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#1 of 32 Old 01-17-2008, 01:27 AM - Thread Starter
 
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Hello,
I want more than anything to have a natural homebirth or at the very least a birth center birth but I don't know if it's possible. I am rh negative and terminated a pregnancy five years ago that could have possibly sensitized me. I was given a shot of rhogam then and given a little card with the doctor's signature. I'm still not sure whether my husband is neg. or pos. though. He's getting tested soon. If he is positive will any midwife take me as a client or am I doomed to hospital birth? I wish the risks had been explained more in depth to me five years ago, but I guess it was assumed that everyone gives birth in hospitals anyway. It was treated as a matter of course. Thanks for any help you can give.
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#2 of 32 Old 01-17-2008, 01:32 AM
 
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I am Rh- and DH is Rh+ and I have had 3 homebirths. I didn't get Rhogam during my last 3 pregnancies but I did get it afterwards. There are tons of threads here about Rh sensitivity and Rhogam so definitely do a search. This certainly isn't something that should keep you from homebirth. It was never a concern of my Midwife's. Exactly what risk are you worried about? I think the more you look into the less worried you will be.
I have had 5 children. My first two are Rh-, second two are Rh+ and we don't know #5.

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#3 of 32 Old 01-17-2008, 02:17 AM
 
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could have possibly sensitized me
A simple antibody screen that is routinely included in prenatal lab work will tell you for sure.

If you were given Rhogam you shouldn't be sensitized. What makes you think you are? Simply being Rh- is not a contraindication for homebirth regardless of your husband's blood type.
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#4 of 32 Old 01-17-2008, 02:25 AM - Thread Starter
 
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I guess I'm worried that because of the abortion I could have been sensitized. I read on another forum posted by a nurse that I would be considered high risk and would have to be closely monitored. She even said that not just one but several amniocentises would need to be taken (which makes less sense if I truly had been sensitized as any invasive procedure would heighten the risks to the baby) to ensure the pregnancy was proceeding normally.
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#5 of 32 Old 01-17-2008, 02:33 AM
 
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I guess I'm worried that because of the abortion I could have been sensitized. I read on another forum posted by a nurse that I would be considered high risk and would have to be closely monitored. She even said that not just one but several amniocentises would need to be taken (which makes less sense if I truly had been sensitized as any invasive procedure would heighten the risks to the baby) to ensure the pregnancy was proceeding normally.
L&D nurse hat on here:

This is total crap. The risk of sensitization from a first-trimester loss or abortion is theoretical, because the fetus' entire blood supply is probably not enough volume to cause sensitization. And you got RhoGam, which brings an already remote risk to infinitesimal.

And you got your antibody screen with your prenatals, right? If it's negative (which I assume it is, since isoimmunized pregnancies are generally out of the midwifery scope of care), then that's fine.

I've had five pregnancies, all prophylaxed, and though I've managed to collect pretty much every other complication in the world, am not Rh sensitized. I would not worry about Rh after one early termination for which you got RhoGam. I'd sooner worry about a meteor hitting the earth in the exact spot my house is located in while I'm in labor.

Never listen to that woman again.

mama to Max (2/02) and Sophie (10/06); wife to my fabulous girl
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#6 of 32 Old 01-17-2008, 03:09 AM
 
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Never listen to that woman again.
:

I'm O-, partner is A+, I've had one known early miscarriage, and I absofreakinglutely had a homebirth, no problem. Baby is A+ also (we got him tested because I didn't want a shot unless necessary), so I opted to get Rhogam after birth, but that's it. Sensitization is a simple test, anyway, even if you are worried. But even with a BIRTH of a full term rh+ baby, you are not guaranteed to become sensitized. I'm wracking my brain, but I seem to remember the number is only around 16% sensitization with no prevention whatsoever. So yea. Bunk. No reason to be worried.
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#7 of 32 Old 01-17-2008, 04:29 AM - Thread Starter
 
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Well, I'm not pregnant yet, just planning and researching. Thanks for your help. I feel worlds better. I'm going to sign myself up for some blood screenings soon. It's good to know there are other skeptics out there- if I could only convince my husband... Thanks again.
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#8 of 32 Old 01-17-2008, 11:25 AM
 
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I've never heard of a midwife risking a woman out just for being rh negative.

