidence and the issues. It’s relevant no matter whether you’re just curious, pregnant, a parent, professional, student, or someone just interested in the topic.

If you want to be led by the hand on a journey through the information, my book is the answer. But I also offer links to a few supplementary Anti-D resources in this blog post. These include documents and resources that offer a variety of perspectives and levels of information.

I believe that women and families need to consider decisions from as many angles as possible. And I consider that professionals can offer the best help when they can explain issues from a variety of perspectives.

As I say in my bookAnti-D is one of the medical world’s success stories. But it still has risks and downsides. It’s always good to ask questions. By looking at the evidence and understanding the bigger picture, we can make the decisions that are right for us.

Introducing the issues

If you want to read the obstetric perspective on Anti-D, the Wikipedia entry on this topic is here.

I’m not generally a fan of Wikipedia. Birth-related entries tend to reflect North American terms, pharmaceutical products, policies and attitudes towards women. They are often obstetrically-focused, not woman-centred, and they do not consider the downsides or long-term effects of interventions. However, there are some useful links to other sources and it’s a good place to become familiar with the terms used to describe this in different countries.

But it IS a very one-sided perspective. As with many pharmaceutical and medical products, much of the information out there is written by marketers whose job it is geared towards convincing you that their product or service is necessary, effective and safe.

Do bear that in mind as you surf.

Poor information

In fact, many of the information sources that I found while checking links for this page (including some written by midwives and birth workers, I am sorry to say) are rather shocking.

The language is often insulting.

Statements are more absolute than is warranted by the state of the evidence, and consent is assumed.

So please use discretion!

In fact, it was while writing Anti-D Explained that I was moved to write this post about language.

A note about safety claims

As far as statements such as ‘Anti-D is perfectly safe for you and your baby’ are concerned, I think it important to point out a key fact.

Even the scientists at the companies who make Anti-D and who spend lots of time and effort ensuring it is as virus-free as possible would not claim that it is perfectly safe

It is as safe as their combined valiant efforts and modern technology can make it.

And they work hard at this.

But no medicine made from blood is ever going to be perfectly safe.

And no scientist would make such a ridiculous claim. More in the book if you’re interested.

A few overviews

Let’s start with a couple of overviews of this area.  These are quite variable in their level of assumed scientific knowledge. One of the better UK ones is that provided by NHS Choices, which has links to a few other relevant pages on their website. This one on Medscape may also be useful.

As I have noted, few resources really explain that women have a choice in this area. I feel quite strongly about that!

Your body. Your baby, Your decision.

During the writing of both of my books on this topic, I was contacted by many women who had concerns and questions about Anti-D. I also heard from women who had experienced problems after having it. So I find it interesting and also concerning that these concerns often aren’t reflected in online information.

Sara explains the issues and evidence, answers key questions and shares information about what we do and do not know about Anti-D and related topics from research evidence and current thinking. A vital resource for parents, professionals and birth workers.

Evidence and guidelines

Maybe you’d like to go a bit further and begin considering the evidence and guidelines. Yes, I do analyse these in depth in my book, if you’d rather have someone walk you through them. But for those who like to do their own analysis as well, here are a few of the key sources.

Let’s start with the current UK guideline, created by the British Committee for Standards in Haematology (BCSH). That details all the points at which rhesus negative women are offered Anti-D in the UK.

If you’re looking for the RCOG guideline, they have now archived this and point you to the BCSH paper instead.

In the UK, the BCSH work also underpins the NICE antenatal Anti-D guidance and a NICE “information for the public” page on antenatal Anti-D.

If you’re in Australia, here’s the info and links from the Australian Blood Authority. And for those in Australia and NZ, the RANZCOG guideline on Anti-D.

If you’d like to know what I have to say about guidelines and the evidence that they sometimes include, have a listen to my induction podcast on The Midwives’ Cauldron!

And I also did a podcast about Anti-D, which you can listen to here.

Product information

Finally, some people like to look at the product information. A few starting points if you’re in the UK are the NICE product information page on Anti-D, the information page on D-GAM and the Rhophylac product information.

There is information on the gamut of variously named US preparations on Medscape.

And the NZ Medsafe drugs list is also useful, but it is frequently updated and you will need to search for the specific preparation you’re looking for.

If you’d like to learn more about Anti-D, take a look at my book.

I wrote it to explain the issues, answer key questions and share information about what we do and do not know about Anti-D.

I look at the pros and cons of having Anti-D, sharing and explaining research evidence and current thinking.

I help you understand the risks and benefits and explore what we can and cannot know.

My aim is to help you to make the decision that’s right for you.

Get your copy here.

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