Rh- mamas, are you getting the Rhogam? - Mothering Forums

View Poll Results: If you are Rh-, are you getting the Rhogam?
Getting it prenatally and after birth if baby is + 26 33.77%
Not getting it prenatally, but will get it after birth if baby + 33 42.86%
Not getting it before of after birth 13 16.88%
Other 5 6.49%
Voters: 77. You may not vote on this poll

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#1 of 64 Old 11-11-2005, 06:14 PM - Thread Starter
 
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With DD, I got the prenatal Rhogam at 28 weeks and then had one postpartum since she was +. I didn't even consider not getting it. Was part of my medical culture I guess. Just like vaccinating, which I stopped after her 2 months shots.

Anyway, time is nearing when I have to make a decision on the prenatal shot. I thought I had decided not to get it, but now worry about the what ifs. I will definitely get one if baby is +.
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#2 of 64 Old 11-11-2005, 07:18 PM
 
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i am not getting it because dh is A-, so baby can't be a positive...no reason to get it for me.

Mama to girl (11), boy (7) and girl (4).  "Can't we all just get along?" joy.gif
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#3 of 64 Old 11-11-2005, 08:17 PM
 
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I literally agonized over this choice. I had a supportive midwife but my backup doc was not supportive of skipping the prenatal dose (what I did, btw). Rhogam has been the most troubling aspect of my pregnancies...I honestly wonder if the stories about women changing their Rh status are true because I sure wish I could.

Anyways, I just felt totally uncomfortable having a human blood product injected into my body while I was carrying my baby. Post-partum, however, I accepted the risk so that future babies will be safe. My births were all gentle homebirths, but knowing that more children were a possibility I felt the benefit of the postpartum shot to be worth the slight risk to postpartum me.

My backup doc even admitted that the 28 week dose was assigned arbitrarily, it will only work if the blood mix occurs in the few day period surrounding the shot.

I had the cord blood of all of my children tested for blood type and they were all + so I got a lovely shot after every birth.

In the end my backup doc did come through and get the Rhogam to my house for me, and his nurse had to jump through hoops to get it, so I can't complain about him in that respect, but it sure did stress me out to have him harping on me about skipping the prenatal dose...

I'll make the same choice in any future pregnancies.

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#4 of 64 Old 11-11-2005, 09:08 PM
 
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I'm almost 37 weeks and still on the fence on this one, so I didn't vote. I see no reason whatsoever to get the prenatal shot (unless you are in an accident or have an invasive procedure or something), so I didn't get it. But I'm still not sure whether it's worth it to get the shot after birth. On every other issue regarding this pregnancy and birth I have put my trust 100% in my body and nature, but I can't seem to do that with this. I am having an unassisted birth and pregnancy and this is my only worry. Right now I'm thinking I will get some eldon cards and test the baby's cord blood after the birth. If s/he is + then I will either call a local midwife (who I haven't talked to, but my mom has and she's UC-friendly) or the local women and childrens' clinic to get the shot within a couple days. But then again this is not something I want to be wrestling with right after the birth of my baby, yk?
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#5 of 64 Old 11-11-2005, 09:11 PM
 
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I got the 28w shot (full of mercury) when I was pregnant with my son. He has autism and I highly suspect the Rhogam (and the flu shot I also got while pregnant). Too bad I was clueless at the time.

This pregnancy, while I know that Rhogam no longer has mercury, I have done my research and could not really find any benefits to the 28w shot. I will get the postpartum shot if the baby tests rh+.

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#6 of 64 Old 11-11-2005, 09:12 PM
 
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My DH is also Rh-, but if he wasn't, I would skip the prenatal shot unless there was a medical reason. And I would get the postpartum shot only if the baby was +.
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#7 of 64 Old 11-11-2005, 10:32 PM
 
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I will get the shot prenatally and after birth if the doctor advises it. I respect everyone's choices. This is my choice and I feel good about it.
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#8 of 64 Old 11-11-2005, 11:26 PM
 
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I got it postpartum with all my previous pregnancies/miscarriages, but never prenatally. I won't be getting either for this baby because this will be my last baby. Might as well save myself all the nasty chemicals.

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#9 of 64 Old 11-11-2005, 11:35 PM
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I got it prenatally at the advice of my DR. DS turned out to be A- so I didn't need it at birth.

