homebirth and rhogham ... and fetal monitoring?

[Adamsmama]

I'm curious about 2 questions...

If you are RH negative ... and need the rhogham shot after delivery how do you go about getting it?

During labor does the m/w monitor the fetal heartbeat like they do during hospital births? I don't mean constant monitoring but just a few times to make sure things are ok or is that unheard of?

[jenfl]

I had a couple options. The midwife can write an order for it, and I can go to the local hospital's L&D triage and get the shot (I did that for the 28 week one). That way, my insurance paid for it.

We're paying out of pocket for the post-partum one, and the midwife is buying it from a supplier and keeping it in her fridge until we need it.

And yes on the occassional fetal monitoring. I didn't have a midwife around until I was pushing with #1, but while pushing, she monitored a few times during the contractions and made sure the heartbeat was rising and falling appropriately. When she noticed that it wasn't recovering quickly at one point, she had me change the way I was laying down, and that fixed it.

[jeminijad]

What about in states where CNMs either can't prescribe or can't do homebirths? Is there a supplier that will outright sell the shot w/out a physician's order in such a state?

Also, I had a specialized dose after delivery b/c of a particular anti-something antibody that turned up in the testing 24 hrs after birth... blood had to be sent out to university hospital as the regular lab at the delivery hospital couldn't do it.

I think about this issue often. I believe avoiding anti-D sensitization to be a very valid reason to accept a vax, and plan to have more children.

[Adamsmama]

Thanks for the info! Jeminijad -- I'm not sure what the answer is there. In the state I'm in, homebirth is legal and insurance covers it. Good to know about fetal monitoring -- that is how the dr. with DS1 found out something was "wrong" ... cord was around his neck and he had to come out quickly...

[CallMeMommy]

My midwife can't order drugs but she knows a doctor at the hospital who is "homebirth-tolerant" and will order ultrasounds, labs, and Rhogam for her.

[Oliver'sMom]

I'm RH negative, and after my homebirth I called my OB's office telling them I needed the rhogam shot. They kind of made a fuss about it, but my mom was able to go pick it up for me and give it to me at home (she's a doc). I did have to pay out of pocket for it. I never got the 28 week one.

During my labor, my midwife would do periodic checks with her doppler to make sure the baby was alright. Her doppler was water proof so she could check real quick without me having to move or change anything...even if I was in the tub. I think she checked maybe 3 times total.