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Any Rh Negative UCers? - Page 5

post #81 of 94

I know, I'm just totally weird like that! What was I thinking? :) Thanks for responding to this Meepy. This IS an important topic.

post #82 of 94

It's my understanding that it's possible to UC and get Rhogam.  Many doctor's offices and clinics will provide the post-partum shot even for patients who they have not provided care for during pregnancy.  ERs also have Rhogam on hand.  

post #83 of 94
Quote:
Originally Posted by stik View Post

It's my understanding that it's possible to UC and get Rhogam.  Many doctor's offices and clinics will provide the post-partum shot even for patients who they have not provided care for during pregnancy.  ERs also have Rhogam on hand.  


Having had two births that were followed up by PP Rhogam shots due to Rh+ newborns, I am not certain that this is going to be reliably true.

 

At my daughter's birth, I had to wait nearly 24 hours for specific antigen testing on a sample sent out to a tertiary care center with a larger lab- after delivering, and full OB prenatal care- which would allow them to determine the correct dosage- it isn't one size fits all, and health care providers are not under any obligation to hand the shot out to women for whom they have not cared.

 

Now, certainly, if you saw an OB/CNM early on, were typed, and then came in after birth, they would be far more likely to administer it. Possibly ERs might, but not necessarily without being subjected to additional testing/exams (otherwise, how do they even know that you delivered that baby, that you are Rh neg, and that the infant is pos?)

 

post #84 of 94

Jeminajiad, my experience backs up your post.  When I was receiving emergency OB care, no hospital gave me Rhogam until they had typed me.  It didn't matter if I was transferred from another hospital, with the EMTs carrying records that said I was Rh-, each individual hospital wanted to retest.  And when there were subsequent admissions, they wanted to retest each time.

 

Retyping before administering Rhogam or donor blood products is best practice, but it can be a giant pain in the veins.  I was receiving care at tertiary centers, and did not have to wait more than a few minutes for test results, but at smaller medical centers, I think you have to expect to go in, give a blood sample, and do some waiting.

 

I don't think there's a population scheming to get inappropriate Rhogam, though.  Since it's effects are not apparent to the patient, or to any casual observer, there's no way to develop the notion that Rhogam is fun.

post #85 of 94

It was my hope that obtaining Rhogam was basically compatible with an otherwise unassisted pregnancy/birth.  ERs and public health clinics will administer Rhogam to women who have had miscarriages, so, in my optimism, I hoped that they would have it available to women who had an unassisted birth (planned or not) as well.  I feel strongly that they should.  I can see that in many circumstances there would be some additional testing and waiting that would most likely be associated.  

 

During my first pregnancy, my CNM assured me that there is a pretty broad window of effectiveness for Rhogam - over a week, iirc.  It's not an emergency where you have to rush to the ER within hours of birth.  

post #86 of 94

I haven't read all of the replies - but here's me: I have had pre-natal (28 weeks) and post-natal Rhogam with both of my babies.  After researching, I just felt safer doing so (we also want many more babies).  I felt the benefit of the Rhogam outweighed the risk of the shot in my final analysis.  

 

Our first was a midwife-attended homebirth.  We had back-up care at an OB practice and got pre-natal Rhogam from them, and then our midwife arranged for another midwife who had Rhogam to come to our house to administer the shot after the birth.  

 

As far as how we did it with our second birth - a UC - we just got it from a nearby clinic during the pre-natal period (we did not UP) and then showed up for it again after birth and explained only the necessary info.  Not a big deal at all.   

 

UC and getting Rhogam have been totally compatible goals for us!

post #87 of 94

The problem with not getting the rhogam after birth (if the baby is rh+) is once your body is sensitized. It always will be. It is a risk you take if you decide not to get the shot.

post #88 of 94

 

I am not sure if this has been said, but get the father of the baby tested. if you are both RH-, there is no need for Rhogam. I declined twice already with hospital births. If the father is + and you are-, and have reservations... unless you have a serious trauma during pregnancy where blood can mix, or spotting etc... you can probably refuse Rhogam during preg and get tested for sensitivity within 72 hours of delivery and take it then if needed... That's what they do in Europe.. Here they shoot every RH- woman up regardless.

