Did you say no to Rhogam?

[littlechickarina]

I would like to not get the Rhogam shot this pregnancy. I have had it with previous pregnancies and mcs -- but don't want it this time. I am 99% sure that #3 will be my last.

I have not approached my midwife about this and would like to be prepared!

Any help would useful.

Thanks,
Chickarina

[julieann199930]

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.
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 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. 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.

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.

HTH!

[JaneSmith1010]

http://www.vegfamily.com/vegan-pregn...tal-rhogam.htm
http://www.vaccinetruth.org/rhogam.htm
http://www.rhogamfyi.com/
http://www.lacarte.org/health/rhogam/index.html
http://www.rxlist.com/cgi/generic/rhogam_ids.htm

Some of these are anti-rhogam others are just 'be carefuls'
one is the med instructions for administration
I had no idea there was a problem with accepting rhogam, but I know very little about it so I learned something.

[13Sandals]

i'm rh- and refused the shots during my past two pregnancies. I would only consider getting the shot after giving birth to a + baby and would not take it during pregnancy. My midwife was okay with it once I made it clear that I understood the risks and would take full responsibility for the consequences if I became sensitized. I was lucky with my last two - though the dad is Rh+, they are both a negative blood types. Good luck!

[MilkTrance]

I was ignorant about vaccines, so I accepted it like a stupid sheep.

Some days I am frightened as hell, and others I am happy because so far DS has not exhibited any signs of nervous system damage.

Only time will tell, but I am sickened with a lot of the things that were done to me during my pregnancy. I am also mad at myself for going against my instincts so often.

[littlechickarina]

Thanks for the info everyone!

I am off to research it even more -- it is SO complicated.

[bri276]

I'm Rh-. I was ignorant and got it after miscarriages and with DD. I would not do it again.

[Ironica]

Wow... I had NO idea that they were giving it even if baby wasn't Rh+! Crazy.

Fortunately, I'm Rh+, so I don't have to worry about it. My mom got it after my birth, though, because she's Rh-.

[joybird]

I would decline the Rhogm shot during a normal pregnancy, but have baby tested at birth and accept the shot if the baby was positive.

I did have it with dd because I experienced heavy third trimester bleeding. I have reservations about that, but I can't say that I wouldn't do it again under the same circumstances.

I also accepted the shot after a miscarriage, after lots of research and thought.

Sara Wickham has a book called Anti-D in Mdwifery that might help.

[joybird]

Originally Posted by julieann199930

[B]

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.

HTH!

Not exactly.

Antibodies are not the same thing as a full-blown immune response, which is what the mother's body is capable of performing once sensitized.

Rhogam antibodies are the same as the mother's, yes. But they cannot ignite the actual immune system response in the mother in the way that her own antibodies can. That is why it works.

This doesn't mean that there might not be unknown issues with Rhogam antibodies coming into contact with the baby, but it is not the same thing at all. If it were, we would be seeing the same numbers (or much higher numbers) of Newborn Hemolytic Disease as we saw before Rhogam was introduced.

Having said that, I still would refuse the shot unless medically necessary, as with all other interventions.

[liseux]

"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" julieann199930

Like joybird said, this is not really accurate. Rhogam works like any vaccine, or also, kind of like a homepathic remedy. A little poison to confuse the immune system into protecting the person, but not a full blown immune response. I have a hard time putting it into words, basically when you are sensitized, you have a titer, anything above 1:1 is considered a titer. In one indiluted drop of blood, you can find the antibody. Then you dilute the blood by one drop of water, whenever you get to the dilution where the antibody disappears, that is your titer. It could be 1:32 or 1:500+ or lower or higher. A rhogam shot may give a mother a titer of 1:1 if she is pregnant right after getting a shot at the end of her last pregnancy, or it may never give her a titer. A titer strong enough to cause anemia would generally start at around 1:16 or 1:32. If its a second or more sensitized pregnancy, the titer may not matter. Titers can go up or down between pregnancies & during a pg. Rhogam definitely has some issues, but it can't truly sensitize a woman.

I used to get rhogam only afterwards, if the baby was positive only. Then, after a loss during delivery & a big bleed on my part, I got sensitized. I don't have any regrets about not getting prenatal rhogam. The bleed I had was so big that the rhogam pp didn't work at all. I have had 2 sensitized pregnancies, the first was worse than the second, although both boys are in great health now. Nowadays being sensitized is not the end of the world, but I have to caution that most midwives and OB's know very little about this & tend to have very old information. When new treatments for fetal anemia are discovered, things like IVIG & EPO treatments for mothers, only the perinatologists get invites to the conferences. Most peri's are not as scared of sensitized mamas as OB's & MW's are.

Sorry to write a book!

[loudmama]

I assume you know your partner's blood type? Both my DH & I have A-, so it wasn't an issue. (He did need to have proof though when I was pregnant with DD.) Though, I did have to remind them more than once that I did not need it with my DS. I had a placental abruption with him, so they were more concerned.

L