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#1 of 47 Old 06-23-2011, 10:06 AM - Thread Starter
 
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I was just told by my midwife that I have a type o negative bloodtype. She said that they will have to give me a shot of Rhogam at 28 weeks in case the baby has a positive bloodtype. She said that it probably won't effect this pregnancy, but it could have "dangerous" effects on future pregnancies. I'm really bothered by this because I don't like the idea of getting an injection. Have any of you experienced this? Are there any alternatives?


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#2 of 47 Old 06-23-2011, 10:51 AM
 
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First, do you know/can you find out the baby's father's blood type?  If he's negative, you're golden.  Two negative parents cannot create a positive baby.

 

If he is positive, you can wait until the baby's born and find out his/her blood type.  If it's negative, again, you're golden.  Some people are uncomfortable with this, though, because of the small chance of the baby's blood mixing with yours during the pregnancy or during the birth and causing problems. 

 

I'm sure smarter people will chime in soon, but my first suggestion would be to find out the dad's blood type and go from there.  HTH!

 

ETA:  Oops, just noticed I crashed your DDC, sorry!

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#3 of 47 Old 06-23-2011, 11:09 AM - Thread Starter
 
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Yep, that's what I'm planning on doing (get daddy's blood type). The thing that...ahem...pisses me off about the situation is that I had to do the research to find out that we could get his blood tested and be golden if he's negative. The midwife made it as though there were no other options. She obviously doesn't respect my wishes to go au natural. Looks like I may have to go midwife shopping! Grrrr!!!


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#4 of 47 Old 06-23-2011, 11:23 AM
 
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That stinks about your midwife. I'm O neg, too, and had the shot w/ my first. Turns out it was a good thing for us as DS is B+ (meaning DH is, too). DH hates needles worse than I do, so he did not want to be tested :( I hope you get your answer soon!


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#5 of 47 Old 06-23-2011, 03:20 PM - Thread Starter
 
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UPDATE: I asked the midwife about screening the father to see what kind of bloodtype he has, and if it's negative whether it would be harmful for the baby. She said that no, if we're both negative, we have nothing to worry about. I said, "Oh good, so then I won't have to get the shot," and she replied, "Well you still have to get the shot...that's our protocol." Grrrrr!!!! So basically even if they know that nothing bad could happen, they still want to pump me with Rhogam because it's "protocol" and I don't have the choice to refuse it. I mean, perhaps it's better to be safe than sorry, and maybe there still is a risk for the baby if we're both negative, but doesn't this sound like hospital-talk rather than midwife-talk?


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#6 of 47 Old 06-23-2011, 03:43 PM
 
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Thing is, DH of BF is not always the same as bio father. People cheat. Some stat indicate that as much as 10% of kids have different bio fathers than mom indicate on the offical birth certificate. Since stakes are rather high, is is safer to cover everyone than deal with implications of having a positive bio dad while mom is indicating someone elce is a father.

 

In  some hospitals docotr will not disloce baby blood type  to dad wihthout talking to mom first to protect privacy

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#7 of 47 Old 06-23-2011, 06:06 PM
 
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Quote:
Originally Posted by Alenushka View Post

Thing is, DH of BF is not always the same as bio father. People cheat. Some stat indicate that as much as 10% of kids have different bio fathers than mom indicate on the offical birth certificate. Since stakes are rather high, is is safer to cover everyone than deal with implications of having a positive bio dad while mom is indicating someone elce is a father.

 

In  some hospitals docotr will not disloce baby blood type  to dad wihthout talking to mom first to protect privacy


Yeah that's why to  some of them it's protocol. They don't want to chance it if the Mom is lying about the paternity.

 

If your DH is a negative blood type then you have nothing to worry about. I'd type the whole explanation about the need for Rhogam if he wasn't but I am lazy. lol

 


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#8 of 47 Old 06-23-2011, 07:35 PM
 
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#9 of 47 Old 06-23-2011, 08:35 PM
 
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I am O- and as much as I like to keep things as natural as possible I have heard the horror stories about people who didn't get it and the affects on future pregnancies.  My husband is positive so it is one shot I have decided to be grateful for!  This is my fourth pregnancy.

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#10 of 47 Old 06-23-2011, 09:42 PM
 
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Even if the father is positive, the 28 week Rhogam shot has a lot of negatives and no real positives. The safest option is to wait to find out the baby's type after birth and get the shot within 72 hours if the baby is positive. The only reason to get it during pregnancy is if you have something happen that increases your risk of sensitization eg. amnio, severe abdominal injury,  etc. There is such a thing a silent sensitization, which means there's no obvious trauma to cause it, but it's rare and you would still have to have the shot within 72 hours of whatever that event was and really, what are the odds it's going to have happened within 72 hours of 28 weeks?