My next pregnancy, I don't know if I will get it prenatally. I've researched and educated myself a lot more about vaccines since then. I really wish I would of done it sooner though instead of taking the Dr's word.
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#10 of 64 Old 11-12-2005, 12:45 AM
 
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I had one after my miscarriage in Jan 04, and got it prenatally with my DD at 28 weeks. She was - so I didn't have to worry about it postnatally. That was a godsend too because we would've had to track it down at a pharmacy w/in 48 hours and bring it to the birth center to be injected. I had my baby on a Saturday too which further complicated the matter.

I had no idea it wasn't just "required". I researched a lot about birth and stuff in general but somehow didn't come across the arguments against it until too late. Next pg I'm not sure that I will get it prenatally. I need to do some more homework but if statistically it really doesn't help anything, then I will not be getting it. And now that I have a - daughter, I feel like my blood's going to kick my DH's blood's booty when it comes to blood type!

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#11 of 64 Old 11-12-2005, 01:44 AM - Thread Starter
 
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thanks everyone for sharing your decisions. i wish i could feel really secure either way. i guess i will have to wait and just follow my gut. i am definitely getting one if baby is negative, but i am leaning toward not getting it while pregnant.
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#12 of 64 Old 11-12-2005, 01:56 AM
 
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I'm still really not sure...right now we're waiting for the results from my husband's blood test, just to make 100% sure that he's Rh+. He's pretty sure he is, but my midwife wanted to test anyway, to see if there was any way to possibly avoid all of this. My midwife is really pushing the Rhogam at 28 weeks, especially since I had spotting at 9 weeks. I got the Rhogam in the ER at 9 weeks, too. I'm just not sure. Hopefully my husband's blood will come back Rh- and we can stop stressing about this. This is the most agonizing thing in the world.

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My backup doc even admitted that the 28 week dose was assigned arbitrarily, it will only work if the blood mix occurs in the few day period surrounding the shot.
How is that so, considering the effects of the shot last for 12 weeks?

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#13 of 64 Old 11-12-2005, 02:14 AM
 
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I had a test for rh sensitity early on and another at 28 weeks. Since both tests came out normal, I'm not doing the rhogam prenatally. I did agree (with my midwife) that if I'm in an accident, have bleeding, or some trauma to my abdomen that I'll come in within 72 hours for the shot. Seems reasonable. I will have it if this baby is rh+ because even though I'm not planning on another baby-you just never know.
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#14 of 64 Old 11-12-2005, 11:20 AM
 
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One more thing... if you decide to get the shot(s), triple check to make sure they are giving you the thimerosal-free version. Don't just take their word for it, ask them to open the box in front of you and hand you the package insert before it's administered.
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#15 of 64 Old 11-12-2005, 11:43 AM
 
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I won't be having the shot prenatally but as yet I am undecided on whether to have a postnatal shot. With DS I did not have a prenatal shot ( in the UK at that time it was not standard prenatal care) but I did have one after his birth as he is RH+.
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#16 of 64 Old 11-12-2005, 12:59 PM
 
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I don't get the prenatal ones except in the case of trauma or bleeding.

Am I wrong or does most of Europe still not recommend the prenatal shot? I was thinking in most of Europe it's still common practice to ONLY give the post natal shot if needed.

Also wanted to add, after our third I was sure we were done and didn't bother getting his cord blood checked or the shot. A few months later I did get tested for antibodies, just in case. I had none. We're pg again and I'm still showing no antibodies, but it's always good to go ahead and get that cord blood tested even if you think you're done. It's true that you never know!

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#17 of 64 Old 11-12-2005, 02:07 PM
 
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I'm kind of a funny case b/c I really don't have rh- blood even though the test shows that at the lab my DR uses. I got the rhogam w/ my first ds b/c I didn't know any better. I didn't get after his birth b/c I tested rh+ at the hospital. He was rh+. I refused the shot this last time and then I tested rh+ again at the birth and he was rh-.

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#18 of 64 Old 11-12-2005, 04:22 PM - Thread Starter
 
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thanks for all the stories guys! interesting about europe, etc. i think i am sticking to my original decision, to only get it if baby is positive after birth.
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#19 of 64 Old 11-12-2005, 07:30 PM
 
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When I was pregnant with my DS (2003 in the U.S.) I wasn't even offered a shot prenatally. They tested him when he was born (he's +) and gave me the shot then. Huh. With this pregnancy, they haven't mentioned it yet, but if they offer I'll decline the prenatal shot and just get the postnatal one. We don't plan to have any more kids, but like maybebaby said....you never know!
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#20 of 64 Old 11-13-2005, 01:23 AM
 
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how sad is it that at 28 weeks, I didn't even think about the thimerosal thing, even though I was in the process of researching vaccine stuff for the baby? Man, it ticks me off how little information I had. I don't know if I would have done anything differently (other than double checking the syringe itself for it to say thimerosal free), but I hate the idea that I was one of those uninformed mothers!

