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Thimerosal-free Rhogam okay? -- UPDATE  

post #1 of 20
Thread Starter 
So my midwife has me scheduled to get Rhogam on the 16th. I just called the pharmacy where they're calling the prescription in to, and they said that they do have a preservative/Thimerosal-free dose of it. According to the Mothering site, "Mothers who hemorrhage early in pregnancy generally receive multiple doses of RhoGAM," and I'm guessing this would apply to me as I had spotting at 9 weeks. I'm a lot less nervous knowing that what I am getting is Thimerosal-free. And yes, I'm going to be double checking the package inserts and labeling. Does this make the Rhogam safe to get?

Update

I went to my midwive's to pick up my records, as we're moving in a few days. The first thing I was questioned about was that I refused the Rhogam. I gave my reasons, mentioning side effects, and was told by two people that they didn't know there were side effects (??). Then one of the midwives took me into a room by myself, and told me that she couldn't force me to get it, and that she thinks I'm making a huge mistake and endangering my child, and that he could need a transfusion after birth. I told her about how at my last regular appointment, the other midwife in the practice couldn't/wouldn't answer all of my questions about the Rhogam, and that I did not feel comfortable getting it, nor did I feel comfortable that they're so strongly pushing it if they can't answer basic questions about it. I mentioned what I read, that "Any amount of antibodies is dangerous because it decreases the baby's red blood cells and hence the oxygen that the baby's brain receives" and everyone in the office that I was talking to said that they've never heard of that happening. When I was talking with the midwife privately (rather, when she was talking at me and not letting me get a word in), I asked "If the whole point is to prevent these antibodies from circulating in the mother during pregnancy, why on Earth would you inject them into the mother exactly when she is pregnant?" (I cut and pasted that, but asked in my own words). She cut me off and actually said -- and this is what made me really angry -- "I don't know, I don't know what's in it, I've never looked at the papers, I just know it works like other vaccines, like the chicken pox vaccine." That boggled my mind. How could she in good conscience be so pushy about a drug she doesn't know about?! Everytime I tried to ask a question, she cut me off. She brought up that we're moving, and said that I won't be protected if we get into a car accident. I told her that I know that in an accident, I would have 72 hours to get the Rhogam...which she admitted is true, but that I should still get it now. She also said that I should get it now because it wears off after 12 weeks, so I need it to be constantly protected. Well, it says in my records that I got it last at 9 weeks, which would make 12 weeks after that 21 weeks. I asked her if it was as vital as she says, that I must have it so there's no interruption of "protection," why wasn't it brought up at 21 weeks? She didn't have an answer for that. Nor did she have an answer as to why some doctors say it has to be given at 28 weeks, and some say 34. Then she got upset when seeing that I refused the GTT test (even though that was approved by the other midwife) and decided she was done with me, said she just had to explain to me what her "views" are to protect herself, and then I was on my way.

I want to know if I'm right to be outraged at how this was handled. I was really made to feel stupid, that my concerns aren't valid, etc...

I'm sorry this is so long, but I am so upset...I'm still fine with the decision I made, but the way I was talked down to, interrupted, not able to ask my questions, let alone get an answer from someone I've hired to give professional advice...I am not happy.
post #2 of 20
I recommend that you do some searches on here (in this forum and pregnancy and/or birth and beyond) for rhogam. I saved part of a thread with a great post from MT about how studies of rhogam are flawed. I researched this because I am rh neg and got the pre-natal and post-natal shots with my dd (she's positive) but declined the pre-natal one with ds (he turned out to be neg like me). I determined that for ME, any possible benefits for the pre-natal shot did not outweigh the unknown risks to the baby I was carrying at the time (it's all about future babies and even though I think I want a third child, I determined that the pre-natal rhogam shot still wasn't a good deal). It can be scary to go against the recommendation but I encourage you do to your research. I don't know how much "spotting" you had but look into it. If you want my info from the old thread, pm me.
post #3 of 20
Thread Starter 
I have done searches many times on these forums, as well as on I don't know how many other sites, as well as asking other midwives...no one seems to give the same information. It's hard to make a decision when each source tells you something different. It wasn't a lot of bleeding at all that I had...not nearly enough to come close to filling a pad, only lasted about an hour. Another concern that my husband had that's making me maybe want to get it is that next week we're moving across country, which involves a few things listed on the "could possibly cause pre-term labor" sheet that my midwife gave me.

