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#1 of 47 Old 03-04-2005, 04:14 PM - Thread Starter
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Okay, I need some clarification for anyone who knows....

I kind of get what this whole thing is about, but some of it is still confusing...
Okay, so I "broke up" with my doctor yesterday because we have decided to have a midwife assisted homebirth (yay!)...but I went to my appointment yesterday anyway, just to tie up the loose ends, get my results of the glucose test (no gd yay!) etc..

...so he tells me I am RH negative, okay cool....I get that, so he offers the shot thing, which I refused for now because I wanted to discuss it with my midwife and also confirm what my hubby is....
My MIL insists that hubby is RH negative, so I thought cool, nothing to worry about, if we are both negative, baby will be negative, no shots, no problem etc---okay, well, my doctor said that he could have a negative blood type but have postitive RH "elements" that make him RH positive---
ARGH the whole thing is confusing to me really...hubby is 35 so I don't think they did the whole RH thing that long ago, I think his mom might be mistaking the fact that he has a negative blood type to say he is RH negative---but does that mean he is or not?

ARGH, I would like to avoid the shot, but of course I will get it if I must....I would like to avoid having to test DH's blood to see if he is RH negative because he doesn't have insurance (I have it through medicaid for pregnancy)...but I guess that is what I will have to end up doing...

Is there anyone who can clear anything up for me? If hubby has a negative blood type, does that mean he is automatically RH negative or what?
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#2 of 47 Old 03-04-2005, 04:27 PM
 
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From everything that I understand about it, if you both have A- for example, you don't need the shot, cause all your babies will be - too. I was told that I just needed to bring a copy of my dh's blood donar card to show that he is - and I wouldn't have to have the shot. I had it with my ds because I wasn't positive what HIS genetic donars blood type was, so I wanted to be safe rather than sorry. With dd I wasn't given a choice.

I don't have a clue what your dr meant by he might have a negative blood type but still be RH positive. The - on your blood type from what I understand is how you determine if a certain enzyme is present. RH- people don't have that enzyme in their blood. I would double check with your mw and see what she has to say about it. Just to make sure.

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#3 of 47 Old 03-04-2005, 04:35 PM
 
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I am B- and DH is A+. I had the Rhogam shot during and after my last pregnancy. I was told that having or not having it would have no effect on my first child, but that NOT having it would be dangerous for my 2nd child, because my body could attack the baby as a foreign body. My dd was born B+.

If you want a cheap (and nice!) way to find out your dh's blood type, have him go and donate blood. They'll test it for him and tell him what it is.
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#4 of 47 Old 03-04-2005, 06:11 PM
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I wouldn't trust my MIL's memory of my DH's blood type. Doctor's won't either...it's just not safe. I think if you have neg blood you are automatically RH neg, that's the whole point...

Bayer makes a non-preservative, non thirmesol form of the shot called Bay-rho.

Agree with Fiddledebbi...donate!
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#5 of 47 Old 03-04-2005, 09:38 PM
 
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I wouldn't trust your MIL's memory, either. My own mother told me I was O+ all my life (she remembers being told that by my ped. when I was born) and it wasn't until I was pg with my oldest dd (at 26) that we found out I am O-.

Any blood bank should type his blood for you- I seem to remember my perinatologist saying that you could be Rh + and have some antibody markers, but I'm not sure.

I got the mercury-free shot Bay-Rho (made by Bayer) instead of RhoPhylac or Rhogam, as my dh is O+

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#6 of 47 Old 03-04-2005, 09:50 PM - Thread Starter
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Well, my hubby was in the army, years ago, and is absolutely positive he is O negative---even says so on his dog tags...but I guess I am confused because I told the doctor that and he *claimed* he could have a negative blood type and still have some positive *elements* or some crap...I always thought if you are whatever negative (blood type) that meant you were RH negative... I am looking for clarification! I am planning on asking my midwife, but she is only in the office 2 days a week and I don't want to page her for this!
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#7 of 47 Old 03-04-2005, 10:23 PM
 
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I was told by my doc that if DH was neg, that I wouldn't need the shot...period. He is A+ so I had the shot until last pregnancy when I developed an allergy to it. (extremely rare...like a handful of cases EVER) DH paid $10 to the bloodbank and they tested him for bloodtype...he couldn't donate for a medical reason.
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#8 of 47 Old 03-04-2005, 10:27 PM
 
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Rh antibodies develop during pg only if you and your baby's blood mix (and the baby is RH+), as I understand things, in the absence of some sort of trauma, this is relatively rare prior to birth.

