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Rh-negative mamas?

post #1 of 15
Thread Starter 

Anybody else here in the Rh- mother, Rh+ father camp?

 

We're coming up on that 28-week mark where the Rhogam decision has to be made, and I wanted to hear what ladies in this DDC are doing/have done, if this applies. I've read through old threads here about it and though they were definitely food for thought I think I still end up on the side of getting it.. mentioned this to my midwife on the phone today and she was like 'well, we can talk about the pros and cons and then if you want it we'll do it.' It'll be interesting to hear what she has to say- I know the 28wk thing wasn't always done, and she originally practiced in England where protocols are still different, so her take might be different.

 

Anyway.. anybody?

post #2 of 15

I am. I have never taken prenatal rhogam, and actually also denied Rhogam after the birth of my 5th child (long story). I am from the UK originally and we don't do it there and I am just not willing to do it prenatally. :) 

post #3 of 15

I'm Rh negative, and my hubby is Rh + enough that EVERY baby has been A+.    I had the 28 week shot for my first baby. . .and haven't had it since.  The point of the shot is to help in cases where mother's blood and baby's blood have mixed.  There is a chance (from what I understand, a small one) that this can happen during delivery, and so that is why the shot is administered after delivery.  But as for the 28 week mark, there is no magic blood mixing that occurs at 28 weeks. . .from what I was told by my Dr., they just do the shot in case you go into labor early or suffer some sort of trauma. . . but this makes absolutely no sense to me whatsoever.  I could see if you were in a car accident. . .or some trauma, to THEN administer the shot, but why the magic 28 week mark?  I'm still baffled by the concept.  So we just do one after birth.  Good luck figuring it out!

post #4 of 15
Thread Starter 

I'd love to know whether hubby's heterozygous or homozygous for Rh factor- sounds like your husband is probably the latter, 5bp, which takes a lot of the guesswork out of it. I should look into that further to see if it would be a possibility.

 

I'm squicked out by the thought of receiving a human blood product and know risks of sensitization are quite low under normal circumstances, but man, Rh disease just sounds so horrible that I'm having a hard time thinking of not doing it without a stronger case against it than what I'm finding out there. It seems like there's a lot of balancing of personal comfort levels with different pros and cons, more so than science one way or the other- which I can accept, but it makes it that much more difficult a decision!

 

I agree about the seemingly arbitrary 28-week thing. It is weird to me because of the +/- 12-week window; why not, say, 30 weeks if a pregnancy will potentially be allowed to go to 42? Or even later, if it's not going to stay in everyone's system for 12 weeks?

 

momtoafireteam, you were denied it?!! Wow. I'd be interested to hear that story if you feel like telling it.

post #5 of 15

No no, I myself denied it. I wasn't denied it by them. In short, I had a horrific, terrible and awful delivery/birth and was in a very dark place immediately postpartum, and the thought of having another child made me feel physically ill. Because I was absolutely convinced I would never have a need to be protected from sensitization again I refused it. Of course time goes on and wounds heal and 2 year later I was pregnant again. Because I had refused both pre and post natal rhogam in the previous pregnancy, they did a blood test that tested my isoimmunity and it was fine (thank heavens). 

 

I was also tested again at the beginning of this pregnancy (because sometimes isoimmunity takes a couple of pregnancies to show up I think? I swear I used to be very well versed on this.....) and was again fine. I did get postpartum rhogam with DD4 though. 

 

Good luck making your decision. For me (with the exception of DD3) getting a postnatal shot but denying the prenatal one was the right middle ground for me. :) 

post #6 of 15

i am rh- and he is positive- my midwife gave me the rhogam prescription to have filled and bring to my 28-week appointment, and i didn't think twice about it. i've had rhogam administered after a d&c before.

 

i admit i was totally unaware that i needn't have it done right now- so i could potentially wait? i didn't question my midwife at all when she brought it up :/

post #7 of 15
Thread Starter 

wendipauline, why don't you give her a call and see what she says? You could also search other MDC threads (keyword 'Rhogam' is good); people have posted a lot of information about risk levels for sensitization before and at birth, etc. and you could evaluate those sources if you have any discomfort with the idea of getting it. I really have gone back and forth but I think this is an intervention I'm comfortable with, even if it were to turn out to be unnecessary. The other option to discuss with your mw would be to have the babies typed at birth and take it then if they're Rh+. 