I will PM you, thanks.
post #4 of 20
I got the prenatal shot with all three of my kids. For me, I felt like the benefits to the shot outweighed the risks and I didn't want to risk problems with future pregnancies from not having gotten it. My dh is rh+ and so were our first two, so I had to get the shot again after they were born. Ds#2 was rh- like me, so I didn't get it after he was born,
post #5 of 20
Quote:
Another concern that my husband had that's making me maybe want to get it is that next week we're moving across country, which involves a few things listed on the "could possibly cause pre-term labor" sheet that my midwife gave me.
I'm curious as to what this list consists of and what about moving makes you at risk of going into pre-term labor. What you have to be concerned about is the risk of your child's blood getting into your bloodstream. That will cause your body to make antibodies against Rh+ blood. If this happens AND your blood gets into the bloodstream of future babies, the antibodies in your blood can attack their blood. If you are birthing with a midwife, I'm assuming you are having a healthy, low-risk pg. When you think about it, do you see how extremely rare the possibility of all that happening is?

I did get prenatal and postnatal RhoGam with my first child, but I will not with this child. Besides that I don't plan on having anymore children, I don't see there's much risk of our blood mixing. I, like you, didn't see any real risks the first time, since there is no mercury, and can understand your fears, considering this is your first birth. In the end, you have to go with what you feel is right for your body and your children. If you are on the fence, you may want to lean more towards only the postnatal injection IF your child turns out to be Rh+.
post #6 of 20
Yes, I agree with what MTR said, you have to do what makes you feel most comfortable. I didn't take the prenatal shot but did the postnatal. But that was mostly because I didn't find any convincing evidence that the prenatal shot was anything other than a "shot in the dark", no pun intended. They didn't really have any strong evidence that it performed any particular benefit in a normal, healthy pregnancy. Prenatal bleeding would possibly have influenced me, but I think I most likely would have just asked them to monitor my antibody levels and go from there. But everyone has unique circumstances, etc, and really there is no "right" or "wrong" decision, only the decision that fits YOUR family.

Congratulations on the new addition to your family.
post #7 of 20
Thread Starter 
I've decided not to get it. A little nervous about calling the mw and telling her I'm cancelling my last appointment (it was an appt. only for the Rhogam). We're moving out of state in a few days, so I have to go in and get copies of my records, and I'm hoping I won't get hassled. They talked about the whole "moving causing pre-term labor" thing because they thought that it could cause me a lot of stress, when in reality dealing with the mw & staff regarding the Rhogam is what's been causing me to stress, far more then moving has! My mw seems unable or unwilling to answer all of my questions about Rhogam, so when she recommended it, I really didn't feel comfortable with that because if SHE'S not confident in her recommendation, then why should I be? schatz sent me some good information originally posted by MT (which answered all of my questions that my mw wouldn't answer), and after reading it my husband was pretty upset that the mw didn't tell us much about it at all, and he is very sure that he does not feel comfortable with me getting it. I have to agree with him. We'll be testing the baby's blood to see if it's necessary after the birth.

Quote:
If you are birthing with a midwife, I'm assuming you are having a healthy, low-risk pg. When you think about it, do you see how extremely rare the possibility of all that happening is?
I do. And yes, the baby and I are both healthy...normal, uneventful pregnancy. I've been feeling really good, and we had an ultrasound 2-3 weeks ago and the baby, fluid, etc., are all looking great.

Thanks, everyone.
post #8 of 20
Thread Starter 
Update...
post #9 of 20
Quote:
I want to know if I'm right to be outraged at how this was handled.
Obviously, I'm not MT, but had to say you absolutely should be outraged and have every right to be. I truly cannot believe you got such garbage from a midwife. Your story is a prime example about how there are bad apples in every profession. My jaw dropped when reading about how the mw said she's never read anything on RhoGam and that it works like other vaccines, which she is obviously in favor of. I guess not all mw's are of the "natural" lifestyle. All I keep saying to myself is "wowwwww".

Good luck with the move. I hope you have found someone who is better than this practice. I think, if I were you, I'd be inspired to write a letter to some midwife associations about how you were treated and pressure to take medications the mw's, admittedly, know nothing about.
post #10 of 20
Thread Starter 
^^ That's fine, opinions from everyone are more then welcomed, I just mentioned her specifically because I read some info that she had written. I am considering writing a letter...when I'm not so upset, though. I don't have a midwife picked out yet in the new place, but I'm definitely being pickier when we get there and I'm able to interview people. This isn't the only issue I've had with this mw practice, but it's by far the most upsetting.
post #11 of 20
I am totally ignorant about this shot but want to learn.

