Not getting RH shot in 2nd pregnancy...?

[shenanegans]

So I am O- my DH is A+ , our son is something +. I got the rhogam shot shortly after my son was born (in Japan). Now I am pregnant again (in Canada) My Dr here is pushing for me to get a shot at 28 weeks and again before birth. I have refused to schedule the 28 week shot and just get the one before birth. I don't understand why I got the shot after my son's birth if they plan on giving you the shot 2 more times in your next pregnancy. I was told at the time it was to protect my future pregnancies. I feel confused. When I mentioned this to my Dr here, he said the shot is only good for about 10 weeks. help!

[amnesiac]

Since this is about pregnancy related treatment rather than vaccines I'm moving it over to I'm Pregnant.

[MaerynPearl]

Your current doctors are correct... and the previous shot after giving birth was not to protect your future pregnancies but to protect you in the postpartum healing time.

From what I know it is common to get the shot at 28 weeks and then again within 72 hours of giving birth.

[sanguine_speed]

It *is* to protect future pregnancies.

It helps prevent your body from developing rh-antibodies that would stay in your body and attack future babies. Generally speaking, if you develop an rh-sensitivity from a a current blood type incompatibility, the current pregnancy is not at risk as it takes time to develop enough antibodies to cause serious harm. The shot during pregnancy is supposed to help protect you against the possibility of beginning to develop antibodies during this pregnancy as can happen if there is any blood crossing in pregnancy or birth. But that 28-week shot really does nothing for the current pregnancy.

Also, I am in Ontario and the regular course is one at 28 weeks and one after birth if your baby is rh+. I am rh- and my partner is rh+...one baby was +, and my subsequent 2 babies were -.

[dogretro]

I did a report on RH disease in college. It is v serious and can lead to kidney failure in babies. I would get the recommended shots to be on the safe side. Even though you got one shot after your son was born, that does not mean that it worked perfectly.

[Cetan Luta]

I am also O-, and my husband is O+. I have had two babies before, and am cooking #3. The 28 weeks shot is a precaution "just in case" you should fall or get in a car wreck, etc. causing some of your blood to mix with baby's, at which point your body would identify the baby (if baby is rh+) as a foreign body and treat it like a virus. The thing is, even if you have the 28 wk shot, they still have to give you another one if an accident actually occurs. I took the 28 wk shot with DS1, and decided to just get one if I actually fell or something with DS2. You Don't have to get the first shot if you don't want to.
However, the shot after birth is given if you give birth to an rh+ baby, because it is assumed that your blood will mix some during birth. Your body could then become sensitised to anything rh+, and would most likely cause you to miscarry any time you became pregnant with another rh+ baby. If you have a rh- baby, they don't need to give you a shot after birth at all. Even if you don't think you want to have any more children after this, I would reccomend getting the post partum shot within 72 hours of birthing a rh+ baby to be on the safe side, because you can't change your mind later.
Sorry that took so much space to say! HTH

ETA I've never heard of getting another shot right before birth, if you are comfortable about it, and want as few shots as possible, you can totally get by with Only getting the post partum shot, and none at all if babe is born rh- too.

[marcib28]

These mamas have already said it best, but thought I'd add my two cents The shot only protects for 12 weeks, which is why it's given at 28w (assumed to protect you until baby's born). Many women choose to skip the 28w shot and only get the shot while they're pregnant if there is some type of fall/accident that may cause the blood to mix. However, then you run the very slight risk of there being a silent bleed for some reason. The pp shot is to protect your future babies by keeping your body from creating antibodies during/because of your current pregnancy. Many dr's won't even test the baby's blood type before giving you the pp shot because the shot is thought to be SO safe! I would recommend have the LO's blood type tested though just so you know if the pp shot is truly necessary. Neither shot is ever for sure needed (even if your babe is Rh+). They are just precautionary to prevent you from having high risk pregnancies in the future. From what I've seen, almost every dr (no matter how crunchy they are) agrees that the benefits WELL outweigh any potential risks (at least in getting the 1 dose pp if babe is +). Good luck with your decision!

[is it puppies?]