 

momtoafireteam, wow- I'm so sorry to hear you had such a rough go with #5, and glad things are looking good for you with the newcomers! Thanks for sharing this. 

post #8 of 15

Hi

 

I am forum jumping here but not much going on in my forum so I am poking around for something fun to talk about! (due in Oct) I also had this issue, and I decided against any prenatal shots since it's a)pretty random that you will become sensitized then, I mean why not give you shots every 12 weeks then through the pregnancy? b) it's a blood product. it has given people hepatitis in the past. it could pass on diseases we don't even know about yet. if you google rhogam the lawyers are all over it hoping for their class action lawsuit lol c) I am not in love with medical interventions or shot happy doctors. d)it is not tested prenatally (says so on insert packaging) and though I don't remember 100% it may even be not recommended for prenatal use?

 

There is some speculation that it contributes to issues in baby- but this is all speculation at this point. I read somewhere in my "research" while making my decision that a far greater majority of children with autism are born to mothers who are RH negative (thus likely had the shot prenatally). There were also some other possible links but of course it was all speculation. But a lot of it seemed plausible to me.

 

The actual numbers in the chances of getting sensitized are so incredibly low, and the shot is not always going to work. There are many cases of babies with RH sydrome when mothers had the shots. The disease can also in a majority of cases be (cured?) helped. And your baby may be born negative anyways (mine was). I had decided that I would consider getting the shot after baby came if baby was positive. I didn't even have to do it!

 

Here's one thread on Mothering that I like (lots of food for thought, both sides):

http://www.mothering.com/community/t/1112562/rhogam

 

This link is one woman's thoughts:
http://www.vegfamily.com/vegan-pregnancy/prenatal-rhogam.htm

 

this following quote came from I have no idea where, probably a forum somewhere (maybe even in mothering), I had it stashed away in an email, I thought it was quite interesting and seemed to make sense. So my apologies to whomever I am stealing it from!

 

"I don't understand why pregnant women have the jab when they are pregnant.

They have the jab because they are told if they have antibodies in the blood from a previous pregnancy that will damage the baby?

Well, keep in mind a very important point about RhoGam and that is that the antibodies attack ALL RH positive cells. The entire premise is that if the mother's blood mixes with the baby's blood, the antibodies will neutralize the baby's blood cells before the mother can create her own antibodies against the baby. The dilemna is that if the mother's and baby's blood does actually mix it is equally likely that the RhoGam antibodies will cross over and attack the baby itself. This happens frequently but isn't discussed by most doctors. It is a big reason to only get the shot after pregancy if the baby really is RH+

The RhoGam antibodies will attach to your baby's blood cells and render them incapable of delivering oxygen. This has long term consequences on brain development. Most doctors are completely ignorant of this issue.

The RhoGam antibodies do not cross the placenta. But neither do blood cells from the baby which is exactly why the RhoGam is injected. In very rare circumstances, such as the mother becoming injured, the blood of the mother and baby can mix. It's a paradox, only when the antibodies are needed can they harm the baby.

The RhoGam antibodies are put there to attack any baby's blood that comes across. But if there is mixing then the antibodies can go across the other way and they do exactly that. Antibodies diffuse much more readily through the bloodstream than whole cells.

Immunology textbooks still correctly point out that RhoGam should be given after childbirth only if the baby is RH+. These are the mothers that are at high risk. However the company that manufactures RhoGam lobbied to have it's use expanded to all RH- mothers during and after pregnancy to 'guarantee' that all high risk mothers were protected. Doctors try to rationalize this by saying that even during the first pregnancy blood can mix and antibodies can be produced that will attack the baby. This almost never happens because the blood would have to mix twice, once to stimulate the production of Abs in the mother and the second time for those antibodies to diffuse to the baby. And regardless, the paradox comes into play because if the mother's Abs can diffuse to harm the baby, then so can the injected RhoGam Abs. They are the same exact antibodies.

Each RhoGam injected contains blood serum pooled from several different persons with the antibodies. The manufacturer can not possibly screen or remove all viruses from it. But that's a separate issue.