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#21 of 64 Old 11-13-2005, 03:29 AM
 
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I voted no, b/c DH is also RH- so there is no need. I don't understand why they don't test the dads before peddling MORE meds... Seems like an obvious i$$ue to me....
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#22 of 64 Old 11-13-2005, 04:22 AM
 
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I am negative. Ex is positive. I got it prenatal and postnatal with all three, and all three were postive.
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#23 of 64 Old 11-13-2005, 09:04 PM
 
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This is such a confusing topic for me... our plan this pregnancy is to do what we did with the last two: no prenatal RhoGam, test baby's blood after birth and if Rh + then I will get the shot. Fortunately my girls are both O- so it hasn't happened that way yet, but the odds of all my children being Rh- are pretty slim so I'm sure I'll have to get the shot eventually. I REALLY feel very leery of it.. it just doesn't seem natural. And since most blood mingling is caused by external factors (cord traction, early cord cutting, fundal massage, augmented/induced labor, etc) then ther should be no reason for me to even worry since I won't be having any of that in my birth. But I want many many children, and don't want to in any way jeapardize that... that old "what if" that pops up.

I have heard about changing from Rh - to + through diet... but honestly I don't want to... I feel like I was born this way and that it's no more "wrong" to be Rh - than it is to be O blood type. That thought alone makes me think that the RhoGam isn't necessary in a natural, unmanaged birth.

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#24 of 64 Old 11-14-2005, 01:28 AM
 
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I've got two questions that my midwife didn't answer...if anyone here know some answers, please share your knowledge with me!

-- I spotted at 9 weeks, and was given Rhogam in the ER. Would this be a reason for me to get Rhogam at 28 weeks, or am I sufficiently protected from the dose I got at 9 weeks?

-- Blood mixing and becoming sensitized would only happen if a traumatic event occurred, right? Car accident, bleeding, some sort of injury... So would it be logical to skip the 28 week Rhogam and only get it if I happen to be in some sort of situation like that?

We're currently waiting to see if my husband is Rh-, but we're pretty sure he's +. My midwife wants me to come in this week to get a blood test...if I decide not to get the 28 week Rhogam, is the blood test necessary?

I'm upset...I had a list of questions typed out that I gave to my midwife at my last appointment, and she just picked and choosed which questions she would answer. That is not satisfactory to me...would anyone else feel that way, too? I'd at least liked to have been told "I don't know" instead of just not getting any sort of answer... She didn't answer the questions I posted, along with whether or not I would be able to get mercury-free Rhogam.

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#25 of 64 Old 11-14-2005, 02:19 PM
 
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Its not an issue for us. Both DH & I are A-. Because he's a regular blood donor, he even carries proof with him. Astounded the nurse when I was pregnant with my first.

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#26 of 64 Old 11-14-2005, 09:05 PM
 
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[/QUOTE]
-- I spotted at 9 weeks, and was given Rhogam in the ER. Would this be a reason for me to get Rhogam at 28 weeks, or am I sufficiently protected from the dose I got at 9 weeks?[/QUOTE]

Ths shot only protects for 12 weeks, so no, you wouldn't still be covered at 28 weeks.

[/QUOTE]-- Blood mixing and becoming sensitized would only happen if a traumatic event occurred, right? Car accident, bleeding, some sort of injury... So would it be logical to skip the 28 week Rhogam and only get it if I happen to be in some sort of situation like that?[/QUOTE]

Yes, blood mixing is very rare - during pregnancy it can occur if there is an abdominal injury or invasive procedure (amniocentesis)... I believe that placenta previa can also cause it. During birth itself blood mixing can occur if there is any cord traction, fundal massage (anything that "encourages" the placenta to dislodge), early cord clamping, and it is possible that things such as induction/augmentation and epidural can also contribute.

[/QUOTE]We're currently waiting to see if my husband is Rh-, but we're pretty sure he's +. My midwife wants me to come in this week to get a blood test...if I decide not to get the 28 week Rhogam, is the blood test necessary?[/QUOTE]

It is most likely that he is Rh+, as only 10-15% of the population is Rh- ... As far as getting the blood test to see if you are sensitized, discuss with your midwife your options and how a positive result might change your decision. I personally would not get the test, but that is because I would not get the shot prenatally regardless.

