Rh Negative Mamas? « Back to Group Discussions

[LilyTiger]

I'm Rh negative and my husband is Rh pos, so we're faced with the RhoGam dilemma.  It's not really a dilemma because there doesn't seem to be much choice (other than risk sensitizing myself for future kids), but there is a DNA test (simple blood test) somewhere on the market that can allow you to check the baby's bloodtype, and if s/he's not Rh pos, you don't have to have the RhoGam shot.  Anyone heard of this?  My OB and the nurses at the clinic were totally unhelpful, which was disappointing.  Is it totally weird to not want to put a bunch of human plasma product and preservatives into my system if it's not necessary?  Argh.

At any rate, are there other Rh negative mamas in our DDC?  Have you talked to your doc about what you're going to do?

[lisarenee25]

I'm Rh Negative and am having a home birth.  My midwives have the ability to test the baby right after being born.  If it's Rh+ then they will give me the shot.

We had a debacle after our second birth with this issue.  We had always thought my hubby was Rh-, so I didn't bother getting the shot.  About 1 month later, my daughter came out Rh+.  What the?  Well, when the baby turned out Rh+ and I insisted that my hubby was Rh- - the midwife gave me this priceless look .  I will never forget it.

We learned that the doctor made a mistake and sent him the wrong blood report.  It was same first name and last name but different birth date.  I was the one who finally noticed.

Low and behold he was Rh+.

So, she then took a blood test and learned that I wasn't sensitized.  UGh, what a fiasco.

[Lizbiz]

Whoa - lisarenee - that is scary!  Thank goodness you weren't sensitized!  What a colossal mess up on the doctor's part! 

I am Rh- and there is a test you can do at home - it's called an Eldon card (maybe there's a better test out there - but this is one you can do right at home).  I don't trust that it's 100% accurate though - so... I take the plunge and get the Rhogam shot every time (one at 28 weeks and one post partum).  For me, I'm not really excited about getting the shot - but we really want more kids and want to take no risks of getting sensitized.  I know that the chances are slim in an uncomplicated homebirth (which both of mine have been) - but I'm a nervous nelly about this particular issue for whatever reason - and so I'm going with my gut feeling on this one.  

My midwife had another midwife come over and give me the shot after my first homebirth, and then for my second birth we convinced a doctor to let us walk in the day after the birth to have a shot administered after our UC at a clinic.  The clinic was very understanding and great about helping us out (we talked to them in advance - but didn't reveal our plan to UC - just sort of spoke in hypotheticals so they were prepared for us).  

This time we're hand carrying the Rhogam back to China from the US because it's now illegal for clinics here to import it (long story) and we'll find a doc willing to administer it again.  It's a pain, but again, very worthwhile in my mind.  

I would just make darn sure that whatever blood type test you do is 100% accurate post birth.  Then yes, I think skipping Rhogam would be great!  Otherwise, just do it for your future babies! 

My two cents :). 

[Mama Chickadee]

I'm Rh-, and DH is Rh+, so am in the same boat. Both my children were tested directly after birth, and were, unsurprisingly, Rh+, so I had the shot after each birth. I also opted to have it at 28 weeks, too. I did a ton of research on it, and though the odds are very low that there will be a sensitizing event during pregnancy, there's no preventing it either, and the health effects on future children can be severe. We vax hardly at all, so I didn't make this decision lightly, nor do I like the thought of putting human blood products, no matter how far removed from the original source, into my body :(

I have seen the DNA test advertised online. I may consider talking with my OB this time around and see what she thinks. This is what I found online - same as what you were referring to?

http://www.lenetix.com/html/rhd___sry_genotyping.html

I think this is the place that has a false negative of 3 out of 1900 (that is, saying a baby is Rh-, and no treatment necessary, when in fact the baby is Rh+) So, basically, doing this blood test would determine only whether you should do the 28 week Rhogam, as a cautious person would always test the baby at birth just to be sure of the blood type, and whether the post-birth Rhogam is necessary.

[LilyTiger]

lisarenee, totally scary!  That's a pretty big deal!  Lucky you weren't sensitized. 

Chickadee, that's the one.  I have no problem testing after birth, and I'm fine with the shots after birth.  I would just prefer not to inject that stuff prenatally if the baby isn't Rh pos.  Again, my doc had never heard of this test, and if I don't get much more cooperation from the practice I'll probably just end up doing the 28 week and the post-birth.  Sigh. 

LizBiz - I'm with you on the paranoia.  The sensitization stuff is scary.  I am totally fine doing it if the baby is Rh+, I just wish you didn't have to do it either way (at 28 weeks).  I'll check out the DNA testing from that company and let you guys know what I find. 

[eleuthia]

I am also Rh negative. My partner isn't sure but thinks he's positive (I'm hoping his mom knows). My antibody screen came back negative, which is good at least. I'm going to bring this up at my first birth center visit next week to find out their protocol. I'd rather not get a shot if I don't have to, but I don't want to risk anything going wrong with this baby, and I can't completely rule out the possibility of getting pregnant again. 

[Mama Chickadee]

Originally Posted by eleuthia 

I am also Rh negative. My partner isn't sure but thinks he's positive (I'm hoping his mom knows). 

You know, if your partner is eligible to donate blood to the Red Cross, after you donate they send you a member card in the mail, and it has your blood type on it. So - save a life, and get your blood typed for free at the same time :)

[DesertSunsets]

My wife (the pregnant one) is Rh- and the sperm donor we used was Rh+.  Of course, the original plan was to choose a Rh- donor and not have to deal with this whole thing, but it was absolutely surprising how many donors are NOT Rh-.  We ended up finding a donor we were very happy with and who met all the other criteria, and decided to go for it anyway.  