 

This is a great thread about Rhogam http://www.mothering.com/community/forum/thread/455838/rhogam


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#11 of 47 Old 06-23-2011, 10:48 PM
 
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Well, odd are not as low as you think once you think about it. And odds are 100 when it happens to you

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#12 of 47 Old 06-24-2011, 12:36 PM
 
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I had it with my first pregnancy at around 13 weeks because of some bleeding and had to continue getting the shot throughout my pregnancy. I had no problems with it.


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#13 of 47 Old 06-24-2011, 12:48 PM
 
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That is just not true.


The benefits  you will not develop antibodies threatening the life of your next baby. Babies used to die or were stillborn due to RH disease.

Yes, there risks but they  blwon out of proportion.

 

Why not google real   sceintific websited with real data?
 

Quote:
Originally Posted by Devaskyla View Post

Even if the father is positive, the 28 week Rhogam shot has a lot of negatives and no real positives. The safest option is to wait to find out the baby's type after birth and get the shot within 72 hours if the baby is positive. The only reason to get it during pregnancy is if you have something happen that increases your risk of sensitization eg. amnio, severe abdominal injury,  etc. There is such a thing a silent sensitization, which means there's no obvious trauma to cause it, but it's rare and you would still have to have the shot within 72 hours of whatever that event was and really, what are the odds it's going to have happened within 72 hours of 28 weeks?

 

This is a great thread about Rhogam http://www.mothering.com/community/forum/thread/455838/rhogam



 

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#14 of 47 Old 06-24-2011, 01:18 PM
 
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Thanks, but my info is from real, scientific websites, including the manufacturer. Getting the shot during pregnancy reduces the chance of sensitization by, at most, 1%. Rhogam is a class C drug. IMO, 1% is NOT worth the risk when no one knows the long term effects, especially on RH + girls and their future childbearing. The antibodies in Rhogam can & have crossed the placenta & killed red blood cells in RH + fetuses. And Rhogam is a blood product. It should be reserved for when it's needed, not given routinely. It is only given after birth, unless there is a situation where there is a strong possibility of being sensitized, in most other other countries.

 

Did you even read the link to the thread I posted? There were several women who posted who were sensitized, including at least one who had the shot multiple times.


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#15 of 47 Old 06-24-2011, 01:34 PM
 
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I would absolutely get the shot if you know your partner is positive.  My DH is pos, I'm negative and I get the shots.  No questions. I remember learning about the importance of Rhogam in an intro to physical anthro calls in college.  I truly can't imagine risking your future fertility.  It really is that simple.

 

I'll be getting at least two shots during this pregnancy. 


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#16 of 47 Old 06-24-2011, 01:57 PM
 
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DDCC- I am A- and have gotten the Rhogam shot with my previous two pregnancies at 28 weeks and within 72 hours after b/c both my kids are Rh+.   Since you would prefer to avoid the shot, definitely type your dh as you could have nothing to worry about, though statistically it's not very likely that he is also negative.   If it's difficult to get it covered by insurance you can purchase an Eldon Card on Amazon and type him yourself at home-  it's very easy and not expensive.

 

As several pp's have said I do believe that it's pretty safe to decline the 28 week shot and just get the second one if baby is Rh+ (and the chances are pretty good since the negative allele is not very common).   I remember reading up on this a while back and recall reading that the sensitization rate with exposure is about 17%.  So first, you have to be exposed and then you also have to fall into that minority that gets sensitized.  BUT, if you do it's permanent and then it could affect future pregnancies.  So to me a good compromise is declining the 28 week (and I am surprised that they don't allow this- is your mw just pushy or will you have to leave the practice?) and getting the postpartum one if necessary.   It's a stinging shot like tetanus (though not quite as bad) so I recommend getting it in your arm to avoid stiffness.

 

Good luck with your decision!


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#17 of 47 Old 06-24-2011, 02:20 PM
 
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Yes, it is a blood product, but donors go through rigorous screening, much more so that usual donors. It is also a plasma donation, not a donation of whole blood. If you wouldn't refuse a blood transfusion because of possible risks, then don't discount the safety of their donor screening.

 

Now, I agree that the 28 weeks shot is mostly prophylaxis, unless their has been an indication that you needed a Rhogam shot. If I was say, getting an amnio or CVS test I would request a Rhogam shot. Now, the theory of why they give the Rhogam at 28 weeks is because the shot lasts about 12 weeks, and since the third trimester is where you are statistically more likely to become sensitized, it may or may not be useful to receive the shot at that point.