So if you are feeling pressured by your OB to make this descision right away, relax, it can definately wait a day or two for you to research this a bit more thouroughly.

Although widely considered safe by mainstream medicine Rogam is a class C drug, so it's prenatal safety hasn't been confirmed in human and animal studies, so IMO you are right to seek more info so that you can make an educated descision about it's risks.
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#9 of 47 Old 03-05-2005, 02:24 AM
 
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If your Dh has a negative bloodtype you do not need a shot. I have never even heard of someone suggesting that a father with a negative bloodtype could somehow have positive elements. That's simply not true. Negative is the recessive type so if you're negative you only have negative. Now your DH could have a positive blood type and yet have negative elements that would lead to you producing a negative child together. That would happen basically 25% of the time that you have kids. So if your doc thought you were basing it on your previously having a negative child well ok that might be one thing. But if both of you are negative and you are sure (my brother's dogtags are wrong *ack*!) then you don't need the shot.

On the issue of whether or not prenatal Rhogam is necessary at all that's a topic up for debate. As someone else mentioned the risk of prenatal mixing of the blood is actually very low. It only occurs in 1.8% of pregnancies and that is including women who were involved in a serious trauma like a car accident or a beating. So for a woman experiencing a totally normal pg the risk of prenatal sensitization if so low as to be barely calculatable. There is also research that indicates that prenatal sensitizations are more minor and that it might take 12 such microbleeds for any true rhesus incompatability to occur. Even with the shot there is still a .4% chance of prenatal sensitization and in fact even some evidence that having the shot might cause it. With all that in mind I refused my prenatal Rhogam this time around with the understanding that if something were to occur that would put me at higher risk (like a trauma) then I would get the shot. We're the only country that routinely does give it to basically all RH- women prenatally. My midwives were totally comfortable with that choice and did not object to it at all even though I'm sure that all their other patients get it. I will get the postnatal shot because that is the one where you truly risk developing the antibodies and then I'm not exposing my child to a foreign substance when the risk is so incredibly low. I did get the shot with my first three but I didn't realize at the time that it was actually a human blood product or the whole mercury issue etc. I did have mercury free available to me but while they were checking into that for me I was doing research and ended up feeling that it just wasn't necessary so I skipped it.
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#10 of 47 Old 03-05-2005, 03:04 AM
 
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Yay, Wasabi! What a great post!
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#11 of 47 Old 03-05-2005, 10:56 PM
 
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Originally Posted by pamamidwife
Yay, Wasabi! What a great post!
Aw thanks. I was having one of those days when I feel like the freak for refusing things so many women get and don't have a problem with so that was good timing.
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#12 of 47 Old 03-06-2005, 01:56 AM
 
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I heard one doctor argue that all Rh- moms should get rhogam because he never knew for sure if the father was really the father. Yuck on doc's part!!!
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#13 of 47 Old 03-06-2005, 02:11 AM
 
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Yeah with my first who I placed for adoption the agency provided all our prenatal care and insisted that I get the shot (not that I really questioned it mind you) even though I knew the father was also negative. They only had my word that he was 1) the father and 2) that his blood type was also O-. Of course he (the baby) had O- blood just like we did but it's actually pretty annoying because with every pg they check my antibodies and since I've had the shots several times now I actually do have antibodies just within normal ranges and that all started with that first shot that I didn't need. Annoying when I think about it much. But you know that extends to a lot of routine care. Pretty much all babies get those eyedrops to protect against STDs that you probably don't have. Sure they test you at the beginning of your pg but maybe you've gone out and had a one night stand since then and just are too embarrassed to admit it. A IRL friend's sister was actually being taught this while going through training to be an L&D nurse. All too often it's just so condescending and insulting. Grrr.
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#14 of 47 Old 03-06-2005, 02:39 AM
 
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Quote:
Originally Posted by wasabi
I have never even heard of someone suggesting that a father with a negative bloodtype could somehow have positive elements. That's simply not true. Negative is the recessive type so if you're negative you only have negative. Now your DH could have a positive blood type and yet have negative elements that would lead to you producing a negative child together. That would happen basically 25% of the time that you have kids. So if your doc thought you were basing it on your previously having a negative child well ok that might be one thing. But if both of you are negative and you are sure (my brother's dogtags are wrong *ack*!) then you don't need the shot.
I am reading Anti-D in Midwifery: Panacea or Paradox by Sara Wickham and she sates that,
Quote:
The first of these concerned the 'Du' blood test result which shows that a woman is weakly rhesus positive. Even though on some tests these women may appear to be rhesus negative, they are functionally the same as rhesus-positive women and therefore do not need to consider anti-D (Hoffbrand et al., 199).
This could be what the doctor was talking about. It is possible for women (and men, such as OVB's husband) to have test results that show an Rh- blood type, but be functionally Rh+.
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#15 of 47 Old 03-06-2005, 02:45 AM
 
