RhoGAM and UC?

[ameliasmommy07]

How do you handle doing a UC and needing the RhoGAM? I am seeing an ob for prenatal care and had to have the RhoGAM with my first DD. I did have the shot today (I am 28 weeks) but I am planning a UC and dont know if I need the RhoGAM shot afterward. What do you ladies do?

[Pirogi]

I am not a very good example, because I chose to forego all Rhogam with my first birth. I had a natural delivery with non-managed third stage, and I was comfortable with the 13% statistic that I might end up sensitized (or 87% chance that I would not be sensitized, depends on how you look at it). My first was a midwife-attended homebirth however, and if I had felt it necessary, I could have gotten the anti-D shot. I had an antibody test prior to conceiving this time so I would know going in if I was sensitized by the first pregnancy. It was negative. My husband is RhD+, but we don't know if he is heterozygous or homozygous. We also have never determined DD's blood type.

I plan to play it by ear this time as well. If I feel it is warranted at any time during the pregnancy (fall, car accident, etc) or after the birth, I will seek it out. My situation is a bit unique, and I can't discuss it right now, but suffice it to say that I would have an avenue to obtain the anti-D shot if I wanted it. However, I will likely be UCing in the future (should we have more children), and I would be very interested in what others say.

[corrio]

I just had a UC birth my husband is A positive and I am O negitive.. Anyways i bought a blood tester card called a eldon card you can buy them here (http://www.birthwithlove.com/categor...did=Eldon+Card) And typed the babies blood after birth.. She came out to be the same blood type as my husband.. I went back and forth on getting the rhogam shot because this is likely my last baby but I decided that since I am so young that I better safe then sorry.. Two days after her birth I went to the hospital and told them I needed a rhogam and got it.. Didnt really have problems with the hospital other then the intake nurse she was snarky but the nurse in the er was nice and the doctor thought I was there because of a m/c.. I needed to explain to both the nurse and the er doctor that i needed a rhogam shot, guess no one reads paper work.. But yah all in all it was fine I got my after birth shot..

[Skrimpy]

I would say go to outpatient at the hospital and say you need Rhogam... here you have to go to the hosptial if you have a home birth with a midwife (with my first few births the mw could give it, but I'm in a different state now).

You could just go in and say you had baby at home and need the shot... taking baby with you. Or you could go w/o baby if you're worried. You need to tell them you had a baby and not a m/c b/c the dosages are different.

I agree with the Eldon card - it can help you type baby's blood after birth. If you are seeing a care provider you could possibly also ask for a new screening that will tell you baby's blood type before birth (it is a blood test done on Mom - non-invasive for the baby). I interviewed the doctor who developed the test here:

Rh Genotyping

That would let you know what baby is now.

I would like to UC with our next babe (last babe was an accidental UC and he was Rh Negative so we didn't even need to worry about the hosptial).

Good luck as you decide what to do. I have always opted for the postpartum shot if my babies were Postive and will try to arrange it for a UC, too.

[Pirogi]

Don't the Eldon cards have a high false negative (?) rate? As in, if they say the baby is RhD+, then baby is RhD+, but if they say baby is RhD-, baby may be RhD- or RhD+. Is this true?

[Skrimpy]

Originally Posted by Pirogi

Don't the Eldon cards have a high false negative (?) rate? As in, if they say the baby is RhD+, then baby is RhD+, but if they say baby is RhD-, baby may be RhD- or RhD+. Is this true?

I've heard this too, but I don't know. My DD was typed using an Eldon card, but all my boys were typed with cord blood. Not sure how/if you can collect cord blood with a UC... maybe if you get a cord blood collection kit and ask a doctor to write a slip to take it to the lab?

[ameliasmommy07]

Thanks ladies! I will probably just wait until the next day or the day after that to get it from my OB. I will not be having anymore children but will get it anyway.

[GinnyMama]

I have not read any of the previous responses (sorry! busy!), but I did not have the prenatal rhogam with my second at all, and I did get the after shot after the birth.

They WILL need a sample of your baby's blood in order to give you the shot after the birth. So it was totally a lose-lose for me... either have an UC, then have to bring my brand new squiggly newborn into the hospital to get his foot stuck for a blood type check, or let him forgo that and not get the shot. If I had had a choice, I would have chosen not bringing him in at all, and forgoing the rhogam. UCs are not high-risk for blood-to-blood transfer.

[Pirogi]

That's weird, and possibly unethical. I understand that if the baby is RhD-, Rhogam is not needed. However, if for whatever reason, the mother refuses to allow her baby to be stuck, are they going to refuse the Rhogam?? I would press the issue if anyone ever told me that. I am consenting to treatment FOR MYSELF, not for my child.

When I had my antibody test done (about a year after the birth), the doc told me she would refuse to order the test unless I had DDs blood typed first. This was a military doctor. I walked out, filed a complaint, and had the test ordered later that day. Ridiculous.

[honeybee]

Originally Posted by Skrimpy

I agree with the Eldon card - it can help you type baby's blood after birth. If you are seeing a care provider you could possibly also ask for a new screening that will tell you baby's blood type before birth (it is a blood test done on Mom - non-invasive for the baby). I interviewed the doctor who developed the test here:

Rh Genotyping

That would let you know what baby is now.

Wow, I'd never heard of this before! Now I have such a dilemma... knowing the rh factor ahead of time would save me a trip to the doc after birth if the baby's positive. (My last two homebirthed babies were -, so it was a nonissue). But I wasn't planning to find out baby's sex... who knew it could be done with a simple blood test instead of an u/s??