My question is, isn't it the second child you have to be concerned about, not the first?

If that is correct, then why not put the shot off until after delivery and after weaning the baby?
post #12 of 20
Hmmm, it won't be very helpful, but I wanted to add: When I was @8wks preg with DS I bled for 4 hours very heavy, and 3 days spotting and no one ever tried to give me a shot.

I think you did good, standing your ground. Your story just reinforces for me that these people look at their job as just that, and a lot of them just do the min. to get by. That means "someone said its good for you" is enough for them, looking things up is way too much work. I am glad that people occasionally post here about finding a great doc or nurse. Otherwise I would be completely cynical about the whole proffesion instead of 'very'.

Best of luck with the move, pregnancy, and delivery!
post #13 of 20
Oh My GOD! RUN, RUN, RUN, RUN, away from these horribly ignorant, dangerous MEDwives as quickly as you can!!!!!! These are not people who care about informing you in order to enable you to make the best informed decisions you can for yourself, these are "OB's in midwives clothes" who only care about medico-procedure and CYA.......obviously, you are moving...so, YAY!!
Okay, now that my initial shock and anger is over...

About the wretched disrespect and terrible treatment by the midwives...UGH...again, UGH...Well, as you see from my sig, I am an Unassisted birther......but even if I were to have an attended birth, I NEVER, regardless of anything, allow anyone, much less my EMPLOYEE, (your midwife is your employee) to be disrespectful to me. Here are some of my mantras that I like to repeat when feeling wronged by the medical system:

Doctors/midwives/etc are MY EMPLOYEES. Like any other employee, I PAY them to HELP me by providing knowledge or services which I do not know how to, or do not care to do myself.
I do NOT pay people to chastize me, argue with me or make me feel bad.
I do NOT need anyone's PERMISSION to do ANYTHING with my own body.
I do not ASK, I TELL my provider what I CHOOSE to do...

You get the drift........

Anyway, I see you are in FLA?? From what I understand, midwifery is highly regulated down there, and the midwives are probably just Really scared about their licenses, etc....Personally, I would be scared to use ANY provider who is more concerned about meeting state regulations than helping women birth naturally.

I also agree with you that the statement about "I don't know how it works.." is EXTREMELY upsetting...... at the very least, I would have expected her to give the mainstream speech about why the shot works (leaving out any potential risks, of course!)....but that fact that she actually said "I don't know how it works, I don't know WHAT'S IN IT".......Well..seriously, would ANY of us ever want to go to anyone who wanted to inject a myriad of chemicals into our bodies while we are pregnant without at least knowing WHAT THEY WERE and WHY WE NEED THEM????????

Sheesh....
post #14 of 20
Thread Starter 
bobandjess99, yes, I'm in FL for just a few more days. I'm so glad to be moving, for other reasons then this, but this just adds to it. An unassisted birth isn't out of the question for us...reading about UC is actually how I got into all of this in the first place. Your post pretty much sums up how I've been feeling tonight! I like your mantras, especially "I do NOT pay people to chastize me, argue with me or make me feel bad." I can see if the mw wanted to express concern, talk about risks, etc., but there's a right way to go about doing that...

Quote:
My question is, isn't it the second child you have to be concerned about, not the first? If that is correct, then why not put the shot off until after delivery and after weaning the baby?
I'm not sure about waiting until after weaning, as everything I've read so far has said that to be effective you need it within 72 hrs. of delivery. From the information that I got that MT originally posted....

Quote:
The makers of rhogam have funded some lame studies to show that getting the injection DURING pregnancy is more effective. Most doctors are not intelligent enough to see the paradox becasue they blindly accept FDA and CDC recommendations. But there is a wonderful study that compared the efficacy of the post-natal vs. the ante-natal shot. The study examined the corporate studies and explained how they are flawed. It turns out there is absolutely no evidence to show that ante-natal is more effective than post-natal. So mothers should only get the shot post-natal IF the baby is rh+ (and the mother is rh-).

Here is a link to that study http://www.upstate.edu/fmed/cebp/Pr...Compilation.pdf You have to go to page 226

Page 234 summary on Th issues states
Quote:

6. We found no direct evidence of benefit of antnatal anti-D prophylaxis in terms of maternal or neonatal morbidity or mortality
I asked the mw about all of this, and once again, no answer.
post #15 of 20
I am so sorry Pariah that I was late coming to this. I had to write something which has caused so much mental stretching, that I couldn't come today, until the guts of it was on paper, because answering questions can derail my brain. I'm not a multi-tasker.