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I wanted to add that I am Rh- (unless I'm weakly Rh+ , hmm, I wonder if I could get my dr to order this Du test for me), and I will be refusing future antenatal doses of Rhogam (anti-D) for all the reasons mentioned by Wasabi. I am still on the fence about the postnatal ones; the book is really thought provoking. I have had 3 doses total of anti-D: one antenatal dose with my 1st pg, the postnatal dose after the birth, and another dose after my m/c.
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#16 of 47 Old 03-06-2005, 05:03 AM
 
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I guess my first question would be how common is this and who even gets this test done? Even very mainstream sources will agree that if your DH is negative you're in the clear. Secondly I can see where it would matter more for the woman since being functionally positive gives you an automatic get out of jail free card on the anti-D issue but if the man is actually genetically negative even if he's somehow functionally positive I guess I would wonder how far that functionally positiveness goes? Can he actually pass it on to his kids or not? I'd be really interested to read any stats about how often people are weakly positive. I know I've given tons of blood and platelets so presumably by now someone would have figured out if my blood acted positive. I'm intrigued but am betting this is something that would be so rare as to barely be worth throwing into the equation. Of course that's from my pov as someone who has decided it's not necessary with a partner who is categorically positive so that's my grain of salt of course.
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#17 of 47 Old 03-06-2005, 05:44 AM
 
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Following this thread but it is confusing! I have heard so many different things. My mid-wife told me it didn't matter what blood type my husband was at all. Or maybe that was just cuz I turned out to be O+? I was also under the impression that RH factor only dealt with type O blood but I guess not. Geez, I'm clueless??????? Will be watching.

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#18 of 47 Old 03-06-2005, 06:25 AM
 
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It's because you're positive. If you're positive your blood has antibodies so your body doesn't react to a baby with those antibodies or a baby who lack antibodies if they have negative blood. It's the same reason you can receive O+ or O- blood. I on the other hand can only receive O- because my blood basically lacks all antigens so I can only have antigen free blood. That's why O- is the universal donor blood type because anyone can take that blood and not have a reaction. If I get any other blood type however my body reacts to the antigens in that type. And theoretically if my body recognized that I was carrying a child with positive antigen blood it would attack it like a foreign body. On the other hand Rhogam/anti-D is fairly new and yet serious cases of rhesus imcompatibility must be somewhat rare otherwise RH- bloodtypes (particularly in women) would have been eliminated through evolution if we weren't able to deliver more than one live offspring from a positive male given that most of the population is positive. My gut tells me that this whole issue must be a lot more complicated than it seems to be given credit for but as I said before right now I'm content with just refusing the prenatal and taking the postnatal so sorry for the segue but I spent months thinking about this so I guess I have a lot to say. :LOL

And yes as you were guessing at the end of your post RH factor is not specific to O blood types at all.
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#19 of 47 Old 03-06-2005, 08:05 AM
 
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Quote:
Originally Posted by wasabi
I guess my first question would be how common is this and who even gets this test done? Even very mainstream sources will agree that if your DH is negative you're in the clear. Secondly I can see where it would matter more for the woman since being functionally positive gives you an automatic get out of jail free card on the anti-D issue but if the man is actually genetically negative even if he's somehow functionally positive I guess I would wonder how far that functionally positiveness goes? Can he actually pass it on to his kids or not? I'd be really interested to read any stats about how often people are weakly positive. I know I've given tons of blood and platelets so presumably by now someone would have figured out if my blood acted positive. I'm intrigued but am betting this is something that would be so rare as to barely be worth throwing into the equation. Of course that's from my pov as someone who has decided it's not necessary with a partner who is categorically positive so that's my grain of salt of course.
My understanding is that, yes, this is very rare. It would more likely, as you mention, be of interest to woman to know that she is weakly Rh+, in order to forgo the Rhogam. Anyway, just wanted to put something out there that might explain the dr's weird assertion. It wouldn't stop me from declining prenatal Rhogam, either, but then I decline and my dh is also definitely Rh+.:
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#20 of 47 Old 03-06-2005, 11:07 AM - Thread Starter
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Well thanks for all your help...I think... lol

jk, no really, I am going to ask my midwife about it--like I said, hubby is definately O- and I guess I will ask exactly what I am...my mom tried to find it in my birth record things, but she could only find HER bloodtype which is O+ ...but since I am definately RH- and blood type is inherited, I am assuming I could be O- ...but then again I never knew my bio Dad, so what he was is a mystery bloodtype-wise...