 

The issue is becoming sensitized. Since IgGs (immunoglobulins that are part of your immune system's second response) can cross the placenta, that is of concern to me. Since I have seen first hand the agglutination of red blood cells when incompatible types are mixed, it makes me a tad more wary.

 

I am willing to subject myself to the very slight risks of a Rhogam shot to prevent myself from becoming sensitized. Since newborn hemolytic disease is so serious I am not willing to risk that by refusing this one shot.

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#18 of 47 Old 06-24-2011, 06:06 PM
 
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I am rh negative, and have had both shots of winrho (Canadian version of rhogam) at 28 weeks and after birth, omitting my one rh-neg child.

We went through the experience of having a positive Coombs test after the birth of our fourth child notwithstanding our preventative efforts. What followed was sheer terror for us, and agony for our newborn, as she had to endure excriciating blood draws. I am being monitored even more closely this pregnancy with biweekly blood draws and pray we never have to go through this again.

With the greatest of respect to all of the members of this wonderful community, I would urge you to first consult with a hematologist before declining this shot. The science behind this is complex, and even my husband who is a doctor was grateful for the information the hematologist provided. This is not a simple decision to decline something medically unnecessary and it is not a trifling risk. My aunt lost four babies before the rh factor was understood, and I would hate for you or your baby to have to experience what we did, looking at our perfect newborn, knowing her blood might try to kill her.

Please ensure you are FULLY informed before you proceed.

With love and respect, to everyone who posted.
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#19 of 47 Old 06-25-2011, 03:14 PM
 
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Quote:
Originally Posted by Jaimee View Post

DDCC- I am A- and have gotten the Rhogam shot with my previous two pregnancies at 28 weeks and within 72 hours after b/c both my kids are Rh+.   Since you would prefer to avoid the shot, definitely type your dh as you could have nothing to worry about, though statistically it's not very likely that he is also negative. "

 

Good luck with your decision!



The correct advice is not "DH " but bio father of the child.

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#20 of 47 Old 06-25-2011, 03:15 PM
 
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1% is very risk worthy when you are talking about your child. 1% is significant.

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#21 of 47 Old 06-26-2011, 12:09 AM
 
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Except that you're taking a risk with your current child if you get the prenatal shot, to decrease the chance of having problems with your next child by 1%.


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Quote:
Originally Posted by Devaskyla View Post

Even if the father is positive, the 28 week Rhogam shot has a lot of negatives and no real positives. The safest option is to wait to find out the baby's type after birth and get the shot within 72 hours if the baby is positive. The only reason to get it during pregnancy is if you have something happen that increases your risk of sensitization eg. amnio, severe abdominal injury,  etc. There is such a thing a silent sensitization, which means there's no obvious trauma to cause it, but it's rare and you would still have to have the shot within 72 hours of whatever that event was and really, what are the odds it's going to have happened within 72 hours of 28 weeks?

 

This is a great thread about Rhogam http://www.mothering.com/community/forum/thread/455838/rhogam



 



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Except that you're taking a risk with your current child if you get the prenatal shot, to decrease the chance of having problems with your next child by 1%.




Can you please cite a peer reviewed journal article to support the claims that you're making?


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#23 of 47 Old 06-26-2011, 11:19 AM
 
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I prefer a hands off approach to prenatal care, but as someone who is rh negative, with the father being positive blood type-its a no brainer for me. If you dont get the shot, and become sensitized,  you might never be able to conceive again because your body will kill off any +blood embryo. If the embryo makes it, then it could be a stillborn, or born deaf. My cousin is deaf because his mother, like me, is rh negative. What if you have some spotting in your pregnancy? What if you have a miscarriage? Why not play it safe if you know the father is  rh positive. On the other hand, if he is negative, then definitely decline the shot (unless you have reason to believe he is not the father, like you dont know right?)  I dont know, personally, i wouldnt take the risk.

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#24 of 47 Old 06-26-2011, 11:25 AM
 
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Quote:
The only reason to get it during pregnancy is if you have something happen that increases your risk of sensitization eg. amnio, severe abdominal injury,  etc. There is such a thing a silent sensitization, which means there's no obvious trauma to cause it, but it's rare and you would still have to have the shot within 72 hours of whatever that event was and really, what are the odds it's going to have happened within 72 hours of 28 weeks?

Rhogam lasts 12 weeks so the idea is that if you get it at 28 weeks, it should last until 40 weeks, offering protection for anything that might happen during that time.  What I don't get is why is the risk for sensitization greater after 28 weeks and not prior to it?  If there is a medical reason to get it during pregnancy besides events that increase risk wouldn't that reason be in effect earlier than 28 weeks?  Am I missing something?