 

post #89 of 94
My Rh- clients often choose to decline the prenatal Rhogam shot and I am comfortable with that as long as there has been no bleeding. I agree that the risks of Rhogam (mostly exposure to blood products) is very minimal and the risks of sensitization after birth are high. I would recommend finding out the fathers blood type so you know if this is even an issue. Just a warning- many of the test to check the baby's blood types at the birth are not very accurate so be careful using them. If you are having an unassisted birth and are Rh- you can either go into the hospital to get your shot or you can probably find a general practice doc who would give it to you. Remember you have 72 hrs after the birth to get the shot. Good luck!
post #90 of 94

I just wrote up my story, without realize there was this thread. duh.gif 
I am trying to avoid doctors all together, if I can, but I need to have rhogam after the birth at least. So I need to figure out what to do. Doctors around here are really anti-anything crunchy. Hell I got a lecture about cloth diapering my youngest, what the hell? So if I come in to an OB a day after I deliver and say "Hey, I need rhogam, just delivered my baby at home." I'd get the "OMG WHY AREN'T YOU AT THE HOSPITAL, YOU ARE PUTTING YOUR CHILD IN DANGER BY NOT GOING TO THE HOSPITAL OMG OMG.".....I wish I was kidding.

I need to figure this out. 

post #91 of 94

A lecture, about cloth diapering?  shake.gif And people wonder why we seem so hesitant to get real medical help if needed. It's for fear of being handled this way.

 

 

 

post #92 of 94

Birdsanswings, your doc sounds bizarre.  I am not generally a fan of the "our paloelithic ancestors did it so it's FINE" approach to logic in re. health practices (for several reasons - we don't really know what they did, but we do know they mostly died young).  But cloth diapers being presented as a health risk?  I can't even imagine the justification.  There were no other options until the 1960s, and sposies were beyond primitive until the late 70s and early 80s - you had to fasten them on with scotch tape, they were originally intended for travel only.  When my dd was admitted to the hospital at 20 months, the nurses asked me not to use my cloth for the duration (they needed to track urine output, and it was easiest for them to do with sposies which are all the same weight), but they gushed about how cute my home-made hemp-bamboo fitteds were anyway.  And they had a work-around ready to go if I insisted on sticking with cloth.  Good doctors really won't bat an eye at patient histories or parenting choices.  I know they aren't always easy to find.  Maybe an older doctor would be more sympathetic?  Do you think you could call your local ER or L&D unit and anonymously feel them out?  

 

 

 

Quote:
A lecture, about cloth diapering?  shake.gif And people wonder why we seem so hesitant to get real medical help if needed. It's for fear of being handled this way.

 

ElizabethE, really?  You think women should be scared of doctors because one woman's doctor had a weird reaction to cloth?  It's like you're working to suggest that all medical care is bad for all women in all circumstances.  I get the vibe that you're a pretty hard-core DIYer on the healthcare front.  You have the privilege of good health and an Rh+ blood type.  Enjoy it.  People who don't share your privileges are going to need a different approach.  

post #93 of 94
Quote:
Originally Posted by stik View Post

 

ElizabethE, really?  You think women should be scared of doctors because one woman's doctor had a weird reaction to cloth?  It's like you're working to suggest that all medical care is bad for all women in all circumstances.  I get the vibe that you're a pretty hard-core DIYer on the healthcare front.  You have the privilege of good health and an Rh+ blood type.  Enjoy it.  People who don't share your privileges are going to need a different approach.  


Yes. That's exactly what I said.

