Pregnancies affected by hemolytic disease of the fetus and newborn (HDFN) are more likely to lead to a cesarean delivery than a vaginal birth. The timing of the cesarean will depend on the development and well-being of the fetus. If fetal distress becomes apparent or HDFN-related symptoms, such as anemia and edema become critical, an emergency cesarean may be performed.
What is HDFN?
Hemolytic disease of the fetus and newborn (HDFN) is an immune-mediated red blood cell (RBC) disorder that occurs when a baby’s RBCs break down quickly, which is called hemolysis. HDFN is caused by a mismatch between a mother’s and her baby’s blood type (A, B, AB, or O) or Rhesus (Rh) factor (Rh-positive or Rh-negative) during pregnancy. Numerous antibodies to RBC antigens can be linked to HDFN, such as those from the ABO and Rh blood group systems.
Regardless of whether your cesarean is scheduled or emergency, the recovery process can take six to eight weeks. In particular, you will need to take special care to support the healing of the deep incision through the abdomen and then into the uterus. Staying in bed for two to three days post-surgery is recommended, and strenuous activity is to be avoided. Initial pain is to be expected around the incision site, which can be treated with pain medication. You will be shown how to take care of your wound to avoid infection, and you will need to stay in hospital for three to five days.
Emotional ups and downs
You will feel tired and overwhelmed at times, due to your fluctuating hormones and the stress of your newborn being in the NICU. Be aware that the “baby blues”—a period of time in which mothers often feel down or depressed—often start within 2-3 days post-delivery and affect up to 80% of new mothers and can leave you teary, emotional and irritable. This period of sadness can last a few days or approximately two weeks.
The added stress of having a baby in the NICU can increase your risk of developing postpartum depression, a more severe version of the baby blues. Speaking to a counselor may help you cope with this emotional time and manage the ongoing situation.
Your baby’s recovery
Most babies born via cesarean spend some time in the NICU. This can be due to a premature delivery, and in the case of HDFN-affected babies, immediate specialized care will be required to treat their HDFN symptoms. First-line treatment for jaundice is intensive phototherapy, and newborns with HDFN often require a longer stay in hospital.
The hospital will ensure you are able to visit, feed and have skin-to-skin contact with your baby during this time. It is important for both you and your baby to have this time to bond.
Your recovery
Be sure you have the right support on hand and that you sleep and rest. While the birth of your baby is a wonderful moment you want to share with family and friends, too many visitors can be tiring and counterproductive for your recovery. You don’t have to be present at every moment, the hospital will keep you informed and your partner can spend time in the NICU while you rest. Your baby is receiving the best care possible while you take the time to recover. Take care of yourself, so you can then care for your baby.