Let me take each section and respond:

Quote:
Originally Posted by Pariah
So my midwife has me scheduled to get Rhogam on the 16th. I just called the pharmacy where they're calling the prescription in to, and they said that they do have a preservative/Thimerosal-free dose of it. According to the Mothering site, "Mothers who hemorrhage early in pregnancy generally receive multiple doses of RhoGAM," and I'm guessing this would apply to me as I had spotting at 9 weeks. I'm a lot less nervous knowing that what I am getting is Thimerosal-free. And yes, I'm going to be double checking the package inserts and labeling. Does this make the Rhogam safe to get?
I'm assuming I answered this.

Note to everyone. I have rampant Alzheimers at the moment. If you ask me a question, I will find the answer, and then wipe it from my brain to go onto the next thing. I'm working 12 hours a day, and remembering who I've responded to isn't a priority. The priority is to answer, answer thoroughly and then move on. So you might have to remind me what I've said sometimes, or give me a URL to the post in question.

Quote:
Update

I went to my midwive's to pick up my records, as we're moving in a few days. The first thing I was questioned about was that I refused the Rhogam. I gave my reasons, mentioning side effects, and was told by two people that they didn't know there were side effects (??).
Red light number one. Surely, a competent midwife would know that there could be side-effects.

Quote:
Then one of the midwives took me into a room by myself,
Warning light number two. Always conduct conversations in front of all midwives, and that way, if one doesn't know something, the others can see their stupidity in broad daylight.

Quote:
and told me that she couldn't force me to get it, and that she thinks I'm making a huge mistake and endangering my child, and that he could need a transfusion after birth.
At this point I would have asked her "Exactly... why?"

Quote:
I told her about how at my last regular appointment, the other midwife in the practice couldn't/wouldn't answer all of my questions about the Rhogam, and that I did not feel comfortable getting it, nor did I feel comfortable that they're so strongly pushing it if they can't answer basic questions about it. I mentioned what I read, that "Any amount of antibodies is dangerous because it decreases the baby's red blood cells and hence the oxygen that the baby's brain receives" and everyone in the office that I was talking to said that they've never heard of that happening. When I was talking with the midwife privately (rather, when she was talking at me and not letting me get a word in), I asked "If the whole point is to prevent these antibodies from circulating in the mother during pregnancy, why on Earth would you inject them into the mother exactly when she is pregnant?" (I cut and pasted that, but asked in my own words). She cut me off and actually said -- and this is what made me really angry -- "I don't know,
Warning light running out of numbers.

Why.... doesn't she know?


Quote:
I don't know what's in it,
Please say 100 times = "I am an automaton"
Quote:
I've never looked at the papers,
Quote:
I just know it works like other vaccines, like the chicken pox vaccine."
:

Quote:
That boggled my mind.
Mine too

Quote:
How could she in good conscience be so pushy about a drug she doesn't know about?!
Forget good conscience. Whatever happen to professional practice?

Quote:
Everytime I tried to ask a question, she cut me off.
Quote:
She brought up that we're moving, and said that I won't be protected if we get into a car accident.
You won't be protected from... what?

Question. If you had an accident, in which there was bleeding, would that bleeding involve your blood mixing with the babies, the other way round, or both?

If they gave you the Rhogam shot beforehand, which is antibodies collected from mothers, those antibodies will be in your body and if they then crossed the placenta into the baby's blood during the accident, what would the consequences of that be?

Isn't that exactly what they don't want to happen? I think that question should be asked of them. Or are they assuming the blood would only go from the baby to you? What crystal ball do they have?

Quote:
I told her that I know that in an accident, I would have 72 hours to get the Rhogam...which she admitted is true, but that I should still get it now.


Wouldn't the safer option would be to assess any damage the supposed accident? Does a sprained ankle count? You would then know IF there was bleeding, and if there was, hopefully there would be no Rhogam shot until after the bleeding had stopped, to avoid any chance of the antibodies getting to the baby. As I understand it.

Quote:
She also said that I should get it now because it wears off after 12 weeks, so I need it to be constantly protected. Well, it says in my records that I got it last at 9 weeks, which would make 12 weeks after that 21 weeks. I asked her if it was as vital as she says, that I must have it so there's no interruption of "protection," why wasn't it brought up at 21 weeks? She didn't have an answer for that. Nor did she have an answer as to why some doctors say it has to be given at 28 weeks, and some say 34.