 

To be serious, you got one thing right... I am becoming more and more DIY on the health care front, and all fronts that I feel I can manage. I'm still not a great auto mechanic, though. eyesroll.gif lol.gif

 

Don't think I don't understand where my privileges are. I do. I am so privileged that I choose to exercise those to my fullest advantage to make my best possible choices. Anything less would be ungrateful and ignorant of me.

 

post #94 of 94

I have done extensive research on Rhogam as I am RH- and my DH is RH+. Firstly, we are against any and all vaccines. Not sure what we consider Rhogam yet, as it's not really a vaccine but more of a medicine? Not sure there. Anyway, it is manufactured with human blood product which in itself, make us a bit nervous. Some people do not consider taking things made from human blood products for religious or just philosophical reasons. Not sure how we feel about that either.

 

Here is what we have done and found out through the journey. We have two boys. DS1 born Oct 2007 and DS2 born Nov 2009. With DS1 I freaked out about this because he Dr. I saw (a backup to my midwife) made it seem I had some disease and I was causing all of this harm to my baby because I was made with a blood disorder. I think that's CRAP. LOL! I dove into research and found that there really is no certainty on any of it. Rhogam is routinely given during pregnancy for two reasons: 1.) It makes more money for pharmaceutical companies so they market it in such a way it seems safe and effective. 2.) More and more women are surrendering responsibility of their bodies to their Dr's so they are making the decisions that protect the baby best.

 

My problem with 1.) is this: Rhogam is a mystery in the length of effectiveness as no one knows for sure how long it's effective or how long it protects. But it is often viewed as 4-6 weeks. That being said, it may or may not be safe. Nothing in the shot promotes life or health, therefore, the safety of it is truly unknown. In most cases, things go fine but there are some where babies and mothers are dying or having serious effects from it. Worth the risk?  Not to me as I know my body well. All homebirth and UC mamas usually do! I am responsible enough that if I was in an accident, a fall (such as from a ladder), had any bleeding of the bright red nature (not tearing from intercourse), etc... I would be the first one to get the shot prenatally. But barring all of these instances, it is really an insurance police for the Dr that I am not willing to part take in!  (I guess that included my qualm with 2.) and well!!!)

 

Now, I do have a back up who gives me the Rhogam as a prescription that I keep on hand and have filled for birth. He prescribes it for 28 weeks but I just get it filled before then and keep it in my fridge. No biggie. We tested cord blood with a blood typing card ($7 online anywhere and you can do your DH, like I did mine, to save money on a Dr. visit.) and both o my children have been RH- so we have not needed the shot. Now, since I have not been in the position to need it (medically) I still battle with taking it if I did. Providing I have an easy birth with no complications and no retained placenta, I don't see the need. From my research, it is unlikely that there will be an event that will cause sensitization commonly, especially in a home birthing situation as it is very gentle and hands off. And even if there were a situation, my research also proved that not always is there sensitization. There is no rate at which they know this and uncertainty is not typically enough for me to inject this stuff, THAT MAY OR MAY NOT work. Because that has yet to be determined as well! It's all so gray! The research and the proof is just uncertain in general. So, now as we are expecting this new baby, I have the paper prescription sitting in my office and I will likely get it filled and then I don't know. If this baby is RH+, I will just have to see how the birth goes and decide from there. I can't make the decision based on informed consent until I know the end outcome. Maybe that makes me weird, but I would rather be overly cautious than have an outcome I regret!

 

Now, if you don't have access to someone who can get your Rhogam to have on hand, you just need to have it within 72 hours of birth. After you settle down from your birth, have a friend or family member take you to the ER or Urgent Care and tell them your birth happened too quickly to make it to a hospital (if you live in a hostile birth environment) or if not, just tell them you had a homebirth, and you are RH- and your baby is RH+ and that you need Rhogam. They will administer it and be on your way. Do not consent to an exam of you or your baby. They have to treat you since it is viewed as an emergency situation. In our area, they would be hostile so I would have to be able to stand my ground.

 

Hope this gives you at least some encouragement that there are others out there in the same type of situation!

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