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The administration of RhD-positive red blood cells (RBC) to females of childbearing potential (FCP) is a contentious issue in emergency and transfusion medicine. The concern stems from the risk of D-alloimmunisation, which can lead to haemolytic disease of the fetus and newborn (HDFN)1 in subsequent pregnancies. Overall, the calculated risk of experiencing severe HDFN in a future pregnancy complicated by D-alloimmunisation that occurred during resuscitation from haemorrhagic shock ranges from 0.04% to 0.24% in one model when the woman has access to modern healthcare.2 3 This very small risk of future severe HDFN must be seen in the context of treating life-threatening haemorrhage, when withholding an RhD-positive transfusion for fear of causing HDFN could be fatal. On military deployments, logistical constraints may necessitate deviation from guidelines that recommend administering RhD-negative blood to prevent D-alloimmunisation. Joint Service Publications and Clinical Guidelines for Operations support this deviation when unavoidable during the management of life-threatening haemorrhage.