Anywhoo, I am glad I refused the shot, knowing how rare the actual disorder or whatever is, and especially since my hubby is 100% positive he is RH- and the doc said I was too, so there is nothing to worry about---
Like I said, the weird thing the doc said about "positive elements" threw me for a loop, but maybe he was just pushing the shot or misunderstood what I said, or like one poster said, maybe thought I was um, of *questionable* morals and maybe my hubby wasn't the father...lol....

I am glad I fired him for my homebirthing midwife....further solidifies that making the decision to home birth is the best one...

Thanks again!
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#21 of 47 Old 03-10-2005, 12:23 PM
 
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another for wasabi! You reaffirmed very clearly why I didn't get the prenatal rhogam shot three weeks ago. I too researched and thought about this issue for months as I am O- and dh is B+. My OB tried to change my mind but once I explained my issues and that I understood that should I experience some sort of trauma in the next few weeks, I would come in and get the shot, she was fine with my decision.
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#22 of 47 Old 03-10-2005, 04:15 PM
 
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Let's see...it's already been established you do not need the shot since DH is rh-. I have what has been called a 'weak-D' antibody meaning on some blood type tests I come up as rh- when in fact I am rh+, always have been. The only place that types me as rh- is the lab my OB uses. I have had them run this several times and they do it again w/ each pgcy. The first time I thought it was odd and agreed to the rhogam (my dh is A+). AJ is A- and I typed rh+ at the hospital when I gave birth to him. This time around I waived the rhogam shot w/ no problems from my OB (he's pretty good if you're educated, but that's another thread). Evan is O+ and I once again typed rh+ at the hospital (you should've seen the nurses flip out when I was in labor though b/c I hadn't had the shot at 28 wks, you'd think I was trying to kill the baby). So, I guess the moral of this story is research, lol, and I just like to talk about my weird blood. I also like the fact that my kids have a 25% chance of being any blood type! :LOL

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#23 of 47 Old 03-11-2005, 12:01 AM
 
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Originally Posted by thepeach80
Let's see...it's already been established you do not need the shot since DH is rh-. I have what has been called a 'weak-D' antibody meaning on some blood type tests I come up as rh- when in fact I am rh+, always have been. The only place that types me as rh- is the lab my OB uses. I have had them run this several times and they do it again w/ each pgcy. The first time I thought it was odd and agreed to the rhogam (my dh is A+). AJ is A- and I typed rh+ at the hospital when I gave birth to him. This time around I waived the rhogam shot w/ no problems from my OB (he's pretty good if you're educated, but that's another thread). Evan is O+ and I once again typed rh+ at the hospital (you should've seen the nurses flip out when I was in labor though b/c I hadn't had the shot at 28 wks, you'd think I was trying to kill the baby). So, I guess the moral of this story is research, lol, and I just like to talk about my weird blood. I also like the fact that my kids have a 25% chance of being any blood type! :LOL
Yeah, that's the "weird" blood type I was trying to describe.
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#24 of 47 Old 03-11-2005, 01:21 PM
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I'm confused. I thought the shots you get now are for the NEXT baby? Is that why some of you are only getting the after shots?


I'm RH- and at this point am just relieved that my OB is willing to see if she can get me some non-mercury stuff...
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#25 of 47 Old 03-11-2005, 05:06 PM
 
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I'm confused. I thought the shots you get now are for the NEXT baby? Is that why some of you are only getting the after shots?
yes, the shot is to prevent sensitization toward a future rh+ fetus. The shot has nothing to do with the current baby you are carrying. After they first figured out the whole rh issue and developed rhogam, they only gave it after birth. But, some women were being sensitized prior to delivery so they decided to start giving the shot at 28 or 34 weeks. But, they never really studied what effect that prenatal shot might have on the current fetus. Most people say it has no effect, others are not so sure.

I had the 28 week shot with my dd and when I found out that there was likely mercury in that shot, I was really pissed. (the number of rh- moms with austic kids is huge in comparison to rh+ moms) In the end, I'm pretty sure the shot I got was mercury free. But, other issues make me leary of the prophylactic (28 week) shot so I have declined it with this pregnancy. Check out wasabi's previous post in this thread -- it pretty much explains it.
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#26 of 47 Old 03-11-2005, 05:19 PM
 
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They have done preliminary tests to see if the prenatal RhoGam shot has any effect at all on whether a child might develope Autism and apparently they have found enough evidence that it MIGHT, for it to show up in my Quarterly Autism magazine. I won't get it again. My dd is fine, but I just don't want to take the risk since I know I don't need to. Just so long as you are making an educated decision, that is the main thing I guess.