There is a lot of good information on here, and I am choosing not to get the 28 week shot because it's just not necessary unless I have a bleed. If I get in an accident or have a big fall I MAY then choose to take the shot. The difference in developing the antibodies between getting the shot at 28 weeks and not getting it until you've confirmed the baby's blood type is something like .02% and it's still a blood product which, in the past, has carried HIV and HEP. There is also the risk of failure of the shot, and I am one of those people who is trying to avoid chemicals while I am pregnant. Look up posts by japonica, she has a lot of information posted on here.

you could also probably look up posts I've commented on for rhogam, I was looking for info previously...

[Southern_Belle]

A little background on the purpose...your babies blood gets nutrients from your placents - which in a nutshell means there will be comingling of blood. If you are - and your baby is +, basically your body will treat your babies blood as a pathogen and your immune system will attack it. Similar to the way blood transfusions are blood type specific.

Rhogam shots are not really something you should take lightly and delay or refuse to get. It really is for the safety of your unborn child.

[sanguine_speed]

Originally Posted by Southern_Belle

A little background on the purpose...your babies blood gets nutrients from your placents - which in a nutshell means there will be comingling of blood. If you are - and your baby is +, basically your body will treat your babies blood as a pathogen and your immune system will attack it. Similar to the way blood transfusions are blood type specific.

Rhogam shots are not really something you should take lightly and delay or refuse to get. It really is for the safety of your unborn child.

A baby does not become sensitized by the placenta de facto. If that was the case, the 28 Rhogam shot would be too late and all rh- moms with rh+ babies would have already developed sensitization by then and Rhogam would never need be given at 28 weeks.
And Rhogam is not all gain and no risk.

And the risk of sensitization without trauma is so very low. I'm not saying it's an easy choice, but I think it's a reasonable choice to wait.

[craftmuffin]

The shot after the birth of your previous baby was to prevent antibodies from forming as a result of baby's blood mixing with yours during delivery.

Any shots you get during this pregnancy are to prevent antibodies from forming as a reaction to contact with THIS baby's blood.

Once the antibodies do form, then rhogam is no longer useful. That's why there are a few different points along the way where your provider may recommend shots. If you had skipped the shot after delivery before, and if antibodies had formed, then it would be too late to get any rhogam shots now.

If you were to develop antibodies during this pregnancy, they may (or may not) affect the current baby - but would almost certainly impact the health of future pregnancies. I'm not at all saying that you should definitely get all of the recommended shots, just trying to explain the reasoning behind them.

[sanguine_speed]

Ooops, nevermind. I misread.

[Southern_Belle]

Originally Posted by sanguine_speed

A baby does not become sensitized by the placenta de facto. If that was the case, the 28 Rhogam shot would be too late and all rh- moms with rh+ babies would have already developed sensitization by then and Rhogam would never need be given at 28 weeks.
And Rhogam is not all gain and no risk.

And the risk of sensitization without trauma is so very low. I'm not saying it's an easy choice, but I think it's a reasonable choice to wait.

To be more exact/precise, the baby doesn't become sensitized, the mother does. A sensitzed mother's body makes antibodies that will attack the Rh+ baby's blood and the RBCs of the baby will be broken down. The risk is the degree of breakdown. No way around that one.

[is it puppies?]

In my particular case, since I am both ABO and RH incompatible (as is the OP), if the baby is ABO incompatible with me there is very, very little chance that I will develop antibodies. If the baby is O+ there is a higher chance I will develop antibodies- and that's something like 10% if I do not take the shot. It's about 2% if I do not take the shot with a baby that is A+ It is 0% with a baby that is Negative (or if my partner were negative). These are potential risks that in my case, I am happy to take, vs. the potential risks of the shot. In many countries they do not give the shot prenatally (which makes very little difference statistically in it's success or failure) and after all the time it has been used it is still not cleared to be used during pregnancy, so why risk it unless there's already a risk due to injury etc? I am satisfied that I can stop at one baby if I do happen to get sensitized, and even after getting sensitized one can go on to have successful successive pregnancies that may not even need interventions if your levels of antibodies do not get too high. If your baby is neg either with the current baby or the future baby, it is an unnecessary risk IMO.

Here's one of the longer threads on Rhogam (if I can link to it properly...)
http://www.mothering.com/discussions...562&highlight=