Thank you to those who offered their perspective. I actually am not overly worried about this pregnancy, despite how it may have sounded. However, I was high risk before (multiple losses, pre-term birth, blood clotting problem, one baby who was IUGR/low birth weight, etc), and really this was the last thing I needed to add on top of everything.
My hospital WILL risk me out at 1:4. They can only handle very low risk deliveries there, and as it is I'm on the border of being risked out anyway. They do no deliveries before 36 weeks, they cannot do exchange transfusions, they cannot intubate or vent, and none of the nurses on the mother infant floor will do IV's because they refuse to do baby care. They rely on the Peds for that, and luckily they have one Ped who can do it. Placing IV's in babies is not something most Dr's are trained to do.
Spark, your list sounds nice, but I was sensitized during my pregnancy, so none of that would have mattered. I was tested in the first trimester and it was neg, and then tested when I went in to deliver and suddenly I was sensitized. I had no signs at all. No amnio, no bleeding, nothing.
The thing is, and this is just my opinion, but if you are wanting to avoid rhogam to avoid interventions, well, the interventions you get when you become sensitized are much more invasive, and, well, sucky. I don't mind so much the extra testing for myself, and I researched this up the wazoo, so I had already made my decisions about what my care should be before I even saw an OB. Her recommendations were the same, BTW. But what really bugs me is not taking my baby home right away. Who wants to spend the first several days or week of their new baby's life staring at them while they are under billi lights? And I have other kids I would be away from. And think about all of the heel sticks, too. Jaundiced baby's are so sleepy, also, that they are really hard to breastfeed. My oldest, who was also a preemie, was so tired that she didn't nurse until she was 6 weeks old. We were dripping breastmilk into her mouth for feeds, and if they are not eating it is hard to clear the billi.
IMO this is what preventative medicine is all about. You choose one intervention to hopefully prevent other more invasive interventions and complications. There will always be anecdotal evidence from people who have never gotten rhogam and never got sensitized, or people who got it and were sensitized as well. But when you look at the literature, seeing patients who are sensitized to anti-D has become more and more uncommon, thanks to rhogam.