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#25 of 47 Old 06-26-2011, 12:03 PM
 
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I am A+, but my mother is A-, and she had the shot. Personally, I would get the shot as well if I were Rh- because the risk of what could happen is just too scary.


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#26 of 47 Old 06-26-2011, 01:00 PM
 
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ddcc---i am due in august. rhogam has been a very sensitive subject for maaaaany, but ultimately, the 28 week shot has been routinely given in the states at an arbitrary time when some bleed "might" occur. it is a way to make more money, it is industry. i personally am 0-, and have had 3 children bourne to me with positive blood types. it has been my choice to decline the rhogam, though not without lots of research and soul searching. yes, it is a blood product. while there is all sorts of donor testing, there have also been instances where contaminated blood got into the system and tooooons of preggo women ended up with hepititas (i'm pretty sure that it was hep, and encourage others to look. it is quite hard to find the info, and i remember this particular fact from research a few years ago. it happened either in  the 70s or 80s, but there are all sorts of blood bourne pathogens that could be put out there- things drs. and such are not even fully aware of at this point).

 

    if your dh/bio papa is negative, i would absolutely decline. even as protocol, you have the right to decline. i personally felt like i would opt to get the shot should i encounter any trauma, but i used a lot of blood purifying and uterine toning herbs throughout pregnancies, plus foods that are specifically good for the blood to help as preventatives. i have been tested for the antibodies, and am freee and clear. this is in my fifth pregnancy free of any rhogam. i feel a lot of this can be attributed to my gentle births.... never having traction on the placenta, episiotomies, etc. the whole management of labor can be a major contributor to why blood even mixes.

 

    there is a lot to look into (but look deeply, as a lot of the info is hard to find), and i encourage women to do so on their own, versus just taking the words of others on this site. clearly there are folks on many places the "necessary" spectrum.

 

   one thing that is a big red flag is that other developed countries with better fetal and maternal outcomes than the states (doesn't take too much, really) do not use the rhogam at 28 weeks. it is considered arbitrary, though they do indicate it's use in the event of a major trauma (car accident, etc)

 

   luck to you in searching.


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#27 of 47 Old 06-26-2011, 03:52 PM
 
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I know someone who was sensitized in her first pregnancy, and now the end of every pregnancy is full of worry, ultrasounds to check for anemia, drawing antibody titers, and inducing whenever it becomes more dangerous for the baby to stay in than to come out - usually before 38 weeks.  she was a "silent" sensitization (happened before 28 weeks, she was already sensitized by then) and she would definitely have gotten the shot if it could have prevented what she goes through.

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#28 of 47 Old 06-26-2011, 04:00 PM - Thread Starter
 
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Thanks for all of the thoughtful insight everybody!


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#29 of 47 Old 06-26-2011, 04:13 PM
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Quote:
ddcc---i am due in august. rhogam has been a very sensitive subject for maaaaany, but ultimately, the 28 week shot has been routinely given in the states at an arbitrary time when some bleed "might" occur. it is a way to make more money, it is industry. i personally am 0-, and have had 3 children bourne to me with positive blood types. it has been my choice to decline the rhogam, though not without lots of research and soul searching. yes, it is a blood product. while there is all sorts of donor testing, there have also been instances where contaminated blood got into the system and tooooons of preggo women ended up with hepititas (i'm pretty sure that it was hep, and encourage others to look. it is quite hard to find the info, and i remember this particular fact from research a few years ago. it happened either in  the 70s or 80s, but there are all sorts of blood bourne pathogens that could be put out there- things drs. and such are not even fully aware of at this point).

There was a Hep C outbreak in Ireland in the 70s caused by an infected donor in the Rhogam donor pool.  Since then, changes have been made to donor screening and to the process of purifying the blood used to make Rhogam to prevent a recurrence.  Because the donor pool for Rhogam is intensely screened, the risks of contracting a blood-borne disease from Rhogam are lower than the risk of blood transfusion.  

 

Historically, there have been many, many cases of stillbirth, late losses, and seriously injured babies due to hemolytic disease of the newborn.  Treating HDN involves a lot of blood transfusions and is not always effective.

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#30 of 47 Old 06-26-2011, 05:15 PM
 
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Quote:
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I know someone who was sensitized in her first pregnancy... she was a "silent" sensitization (happened before 28 weeks, she was already sensitized by then)

So why 28 weeks?  If it's an industry as several have indicated, why isn't it offered at 16 and 28 weeks?    
 

 


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