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#27 of 47 Old 03-11-2005, 05:28 PM
 
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I guess I didn't talk about mercury and RH- since there are mercury free shots but of course not everyone can get them. So yes RH- women are 3% of the general population but have 56% of the autistic children. Recent studies in mice have shown mercury exposure led to autistic like symptoms in those who were genetically predisposed. Given that such a small portion of the population gives birth the majority of the autistic kids I'd say our kids are predisposed. This was why I originally started thinking about skipping the prenatal shot. So if you are going to get Rhogam please get the mercury free version!

The major medical associations recommend postnatal usage only because we have not done studies on the effect on the fetus. It's the manufacturer who recommends we get it prenatally as well. This couldn't be about money could it? Surely not! Anyway basically they tested Rhogam on male prisoners and found that giving them Rhogam within 72 hours of an exposure stopped sensitization. Based on that alone we now say women have to have Rhogam within 72 hours of a birth, miscarriage, abortion, trauma etc. But honestly we have no idea that it needs to be 72 hours. It might well be that a week would do just fine. It might be that the shot really doesn't do anything. A friend posed to me the question of why some other women's antibodies being injected into me would be good but my body making its own would be bad? But regardless the picking of 28 weeks is fairly random. I think it has to do with the fact that theoretically we'll give birth within 12 weeks and the shot is only good for 12 weeks. Of course if you go overdue they don't give you another dose even though the original has worn off. Not to mention which who's to say that you haven't had a microbleed more than 72 hours prior to 28 weeks? The whole thing is a bit silly considering the low risk prenatally for most women. The postnatal shot is a different issue and certainly more of us feel comfortable exposing ourselves to it than do exposing our babies to it.
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#28 of 47 Old 03-11-2005, 05:43 PM
 
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to wasabi -- gee, I wish I could have had you on the phone with me when I had to explain my reasons for opting out of the 28 week shot to my OB. I did a pretty good job but you've got it all pulled together on this one.
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#29 of 47 Old 03-12-2005, 04:27 PM
 
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for all the info on this thread.

I am not a fan of routine 28w rhogam, and I'm a huge fan of Wickham's book.

With that said, I wanted to point out that not receiving rhogam during your pregnancy can affect your current baby. Sensitization can occur at any point during pregnancy, most likely ift is after some kind of trauma--a bleed, a blow to the abdomen, but Wickman also points out other ways that a microbleed might happen---after doppler/ultrasound use for example. Now if these things happen early on in the pregnancy, it could compromise the baby. It is rare, of course, but it can happen. The reason it is given at 28w, is 2fold, 1)it lasts about 12w bringing you up to birth, and 2)most cases of sensitization occur after 28w. This is part of the reason why, after a lot of soul-searching, I received rhogam (mercury-free) at 20w after I started bleeding from a low-lying placenta. I also want more children, so for me it sealed the deal,

Of course, this does not matter to our-veggie-baby, b/c her hubby is neg anyway :LOL
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#30 of 47 Old 08-07-2006, 03:20 PM
 
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I am rh negative type A. I had three positive babies and had rhogram shots. Sadly, this was when they had mercury in them. I had my first one after my son was born, my second son, I had two shots after he was born. With my daughter I had one when I was 7 months pregnant and one after she was born. But my husband was positive. I was told that if your husband was negative you DO NOT have to have a rhogram shot. Two confirmed negatives, that means you are 100 percent sure you are both rh negative, cannot have a positive child, and so you would not need the shot. I am one of the unlucky ones whom the rhogram did not work on. It is supposed to keep you from building up antibodies. I was still building them in my third pregnancy, so they did not work. What I don't understand is why they kept giving me the rhogram when I already had and have the antibodies, that is like shutting the barn door after the horse is already out. After my second child my doctor told me no more children. I think it was because the rhogram wasn't working and since my husband was positive we were not going to have any negative children. But to me, it seems like sometimes the medical profession is trying to give the rhogram shots when they are not needed (1) when both parents are rh negative (2) when the mother has already built up antibodies(because it is no good then, it is supposed to keep you FROM building antibodies, once you have them, you have them always) Someone needs to take the medical community to task for the unecessary rhogram they are giving in these instances.
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