RH- rhogam shot - your thoughts?

[schatz]

I've read several threads on here and some other info on-line about the rhogam shot for moms who are RH- with RH+ partners. I am in that boat (I'm neg, dh is pos). So at my appt yesterday, my OB says "come back in 5 weeks instead of 4 because then you can do the glucose test and the antibody screen in the same visit and then you'll just have to come back for the shot" I did check the last time I was there and the clinic uses a mercury free rhogam product.

So, I'm trying to decide if I want to be stubborn and refuse the prenatal shot and just wait to see if the baby is RH+ or if since the shot is mercury free, I should just get it. I know it's a blood product and there are some risks with that but the potential mercury exposure is what really had me scared (a non-issue now).

What do others think about this?

[Jaimep]

It isn't an issue with baby #1. But your body will make antibodies after pregnancy #1 and then it is an ISSUE with baby number two. Your body could see the babies blood type as foreign matter and try to attack it.
So if I was you and I am...because I am - and DH is + and on baby number 2 or more I will definately get it.
But thats just me.
Anyone else?

[schatz]

From what I've read, you only make antibodies if some of the baby's blood mixes with your own and the baby is RH+. If the blood does not mix, no problem. Generally, the blood doesn't mix unless some more invasive interventions are performed during delivery. So, the shot after delivery in the event of a RH+ baby is a good safeguard. I am questioning the usefulness of the 28 week prenatal shot as it is quite unlikely that there would be blood mixing prenatally (I haven't had an amnio or any other such procedure). Some people are really leary of injecting blood products. I was worried when the shot contained mercury (thimerosal) but that's gone from the shots at my clinic. So..... I'm trying to decide if I want to swim against the mainstream and refuse the 28 week shot and opt only for the post-natal shot.

[sweetc]

I am not getting a rhogam shot during pregnancy this time, unless there is an indicated need... For example, bleeding later in pregnancy or my blood works shows some need (its early am here and I can't think of the term).

It isn't a given that your body will produce antibodies during the second pregnancy. If you got the rhogam after your last birth, you are probably okay with this pregnancy (and there is a possibility you would have been okay during a second pregnancy even without it). My midwife checked my blood for titers and I showed no signs of producing antibodies (again, I think that's the correct terms). She'll check again as my pregnancy continues (I am 21 weeks now).

I got a shot during and after my first pregnancy when I had a Rh pos baby. And, my OB gave me one after my miscarriage. I am with a Midwife now and feel more comfortable with her informed approach. If I do have another RH pos baby, I will get the rhogam after I give birth.

Other mommas on this board are more informed on this and could give more of a technical explanation.

[natashaccat]

After doing some online research I decided to go ahead and have the thimerosal free version at 28 wks. I really want at least one more baby and just didn't feel that the arguements against prenatal rogham out weighed potential risk (admittedly probably very small) in not getting it.

It's definately a good idea to research this though so that you can make a fully informed choice.

[kater07]

We did not do the 28wk rhoGAM shot this pregnancy. I am not comfortable putting a blood product into my body while my baby is still inside me, besides, it's there for protection for the NEXT child. I had both shots last pregnancy, and IF this baby is RH+, which is probable, then I will get the shot after birth.

HTH

[thepeach80]

I did a lot of research on this as I have funny blood (strange story) and I knew my OB would offer it. I took it w/ AJ and I didn't need it after his birth so I started reading. If I were trule rh- (which I'm not) I wouldn't get it during birth unless there was bleeding or I had an invasive procedure like an amnio (which I wouldn't) done. Once baby was born and typed, I would get the shot then if needed. So far I have 1 rh+ and 1 rh- baby. My DR didn't care I skipped it during pgcy, but you should've seen the nurses flipping out when they found out when I was in labor. You'd think I was trying to kill the baby or something.

[lisa2976]

Everyone seems to be well educated. I spent the summer learning everything I could, and decided to skip the 28 week, take the postnatal IF baby is +, and take the antenatal IF there were a reason (belly trauma, car accident, bleeding, whatever).

From all of my stats studies, it appears that the 28 week shot has about a .03% decrease in the creation of antibodies. DH and I talked, and decided that .03% was not significant enough to expose baby to another substance, we'd rather give this babe every chance at normal/healthy with the odds of being sensitized.

In a "normal" preg/birth there shouldn't be mixing of blood. Mixing most often happens in the hospital when an OB grabs the cord to "help" pull the placenta out, tearing it and allowing blood to get into mom. The rates of sensitization are much lower among home births.

FWIW, check carefully on the package. There are still doses out there with mercury (even though the companies have changed to non-merc ones) because the shelf life is pretty long on merc shots. There were merc made ones as recent as 2 years ago.

I plan on asking for bloodwork at my 6 week pp checkup, to see if I did develop antibodies, to help us prepare in our planning for more children. While many sensitized moms do carry babes to full term (and the medical technology is out there) that's another decision we'll have to think carefully about before jumping into.

Lisa