Foregoing Rh testing and anti-D immunoglobulin for women presenting for early abortion: a recommendation from the National Abortion Federation's Clinical Policies Committee

Abstract

Abstract Early abortion continues to expand outside of traditional clinics, through telemedicine, self-managed abortion, or in smaller offices that do not specialize in obstetrical care. Consequently, requiring Rh testing and anti-D immunoglobulin as part of the abortion service is becoming a barrier. Although many professional societies recommend Rh testing and treatment for Rh D-negative women before any induced abortion, the evidence of clear benefit in early pregnancy is not well established. New epidemiologic data about low sensitization rates in countries without Rh testing and treatment for early abortion, and emerging biologic evidence demonstrating the low risk of fetal-maternal transfusion after early abortion, shows that Rh testing and treatment may not be necessary. Because of these findings, the National Abortion Federation's Clinical Policies Committee recommends that clinicians may forgo Rh testing and anti-D immunoglobulin for patients who are having an induced abortion before eight weeks from their last menstrual period.