Laura, CBE and mom to Maddiewaterbirth.jpg ( 06/03/04) & Graceuc.jpg (  09/10/06)
 
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#9 of 32 Old 01-17-2008, 11:55 AM
 
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I'm not a skeptic, I just don't think you or your husband are well informed about this. Managing Rh- is not a big deal.
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#10 of 32 Old 01-17-2008, 12:18 PM
 
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Totally off topic....

Where in WV are you? I'm in the Eastern Panhandle and don't see many WV moms around here.

Karen - Mama to Haven (9/00) , Lillie & Faith (MZ - 12/02) and my first homebirthed baby, Willa (3/08)
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#11 of 32 Old 01-17-2008, 02:57 PM - Thread Starter
 
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Southwestern part, Huntington.
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#12 of 32 Old 01-17-2008, 03:01 PM - Thread Starter
 
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Did you find your midwife in WV? I found a website for a midwife organization in WV but it hadn't been updated in several years and appears to be abandoned. When I do a yellow pages search only one listing pops up in the whole state.
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#13 of 32 Old 01-17-2008, 03:24 PM
 
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Hello,
I want more than anything to have a natural homebirth or at the very least a birth center birth but I don't know if it's possible. I am rh negative and terminated a pregnancy five years ago that could have possibly sensitized me. I was given a shot of rhogam then and given a little card with the doctor's signature. I'm still not sure whether my husband is neg. or pos. though. He's getting tested soon. If he is positive will any midwife take me as a client or am I doomed to hospital birth? I wish the risks had been explained more in depth to me five years ago, but I guess it was assumed that everyone gives birth in hospitals anyway. It was treated as a matter of course. Thanks for any help you can give.
My homebirth midwife carries Rhogam when needed. You will just have to ask around. Don't know where you are in WV but I do know a midwife over the border into PA that can do this for you if you PM me. You would have to go to her birth center (top floor of her house) since she doesn't travel to WV. Depending on where you live I might also know a MD midwife who can help you.
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#14 of 32 Old 01-17-2008, 11:21 PM
 
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i am differing a little bit from the general opinion here, it can be a very serious issue. i think the main thing is how many kiddos do you want to have.

my mom is rh-, my dad rh+, and she started having babies before rhogam was discovered, and so never had it. she had 5 live babies and 2 miscarraiges, and she had LOTS of problems. The first two were normal pregnancies, normal deliveries, no problems. The last three were all high crisis, major problems, almost lost. oh all 5 of us are rh+, she probably wouldn't have had so many issues if a couple of us had been rh-. (this is really weird for me to be typing from an objective kind of view, but i'll try)

baby #3 -was born a month premature, was born totally blue, and not breathing. he was resuscitated, but had suffered brain damage due to hypoxia.

baby #4 was born full-term, but also had major hypoxia issues, was incredibly small -weighed in grams and according to my mom "fit into a shoe box". she was rushed to a specialty hospital nicu where she spent the first several months of her life.

baby #5 (me) -in the 7th month of her pregnancy my mom began to hemmorrage uncontrollably and she was hospitalized for an entire month before they took me via c-section as soon as they thought my lungs were developed. her bleeding was so severe that at first they would let her walk to the bathroom in her room and then she started hemmorraging just with those few steps. i had to undergo a complete blood transfusion and was anemic although otherwise healthy.

sooooo, *i* don't think that where you birth is all that critical, if you have received rhogam so that your births/pregnancies will stay low risk. i have read that you should receive rhogam within 72 hrs after birth, so you could possibly even go to your ob and receive it after you give birth at home... just another other option that might work. (and of course you'd only need it if you gave birth to an rh+ baby)

also, they used to make rhogam with mercury in it, so i'd make sure that the ones you get don't have it, and i would also decline any that they'd want to give you while you are pregnant -again just my opinion.

good luck!!!
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#15 of 32 Old 01-17-2008, 11:24 PM
 
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This is total crap. The risk of sensitization from a first-trimester loss or abortion is theoretical, because the fetus' entire blood supply is probably not enough volume to cause sensitization. And you got RhoGam, which brings an already remote risk to infinitesimal.
i totally agree with this!!! receiving rhogam reduces your chances of being sensitized to 1-2 %.
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#16 of 32 Old 01-18-2008, 12:27 AM
 
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blue_bug, you're right that it can be a serious issue if you don't have access to Rhogam (as it was tragically for your mother). But with the advent of Rhogam and antibody titers, being Rh- in this day and age is not a big deal, and there's no reason for the OP to think she has been sensitized or can't be protected from being sensitized in the future.