[/QUOTE]I'm upset...I had a list of questions typed out that I gave to my midwife at my last appointment, and she just picked and choosed which questions she would answer. That is not satisfactory to me...would anyone else feel that way, too? I'd at least liked to have been told "I don't know" instead of just not getting any sort of answer... She didn't answer the questions I posted, along with whether or not I would be able to get mercury-free Rhogam.[/QUOTE]

Your midwife probably didn't know the answers to the questions she ignored... did she take a copy of the list with her? If so give her a call and ask if she'd had time to find the info you needed. If she didn't, call or email her and repeat the questions to her, letting her know that you hope she can find that information for her. This lets her know you see her as a resource, and that you don't expect her to know everything about everything. Also, these questions you're asking are probably pretty uncommon ones, many people do not even ask. I personally think she should have answered with an "I'll get back to you on that one"... I also think that you should feel comfortable enough with her to let her know what you need from her. If you don't feel 100% comfortable with someone at a prenatal appt, that is NOT going to change when you're in labor which is when you really need someone you fully trust and feel safe with. You need that rapport! I'm not saying that she doesn't deserve a chance to develop that with you; but it is something to be aware of. At the next meeting, put at the top of your list your concern that she is ignoring your questions and you don't know if it is because she thinks they aren't important, or because she needs time to get more info. And maybe read the list to her, rather than giving it to her to read, so that she can't avoid any questions.

HTH!!

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#27 of 64 Old 11-17-2005, 10:32 AM
 
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Quote:
Originally Posted by reader
One more thing... if you decide to get the shot(s), triple check to make sure they are giving you the thimerosal-free version. Don't just take their word for it, ask them to open the box in front of you and hand you the package insert before it's administered.
All versions in the US are thimerosal-free now, as the expiration date on the last lots manufactured with it has passed. Not sure what the rules are in other countries, but here, it's okay.
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#28 of 64 Old 11-17-2005, 10:43 AM
 
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Quote:
Originally Posted by Pariah
I've got two questions that my midwife didn't answer...if anyone here know some answers, please share your knowledge with me!

-- I spotted at 9 weeks, and was given Rhogam in the ER. Would this be a reason for me to get Rhogam at 28 weeks, or am I sufficiently protected from the dose I got at 9 weeks?

-- Blood mixing and becoming sensitized would only happen if a traumatic event occurred, right? Car accident, bleeding, some sort of injury... So would it be logical to skip the 28 week Rhogam and only get it if I happen to be in some sort of situation like that?

We're currently waiting to see if my husband is Rh-, but we're pretty sure he's +. My midwife wants me to come in this week to get a blood test...if I decide not to get the 28 week Rhogam, is the blood test necessary?

I'm upset...I had a list of questions typed out that I gave to my midwife at my last appointment, and she just picked and choosed which questions she would answer. That is not satisfactory to me...would anyone else feel that way, too? I'd at least liked to have been told "I don't know" instead of just not getting any sort of answer... She didn't answer the questions I posted, along with whether or not I would be able to get mercury-free Rhogam.
I think others have given good advice here. If I were you I absolutely would get it due to the earlier bleeding- I had that as well, and got the shot, and will be getting it at 28 weeks as well. My midwives strongly suggest it (who are not at all pro-intervention, etc.), and since I know I will want another child, I am NOT going to play around with the risk of giving him/her hemolytic disease, which is a big deal. People seem to forget that and how awful it was when it somewhat routinely happened.

No Rhogam in the US has mercury in it anymore, and hasn't for about three years. You don't need to worry about that part. My midwives didn't know that either, and that REALLY irritated me. I was just lucky- they were like, "oh, I don't know why it would have had mercury", when it used to have quite a bit! And at 7 weeks pregnant, I think that would have been an unacceptable risk.

The idea of "changing" your blood type by diet is total bunk. Please don't put your kids at risk by considering this.

I think because you had bleeding, it puts you in a risk catagory where you can feel pretty comfortable getting the 28 week shot. I understand people who are very low-risk not getting it, but on the other hand, every labor is different, and I disagree that blood mixing is caused only by "invasive" non-natural things like picotin, massage, etc. I think the natural rigors of labor, in someone who is having a really hard time, can cause it too, and you never know if you're going to end up having some sort of an intervention due to an emergency. I just think, for myself, the risk of having complications due to Rh incompatibility way outweigh any theoretical risks of the shot. It's important to have full information about those, too.
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#29 of 64 Old 11-17-2005, 05:51 PM
 
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I don't really understand why early spotting which is often just a normal part of pg would be considered reason to get Rhogam either at that time or at 28 weeks. I did have a small amount of spotting with both my third and fourth pgs and no one suggested I get Rhogam. We don't do the shot until later because as rare as prenatal sensitization is it occurs more frequently later in pregnancy when the fetus has a sufficient blood supply to even cause a sensitization.
Quote:
-- I spotted at 9 weeks, and was given Rhogam in the ER. Would this be a reason for me to get Rhogam at 28 weeks, or am I sufficiently protected from the dose I got at 9 weeks?