Our first midwife appointment is next week, we'll be asking about it but I assume they'll want to give DW the injection at 28 weeks and again after the birth.  

Looking forward to seeing what everyone's providers say about the Rhogam shot!  

[Lisanne]

I'm negative and DH is positive. I always get the 2 shots. One in pregnancy and one right after birth if the baby is positive.

[Lizbiz]

Hey LilyTiger - I just wanted to mention that while it's protocol in the US to do two shots (one at 28 weeks and one postpartum) - it's not that way the world over.  I'm pretty sure in Europe (don't quote me, I'm parroting my German doctor!) that many countries only do one post partum shot - unless there've been circumstances during the pregnancy (e.g. a bad fall, a car accident) that could cause a blood crossover.  

However, the reason they do two shots in the US is that there are very rare cases of 'silent' bleeds - in other words - no apparent reason, but the blood mixes.  Since most of these happen in the last trimester, the US has implemented a shot at 28 weeks to try to 'catch' most of these.  This 28 week shot lowers the risk of sensitization by another 2% or so.  

So, there's a decent argument to be made for the decision to just have the post-partum shot if your baby tests Rh+, unless something happens during the pregnancy.  Most women world over do this - but we are very very hyper vigilant about it in the US and do two shots as a regular course of action. 

[eleuthia]

I had the tiniest bit of spotting this morning (pink-tinged mucus, then a tiny clot, then a little more pink/red-streaked mucus). I called the birth center office and they had me come in. I have a cyst, a fibroid, and a big polyp on my cervix, and any of these could cause bleeding (most likely the polyp). The midwife did a vaginal exam and didn't find any blood and my cervix is just how it should be, but we decided I should get the mini-dose rhogam shot to be safe (since sensitization this early could endanger this pregnancy). It only hurt a little more than a flu shot (so not bad at all). 

And... while I was there she found the heartbeat on the doppler so I finally got to hear it! That was *very* reassuring - nice and strong, right around 170bpm. 

[LilyTiger]

Great news on the heartbeat, eleuthia!  I haven't heard mine, but we saw it on the ultrasound.

I really can't decide whether the Rhogam thing is no big deal or something to be avoided if possible.  My OB certainly didn't take my concerns seriously, but she didn't take the idea of a birth plan seriously either. 

[lisarenee25]

Sounds like you need a new OB.

Originally Posted by LilyTiger 

Great news on the heartbeat, eleuthia!  I haven't heard mine, but we saw it on the ultrasound.

I really can't decide whether the Rhogam thing is no big deal or something to be avoided if possible.  My OB certainly didn't take my concerns seriously, but she didn't take the idea of a birth plan seriously either. 

[atlyogamomma]

I'm A- and DH is O+. I had the 28wk Rhogam with DD, but didn't need the 2nd dose b/c she's A- like her momma. My midwives operate off the European model of one dose post-delivery if needed, but their back-up OB will give me the 28wk dose if I want it. Still haven't decided.

[LilyTiger]

lisarenee, I'm in the process of finding a new OB.  Even my husband, who is very medically-minded, was really upset with how she treated what I thought were pretty normal concerns.  So, we're on the hunt.  I'm attending a meeting of our local area birth network to get ideas at the end of the month.

[eleuthia]

I got a full dose of rhogam at my visit yesterday because I'm still experiencing spotting. The full dose lasts 12 weeks, so til 26 weeks for me. I'm hoping I'll just need another one then and not again after birth; my arm is more sore than it was with the mini dose (which lasts 3wks). I don't love the fact that I'm getting blood products 3x in pregnancy, but the consequences of sensitization for this pregnancy are concerning enough that it's worth it. And it means I don't need any potentially painful/bloody/scary procedure to remove the polyp that is most likely causing the bleeding.

[CCoello]

I'm going with the RhoGam shots, probably the whole battery of vaccines too. I'm a pretty natural girl, but I really want more kids and don't want to take any chances with that! Plus I really truly believe that vaccines save lives. I'll watch closely for reactions, especially since my brothers and I all spiked fevers after our pertussis shots, but I want my kiddo to be as protected as possible.

[eleuthia]

I wanted to mention that the shot I got (which is actually HyperRho S/D, not the RhoGam brand, but they're all Rho(D) Immune Globulin) is latex & preservative-free. So there is no worry of thimerosal/mercury. I think they eliminated the preservatives from most of these shots a number of years ago - but you can always have your provider check their supply to confirm. 

[LilyTiger]

I just get a little squicked out that I'm getting a human plasma product injected into my body while I have a baby in there.  If I could avoid it, I would.  I haven't seen anything to suggest there are any dangers that would offset the risks of sensitization, so we'll probably just do it.  But I wish the DNA test was more well known so that if the babe is Rh- I wouldn't have to dose him/her.

[eleuthia]

If I had more of a choice (as in, I was just getting the 28wk injection, rather than needing it for bleeding now), I'd probably request the RhoGam brand since they have a small donor pool, which seems safer. Here's a link to their program: http://www.rhogam.com/Professional/PlasmaSafety/Pages/RhoGAMPlasmaDonorProgram.aspx (at the bottoms is a link to a sad but sweet story about a mom who lost babies to HDN in the 1950's/60's and is now a RhoGam plasma donor)