Mercury was taken out of all brands of Rhogam in the U.S. years ago.
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#17 of 32 Old 01-18-2008, 12:31 AM
 
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I would not worry about Rh after one early termination for which you got RhoGam. I'd sooner worry about a meteor hitting the earth in the exact spot my house is located in while I'm in labor.

Never listen to that woman again.
ITA. I'm rh- and had two miscarriages before having dd- one requiring a D&C. I had rhogam both times and during pregnancy (which I wouldn't do again) and after giving birth. it's not a problem!

DD1 7/13/05 DD2 9/20/10
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#18 of 32 Old 01-18-2008, 09:50 PM
 
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blue_bug, you're right that it can be a serious issue if you don't have access to Rhogam (as it was tragically for your mother). But with the advent of Rhogam and antibody titers, being Rh- in this day and age is not a big deal, and there's no reason for the OP to think she has been sensitized or can't be protected from being sensitized in the future.
that's EXACTLY the point i was making.

sooooo, *i* don't think that where you birth is all that critical, if you have received rhogam so that your births/pregnancies will stay low risk. i have read that you should receive rhogam within 72 hrs after birth, so you could possibly even go to your ob and receive it after you give birth at home... just another other option that might work. (and of course you'd only need it if you gave birth to an rh+ baby)
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#19 of 32 Old 01-18-2008, 10:15 PM
 
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I'm Rh- and planning my first homebirth. I'm happy to say that my midwife carries and can use rhogam, and does blood typing right there after the birth to find out whether we need to do the injection or not. Makes me happy to know I won't need to hike to a hospital just for an injection! My first two babies have been Rh+. I did prenatal rhogam for both of them, but declined it for this 3rd pregnancy. My midwife didn't even blink an eye. All of that combined with the information I've found through threads here on MDC, I'm not worried about it at all, and they're definitely not treating me as a risky pregnancy.

SAHM to Melinda (Oct '03), Jacob (Aug '05),  Alex (Apr '08), and baby.gif Malcolm (Sept 29, '11)

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#20 of 32 Old 01-18-2008, 10:28 PM
 
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My grandmother is Rh- and had 3 Rh+ babies in teh 50's. My dad was her first, and he was a big healthy 22" 9lber. She was EXTREMELY sick with her 2nd and 3rd pregnancies (nausea and vomitting the whole time, was told it was b/c of the Rh incompatibility) and they were not so big and healthy when they were born, but they are fine as adults now.
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#21 of 32 Old 01-19-2008, 01:10 AM
 
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I did prenatal rhogam for both of them, but declined it for this 3rd pregnancy.
I'm positive and our donor is negative. Why would I refuse a rhogam during pregnancy? My midwife thought we'd wait until after the birth, but I thought it'd be a good idea to get the shot while pregnant. Admittedly, I haven't researched this very well yet (she was nonchalant about it and it doesn't seem like much of a problem when you know your status) but can some one start to fill me in?

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#22 of 32 Old 01-19-2008, 01:25 AM
 
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I'm positive and our donor is negative. Why would I refuse a rhogam during pregnancy? My midwife thought we'd wait until after the birth, but I thought it'd be a good idea to get the shot while pregnant. Admittedly, I haven't researched this very well yet (she was nonchalant about it and it doesn't seem like much of a problem when you know your status) but can some one start to fill me in?
If you're Rh positive, you don't need RhoGam at all -- did you mean you're negative and the donor is positive?