-- Blood mixing and becoming sensitized would only happen if a traumatic event occurred, right? Car accident, bleeding, some sort of injury... So would it be logical to skip the 28 week Rhogam and only get it if I happen to be in some sort of situation like that?

We're currently waiting to see if my husband is Rh-, but we're pretty sure he's +. My midwife wants me to come in this week to get a blood test...if I decide not to get the 28 week Rhogam, is the blood test necessary?
Well your protection from the 9 week shot ends at 21 weeks so there's a gap there anyway and I doubt anyone is going to suggest that you need a shot at 21 weeks to tide you over. The whole timing is just because 28 weeks plus 12 weeks gets you to 40 weeks when you will theoretically deliver and yet no one insists that people get another shot if they go past their EDD. Most countries do not do the prenatal shot and doing so here did cause health problems. Just something to consider why the US considers it necessary while other countries don't (hint pharmaceutical companies like to make money). All that said I think that theoretically if you had been exposed to mixing at 9 weeks the shot should have combated it. You would not be protected if you were to have a new exposure but I don't believe the blood from 9 weeks is still hanging around in you waiting for your shot to wear off. So I believe that threat has basically been dealt with and you are not currently at any higher risk without a trauma of some sort. If you decide you are absolutely not getting the shot then there's no need for a blood test. For that matter if you have the blood test and they find that you are sensitized then Rhogam can't help at that point so I don't know that it does matter in your decision as far as whether you get the shot or not. Also someone else was asking about the timing and there seemed to be a bit of confusion over the duration of the protection the shot gives and the timing of the shot. The US gives everyone a shot around 28 weeks however that will only protect you if you have not been exposed yet or have only been exposed in the last couple of days. If you have an exposure between 2 and 27 weeks that has no outward sign then getting that shot at 28 weeks is not going to do anything for you.

With my first two I had the prenatal shot. With my first I knew the father was negative so I was quite annoyed that they insisted I get it. No postnatal shot since the baby was of course negative. With my second we didn't know now-DH's bloodtype so I had the prenatal shot and then a postnatal shot when she was positive. I also had a shot after an extremely early m/c which was almost definitely totally unnecessary since I don't think the baby even had its own blood type then. I didn't even know Rhogam was a blood product until partway through my third pregnancy. So much for informed consent! I can't remember if I'd already had my prenatal shot by then or not but I did get it and then a postnatal shot when DD#1 was positive. The 4th time around though I did my research. After discovering that my risk of prenatal sensitization was less than 2% even if I was in a trauma I decided there was absolutely no reason for me to get myself injected with all these chemicals and expose my baby for an extremely low risk of problems. Besides that I know there is research indicating that most prenatal sensitizations are so low that you would need 12 incidences before the 13th baby had a problem. Most of us don't have 13 babies so not a huge issue for us. And if my risk is 2% over my entire pg what are the odds that my microbleed would play nice and only occur within 27w3d and 28 w? I know all Rhogam is now mercury-free (which my midwives did not know! When I first started asking they said they'd have to find out if they could even get the mercury free version) and that was a huge concern of mine due to the high correlation of autism with Rh- moms but even without it it just wasn't something I wanted my baby exposed to for no reason. My midwife felt I was very informed and was comfortable with my decision. We agreed that if I were to be in a car accident or a serious trauma and experienced late term vaginal bleeding without a cause that I would get the shot. That never happened so I didn't get the prenatal. DD#2 was positive again and so I did get the postnatal shot. I'm not entirely sure that it's necessary and I lean towards the idea that it's not. However I'm more willing to take a risk with myself to give (theoretically) protection to any future babies I might have. So far my blood tests have always indicated I do not have sensitization. So anyway there's my $20 on the subject. :LOL This link had a lot of good info as well and there's a book out there that goes even further. Good luck deciding.

http://www.*********/a/rhogam.html
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#30 of 64 Old 11-17-2005, 07:37 PM
 
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Lucky me! My DH is A- ( I'm O-) sooo as far as Rh goes --- no worries about ever having a + child!
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