Originally Posted by AmyD
Wow, you sound like a walking advertisement for rhogam
If I didn't know any better, I would think you worked for them, or something
Hmmm. Riiight. I work for the Rhogam people. I wish I had a job with ANY people, right now!
I took all information into account and made what I thought was the most reponsible decision. I think it's important to question *ALL* information- including the one book people seem to be pushing on here like crazy. I don't think it's good to only have one source of information, and I think my midwives are very well balanced about that. (Midwife, not OB.)
If it were legal in my state, I"d probably have a homebirth, and I don't want medication during labor/eyegoop/early vacc/vitk/ you name it, in case I need to impress some "credibility" to these boards, which seems to be important to certain people. To me, however, the benefits of the Rhogam shot (what else are we supposed to call it?) outweighed the negatives, because hemolytic disease is so terrible. Everyone can make their own decisions about this, but it's important to consider all sides- including what happens when something goes wrong. If it were possible to have some indication of small tears/abruptions, I would wait to get the shot only if needed. But, it's not possible to have this information, and that's why I made my decision. My decision WOULD HAVE BEEN DIFFERENT if it still had mercury in it. That changes the risk balance, to me. There *is* evidence that small number of women who only get a post-natal shot still get sensitized. This is what I considered.
It's important to question all sources of info, not just those on the "don't get it!" side. There's blatantly incorrect and outdated information on the web also- it's hard to get real information, of course. For example, the blanket statement that "Europe doesn't give the 28-week shot" is plain wrong. Where are people getting this from? The book? What countries in Europe? (which is not just one big country!) They do it in Austraila. The incidence of Rh factor in Africans and Asians is less than 1% (while it is aorund 15% in North America and Europe), so that may explain why it is not used as often in those countries.
An interesting recent (2003) document, establishing standards for the NHS (UK) suggests the 28-week shot. You can find the (large, interesting) document here:http://www.rcog.org.uk/resources/Pub...natal_Care.pdf
Here's an excerpt:
Guidance on the routine administration of antenatal (here this means pre-birth) anti-D prophylaxis for RhD-negative women has been recently issued, which recommends that anti-D is offered to all pregnant
women who are RhD negative. 
Women should be offered testing for blood group and RhD status in early pregnancy. [B] It is recommended that routine antenatal anti-D prophylaxis is offered to all non-sensitised pregnant women who are RhD negative. [NICE 2002]
As does this book chapter from a UK book:http://www.intl.elsevierhealth.com/e-books/pdf/321.pdf
The UK is actually a lot better about additionally testing the blood of pg women for antibodies than the US is.
So, why does hemolytic disease still exist? Some women never get the shot. Some women that only get the postpartum shot still get sensitized. The theory is that they got sensitized in the last 12 weeks of pregnancy. This is why the 28-week shot was started.
It's also really interesting that there are other blood factors that can cause this disease- the one Rhogam takes care of (D) is most common, but there are like three others that are slightly more common, and more that are really rare (they talk about this in the NHS document). Perhaps that was what the other poster was talking about, when two "negative" people still had a "postive" baby- perhaps it was positive for -c or one of the other factors? -j