Quote:
Then she got upset when seeing that I refused the GTT test (even though that was approved by the other midwife) and decided she was done with me, said she just had to explain to me what her "views" are to protect herself, and then I was on my way.

Quote:
MT, I ask you to read this because I know you're knowledgeable on this, and I want to know if I'm right to be outraged at how this was handled. I was really made to feel stupid, that my concerns aren't valid, etc...
More than outraged. That is the most ignorant unprofessional display I have heard in a long time. But ranting like this, is to be expected when the ignorant are skewered by the short and curlies by knowledgeable mothers. The sad fact is that you would never have known what she didn't know, if you hadn't found it what it is she should know.

Most mothers would never find out how ignorant medical people can be, because they don't have the facts to skewer them with.

Quote:
I'm sorry this is so long, but I am so upset...I'm still fine with the decision I made, but the way I was talked down to, interrupted, not able to ask my questions, let alone get an answer from someone I've hired to give professional advice...I am not happy.
Yes, I think she deserves a very long letter. Don't take your blood pressure for a week

My prescription for you. Make skewered sates and grill them. Put on much sauce and chew with vigour.
post #16 of 20
Quote:
Originally Posted by Gitti
I am totally ignorant about this shot but want to learn.

My question is, isn't it the second child you have to be concerned about, not the first?

If that is correct, then why not put the shot off until after delivery and after weaning the baby?
Rhogam is given to rh- mothers when the father is rh+. In the past, the baby would be tested after birth and if rh+, the mother received rhogam to ensure that her body didn't develop a sensitivity to rh+ blood which could endanger future babies. Apparently at some point in history, the drug mfg or doctors (not sure which) discovered (or decided) that some rh- women were being 'missed' and were not getting the shot when they "should" have been. So they started giving the shot at 28 or 34 weeks (sometimes both) as a precaution. Thing is, rhogam is a blood product and they never did any studies on the effects on the current fetus. The evidence FOR the pre-natal shot is really shaky. AND, the rate of sensitization when only the post-natal shot is given is something like 1.3% but when the pre-natal shot is also given the rate drops to 1%. WHoopee! Either way it's really, really low. OH, and the 72 hours is arbitrary too. They really don't know how long it takes a woman to develop antibodies -- 72 hours was the time in which the docs could come back to the women's prison to give the shot in the first studies on this. AND, if you don't have any invasive procedures like an amnio, don't have a managed third stage of labor, and don't get in any kind of accident, the chances that the blood would mix is really, really, really slim.

(I hope I got all that correct - I haven't thought about this stuff in about a year.)

Quote:
Originally Posted by pumpkinsmama
Hmmm, it won't be very helpful, but I wanted to add: When I was @8wks preg with DS I bled for 4 hours very heavy, and 3 days spotting and no one ever tried to give me a shot.
my guess is that you are rh+ in which case you would have no need for a shot. BUT, if you are rh-, then perhaps your care provider isn't as jumpy about rhogam.

I had a similar battle as Pariah with my OB when I also refused the 28 week rhogam shot. After demonstrating that I had researched the issue, she confessed that she had only seen one case of sensitization and it was years ago when she was a resident. But (you'll all enjoy this) she did start out the conversation (the nurses had told her I didn't want the shot so she tracked me down at home on a Friday night) with

"you aren't afraid that the baby will get autism are you? That drives me nuts - the media has blown that way out of proportion"

post #17 of 20
You have a right to be outraged any time you research something and then are talked down to as a child.

YOu are not a child, you are an adult....buckle your seatbelt, this is only the beginning.
post #18 of 20
I had no clue i would need that shot until after i had miranda (as i thought i was A+ and come to find out after a blood test i'm o-) So i had no time to research.. didn't know it had mercury in it or anything.. me and miranda both got it. after getting home and reading about it i felt just horrible. I spent the whole 4 days i was there trying to protect her from the HEPB shot, when i should of been saying no to the Other one too. miranda was cut up when she was born so she did get the vitamin K shot, although orignally i did want it in Oral form. but the whole birth was messed up so.. lol

Next time.. different hospital. lol
post #19 of 20
Quote:
me and miranda both got it.
I think you are mistaken. They don't give RhoGam to a child. If your child is Rh+, it would've killed her.
post #20 of 20
I bumped up a thread for you, OP.

hope you can read it....good luck.
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