- While Yeager was pregnant, Courtney Yeager’s antibodies began attacking her son.
- Doctors administered blood to the fetus through the umbilical cord.
- The stress of the situation contributed to postpartum depression for Yeager.
This essay is based on a conversation with Courtney Yeager. It has been edited for length and clarity.
I work as a radiology assistant, so I’m around a lot of pregnant people getting ultrasounds. My blood group is also negative. In school I learned how it can cause complications during pregnancy. I hid that information, thinking that maybe one day I would have to come back to it.
Of course, I did. During my first pregnancy, doctors explained that I was at risk RH incompatibility, This condition meant that my body could make antibodies that would attack the fetus’s red blood cells. My medical team gave me a drug called RhoGAM, which stopped my body from making antibodies, and my first son was born without any complications.
During my second pregnancy, things got more complicated. I started making more antibodies, and the medicine wasn’t 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 any complications.
Unfortunately, Rh incompatibility often becomes worse with subsequent pregnancies. When I became pregnant with my third son, Beau, things got pretty scary.
Beau needed a blood transfusion at 23 weeks pregnant
Now to Beau, my doctor Fetal Care Center At Yale New Haven Children’s Hospital the antibody levels in my blood began to be measured. By 16 weeks my levels had reached a level that could be unsafe for the fetus. That’s when we started ultrasounds twice a week.
During the ultrasound, the technician examined a blood vessel in Beau’s brain. The way blood is flowing in that area can indicate whether he is becoming anemic. Anemia or low red blood cell count may cause his organs to shut down. This can be fatal for the baby.
At 23 weeks, doctors delivered bad news: Beau was suffering from anemia. He will need a blood transfusion even before he is born.
I needed to prepare for the risk of an emergency C-section.
I went straight from the outpatient clinic 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 if something went wrong I would need an emergency C-section.
The neonatal team, who specialize in premature babies, spoke to me. But I knew that if Beau was born at 23 weeks, he would not survive. We took the decision despite knowing that it was costly to do the transfusion, but we had no option. He couldn’t wait.
This procedure can be done under general anesthesia or with an epidural. I opted for the epidural because if I needed a C-section, I would at least be able to see my baby born.
After being given anesthesia, I lay on my back in the operating room while doctors inserted a needle through my abdomen, into the amniotic sac, up to the point where Beau’s umbilical cord was attached to the placenta. Once there, he donated blood which saved Beau’s life before it even had to begin.
I was looking and feeling fine between procedures
Each transfusion saved Beau from anemia for two weeks. I needed six procedures, each time with an epidural. Usually, I would go home after the procedures, but twice, I had to stay overnight in the hospital for observation. Between appointments, I looked and felt fine, which made it difficult for friends and family to understand how serious the situation was.
Doctors said that by 34 weeks of pregnancy, this process had become riskier than early delivery. My last transfusion was at 33 weeks and was induced at 35 weeks.
Despite having already had six epidurals, I wanted an unmedicated birth for Beau, as I had during my previous two pregnancies. My high-risk team was amazing and helped me work with the midwives to make this possible. The calm, peaceful birth I dreamed of in the midst of so much trauma meant everything to me.
Beau required three more blood transfusions after birth
Unfortunately, the birth wasn’t the end of Beau’s health concerns. He needed to spend six days in the neonatal intensive care unit because he was suffering from severe jaundice, another complication of Rh incompatibility. I was not able to hold him or breastfeed him for four days.
When Beau was three weeks old, I noticed he was very pale, which could be a sign of anemia. Of course, he needed a blood transfusion. Because she had received so many blood transfusions as a fetus, her body had become dependent on donated blood and was no longer able to produce enough red blood cells on its own. Beau required two additional blood transfusions, but was stable and healthy for five months.
Then all the emotions of the past eight months hit me like a ton of bricks. Beau eventually recovered, but I experienced postpartum depression and anxiety. I was able to advocate for myself, just like I advocated for Beau, and I got the help I needed. Today, Beau is a busy 18-month-old, and we are both happy and healthy.
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