The Rhogam antibodies in the injection are identical to the antibodies that the Rh- mother makes against her child. The Rhogam antibodies were collected from RH- mothers who did have an immune response to their RH+ babies. The Rhogam antibodies will attack and destroy the baby's red blood cells (if they do come across the placenta) before the mother's immune response kicks in and makes her own antibodies. You give rhogam to a mother after delivery because that is when the blood mixes. The rhogam antibodies destroy the baby's cells so that the mother's immune system never sees them and therefore never becomes sensitized to make those exact same antibodies.

If you give the Rhogam antibodies during pregnancy you have just created the situation you were trying to avoid. The whole point is for the pregnant mother to NOT have antibodies against her own child circulating in her system while she is pregnant.

Any blood mixing would allow those antibodies to attack the baby.

It does not matter if the mother's immune system made those antibodies or another mother's immune system (rhogam) made those antibodies. They are identical down to their molecular structure and you do not want them to contact the baby."
 

post #9 of 15
Thread Starter 

My problem with that last point is that I've been unable to substantiate it anywhere outside internet forums. If anybody has seen such a source, I'd be grateful for a link!

post #10 of 15

I think in the mothering forum link there was a title of a research paper that discussed it (or if you can find that paper you can find the others- from the 60s and 70s if I remember correctly), likely in google medical. It also makes sense. I mean, they are weaker but that's what the shot is, no?? it tricks your body into thinking you've made the antibodies by putting somebody else's into you? So theoretically your body will not make it's own antibodies because they are there.
 

post #11 of 15
Thread Starter 

Right, but that's kind of what I'm saying. People throughout history have believed all kinds of things that turned out to be utter nonsense--or that were even known to be so at the time--because they seemed to make intuitive sense- for me, the bar needs to be higher than that. From what I've seen, people are propagating this theory without providing any solid backing for it (though.. that's pretty much what the internet is for, right? lol.gif). I didn't find any citations in reviewing that thread, but the fact that folks are pointing to research that's half a century old is a red flag in itself--that's absolutely ancient, and would necessarily ignore anything we've learned about Rhogam since it was first distributed in 1968. (Another reason why date matters: the autism thing isn't a hill I'm willing to die on or something I'm interested in debating, but most of what I've seen was people suspecting a link between the mercury-containing version of the injection; Rhogam is now thimerosal-free.)

 

I want to be clear here that I'm not making any kind of judgment about whatever decision you ultimately make- weighing these risks is a hugely personal decision, and a particularly heavy one because it's not just about us. I'm just a stickler for evaluating the relative weight of the different claims that are out there and not presenting all of them as if they have equal scientific validity. This is a really tough area because we can't always count on the research to be looking at the things we want to know about.. but there are some basic questions that can be asked when people bring these things up, and I think we need to.

post #12 of 15

And that's my point, too. A person needs to be evaluating both sides- and know that what the medical system is doing on behalf of making more money (filling pregnant women with an untested drug with little measurable benefit) and believing it's only going to help and not cause any problems. This protocol is relatively new, and untested, and only used in a few countries. Too many people will blindly accept what doctors say/do- and there are things doctors have done through out history that also turned out to be utter nonsense, or very harmful.
 

post #13 of 15
Thread Starter 

I'm actually making a somewhat different point, about the relative quality and reliability of sources, which isn't determined solely by which side of the issue the source lands on- but we can definitely agree on what you've just said about the importance of looking at--and critically evaluating--both sides.

post #14 of 15

Hmmmmm.  These are great points! I was always under the "impression" that RhoGam worked by decreasing your immune system--causing your body to NOT react to any blood exposure by NOT making antibodies.  I "verified" my "impression" by the fact that I would always get sick after I had my babies (and RhoGam) and figured my immune system was suppressed by the shot.  Don't you just love my research methods!! I guess I'd better do some reading as well LOL :-)

post #15 of 15
Quote:
Originally Posted by wendipauline View Post

i am rh- and he is positive- my midwife gave me the rhogam prescription to have filled and bring to my 28-week appointment, and i didn't think twice about it. i've had rhogam administered after a d&c before.

 

i admit i was totally unaware that i needn't have it done right now- so i could potentially wait? i didn't question my midwife at all when she brought it up :/

That is why it is so important to educate people and the medical industry will not do it for us.

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