Is Rhogam still risky or is it now safe? - Page 2 - Mothering Forums
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#31 of 38 Old 09-10-2008, 01:48 PM
 
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hank you for all the replies, they've been very helpful.

I recognize there is a small risk in not taking the prenatal rhogam, but I think I've decided to wait for the postpartum dose. I'm already 30 weeks so I think it's too late to look into the prenatal testing for the baby's blood type...i should have had the shot already.

I'm thinking if I give the prenatal shot, I am definitely putting this baby at risk (that risk might be small, but I am still accepting to put something into my body that could negatively affect this baby).

If I don't take the prenatal rhogam, this baby won't be at risk at all. Future pregnancies might not be at risk at all (if this baby is negative), or there is a 2% chance that future children would be affected. We would like to have 1-2 more children after this one, but there is no guarantee we will get pregnant again. So I feel like we'd be putting the baby that we do have at risk for future babies that we are not guaranteed to have.

this has been such a hard decision, and I'm still not 100% sure....sometimes i think i am just overreacting by questioning a decision that is considered safe and is part of standard medical procedure. My mom is a nurse and I haven't even told her that we refused the prenatal rhogam (and I don't plan to tell her) because I think she would view us as being foolish and I don't really have any studies to cite that rhogam could be harmful.

I really wish I was just positive myself and didn't have to worry about this!!
Sounds like you've made the decision, difficult as it may be, that sits right for you...and I know what you mean about wishing you were positive...I wished that too after what we went through and I also wished DH was heterozygous for D (i.e. that we had a chance of a baby who would not be affected by my antibodies) but that was out too...

best of luck to you...((HUGS))

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i gave the dr. an earful the next day. i waited until almost 48hrs post labour to get my winrho shot.

i said that not only did i not appreciate the attitude given that i had a preemie, but that my midwives supported my decision not to receive the winrho shot before giving birth, and that as primary health providers in ontario, that that doctor was in effect questioning the care of my midwives.

i then asked why it was that the doctors there couldn't tell me why my son was born premature (no medical reason) but that i should be questioned about not taking winrho at 28wks. then i angrily said, because you seem to have all the answers...never saw that dr again, and thankfully the rest of the staff were professional. yeah, don't mess with a woman who speaks her mind especially after a difficult birth!
Yeah! You go, girl!

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#32 of 38 Old 09-10-2008, 08:59 PM
 
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Originally Posted by whalemilk View Post
The main consequences for me were:

1. No more homebirth. At first we were going to comanage with a perinatologist, but insurance won't cover both so I switched to CNMs in the peris hospital...and then my titers went up (meaning the odds of it affecting the baby went up slightly too) and I got entirely sent to the peris, who are very conservative. This has a lot of ramifications for what kind of birth I'm going to end up having.

Some homebirth midwives will see you even if you're sensitized (depends on the state and the mw's comfort level) but generally speaking if your titers increase, that's a definite risk-out because it often means some blood mixing is occurring again and/or that the fetus is at greater risk of being affected by the antibodies.

...
my midwives didnt even suggest that i should get rhogam prenatally or get antibody tests done unless i felt i should. they would not deny care based on me getting or not getting medical tests done, everything is my choice in my homebirth. maybe not all midwives can or do practice like this but i am choosing not to get the 28 wk shot and i did get a titer check once which showed i am not sensitized but i wont be doing this again during this pregnancy unless it seems i should due to some issue.
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#33 of 38 Old 09-11-2008, 10:14 PM
 
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Originally Posted by arismama! View Post
my midwives didnt even suggest that i should get rhogam prenatally or get antibody tests done unless i felt i should. they would not deny care based on me getting or not getting medical tests done, everything is my choice in my homebirth. maybe not all midwives can or do practice like this but i am choosing not to get the 28 wk shot and i did get a titer check once which showed i am not sensitized but i wont be doing this again during this pregnancy unless it seems i should due to some issue.
i was going to say something similar - i was cleared for a homebirth (was actually my heart condition that was the issue not the rh- status). that was until my footling breech baby decided to show up 6wks early. but they definitely were okay with homebirth and rh- status even though i refused the winrho while pregnant since you have up to 72hrs to take the shot after birth. my husband is rh+ and everyone in his family is so i knew i'd have an rh+ baby.

i refused the shot until after labour not only for my son's health, but i had a history of bad reactions to vaccines as a child (in the early 70s when we didn't get jabbed as much!) and didn't want to risk a reaction at the 28wk mark!

i had my titers checked almost every week from 28wks on. easy-peasy.

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#34 of 38 Old 09-11-2008, 10:16 PM
 
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Originally Posted by japonica View Post


Yeah! You go, girl!
thanks, i must have shook for several minutes after dr. ignoramus walked out the door from the emotion of it all...

mama to callum (april 8,07) and everett (sept 24,09) - blessed to be married to my life's love since '98. novaxnocirc.gif

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#35 of 38 Old 09-12-2008, 11:15 PM
 
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I think you're misunderstanding what whalemilk is saying. She BECAME sensitized, and thus risked out of homebirth. No one is saying you can't have a homebirth and be Rh- that I can see.

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#36 of 38 Old 09-17-2008, 04:35 PM - Thread Starter
 
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Well i had another midwife appointment today and the midwife again tried to convince me to get rhogam. this is the 3rd midwife i've talked to about this (there are 5 midwives in the practice). They've discussed my situation with each other and with the OBs at the practice and i feel like they are all very concerned about getting us to change our minds.
On one hand, I'm tired of discussing this and their insistence makes me wonder if I'm overreacting by refusing the shot. I also feel like if I do end up getting sensitized, I would feel extremely guilty and remorseful for not getting the shot, since we do want more children. Also, there is a good chance we will be living in east africa again when we have another baby and would not have access to all of the medical technology to deal with a sensitized pregnancy.
So I have an appointment to get rhogam tomorrow. i'm still not very comfortable with it but i'm tired of fighting the midwives and i really don't want to be sensitized. I've also stressed over this so much that i don't want to have to think or worry about it anymore.
i hate this - i have very little faith in the american medical institution and it's so hard to know what is the best decision for my baby. of course my key concern is to do what is best for this baby or future babies but i just don't know what the best thing is.

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#37 of 38 Old 09-17-2008, 05:21 PM
 
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What exactly is your concern about getting the Rhogam? The risks of either decision are small, but the risks of getting Rhogam are infinitesimal compared to the risk of sensitization.
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#38 of 38 Old 09-18-2008, 03:41 PM
 
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I'm sorry you're feeling pressured. That's really stressful, and not the way I think midwives should act. For any medical decision, I think care providers should help you get access to as much information as possible, then stand back and respect your decision.

Maybe you can take a while to really think this over. I would try sitting down and actually writing out all the pros and cons. There may not be enough hard evidence to feel secure about your knowledge, but if you know that you have all the available information, at least, you can think things over with a clear mind and make a decision you can be happy with. Then don't let anyone else influence you, unless they provide new information.

Once you've made your decision, there's no point worrying about it, so try to relax. In my first pregnancy, I got three doses of rhogam - the regular two, plus an extra one after my external version. I wasn't as informed as I could have been, but I was doing the best I could with the information I'd been able to find. My baby was just fine (super smart and happy, actually). He was slightly jaundiced (needing no treatment besides sunshine), but that's almost surely from the bruising from a long pushing stage, not from the rhogam.

I'm a lot more informed now than I was then. I'll still probably get the rhogam prenatally. This time I'll look into the Kleihauer-Betke test first, though.
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