Some people decline the antepartum RhoGam because the rate of sensitization during pregnancy (in the absence of a bleed, like an abruption, an MVA, an amnio, etc.) is very low, and as a blood product, RhoGam is not without risk. However, it's possible to have a silent bleed and become sensitized. I chose antepartum RhoGam with both pregnancies that made it to 28 weeks and would choose it again.

mama to Max (2/02) and Sophie (10/06); wife to my fabulous girl
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#23 of 32 Old 01-19-2008, 01:25 AM
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If you are rh+, you don't need rhogam. Rhesus factor is either present or absent. If you are rh+, it's present, and your immune system will not target blood cells that have it. If you are rh-, your immune system will attack rh+ blood cells. rh+ immune systems don't attack rh- blood cells because the immune system goes after foreign cells, not the absence of foreign cells.

Your children won't need rhogam at birth, even if rh-, unless you develop a major hemorrhage.
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#24 of 32 Old 01-19-2008, 01:30 AM
 
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If you are rh+, you don't need rhogam. Rhesus factor is either present or absent. If you are rh+, it's present, and your immune system will not target blood cells that have it. If you are rh-, your immune system will attack rh+ blood cells. rh+ immune systems don't attack rh- blood cells because the immune system goes after foreign cells, not the absence of foreign cells.

Your children won't need rhogam at birth, even if rh-, unless you develop a major hemorrhage.
Babies are NEVER given RhoGam, whether or not they are discordant with mom or whether or not she bleeds.

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#25 of 32 Old 01-19-2008, 02:46 AM
 
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If you are positive, you have no worries. If you are negative, you don't necessarily have any worries either.

Being negative is NOT a problem at all! If you are negative and have a positive baby AND have become sensitized, THEN you have a problem and may end up with all the interventions you mentioned. But rogahm can prevent that.

Rh- by it self is not a problem. And sensitivity will be determined with lab work every easily. I would not think that you could possibly have any problems at this time with that.

Any misspellings or grammatical errors in the above statement are intentional;
they are placed there for the amusement of those who like to point them out.
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#26 of 32 Old 01-19-2008, 06:06 PM
 
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Why would I refuse a rhogam during pregnancy? My midwife thought we'd wait until after the birth, but I thought it'd be a good idea to get the shot while pregnant. Admittedly, I haven't researched this very well yet (she was nonchalant about it and it doesn't seem like much of a problem when you know your status) but can some one start to fill me in?
Here's an article discussing the prenatal use of rhogam (it refers to rhogam as Anti-D, which is the European name for it, I believe).
http://www.withwoman.co.uk/contents/info/anantid.html

I've also seen this book recommended, but I haven't read it myself:
http://www.amazon.com/gp/product/075...books&v=glance

Here's a collection of articles, discussions, quotes, etc. about prenatal Rhogam:
http://www.gentlebirth.org/archives/...re.html#RhoGAM

SAHM to Melinda (Oct '03), Jacob (Aug '05),  Alex (Apr '08), and baby.gif Malcolm (Sept 29, '11)

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#27 of 32 Old 01-19-2008, 07:28 PM
 
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If you're Rh positive, you don't need RhoGam at all -- did you mean you're negative and the donor is positive?
oops. sorry. yes. he's b+ and i'm o-.

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#28 of 32 Old 01-19-2008, 07:36 PM
 
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oops. sorry. yes. he's b+ and i'm o-.
I am - with a + male and refused rhogam until after pregnancy. Since Rhogam is only useful w/i 72 hours of exposure, the random times it is usually given during pregnancy doesn't necessarily help anything. Plus, without any complication, there is small risk of blood mixing. Of course, there is also the risk of any foreign substance entering your body and your fetus' body.
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#29 of 32 Old 01-19-2008, 08:29 PM
 
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I am - with a + male and refused rhogam until after pregnancy. Since Rhogam is only useful w/i 72 hours of exposure, the random times it is usually given during pregnancy doesn't necessarily help anything. Plus, without any complication, there is small risk of blood mixing. Of course, there is also the risk of any foreign substance entering your body and your fetus' body.
The reason it's given at 28 weeks is that it lasts approx 12 weeks, or until term, and the risk of fetomaternal bleed of sufficient size to cause isoimmunization is most significant in the third trimester.

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#30 of 32 Old 01-19-2008, 08:45 PM
 
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Another Rh- homebirth mama here! . . . It was no problem. I even had the 28 week Rhogham (because of an early bleeding incident & Rhogham) and it was administered in my HB midwife's kitchen.
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