how do you feel about rogham? - Mothering Forums

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Old 08-20-2007, 06:13 PM - Thread Starter
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i had the whole thing w/ my last pregnancy as it was all in hospitals etc.

this time i am visiting an OB and planning a UC mostly because of past experience w/ CPS. i'd like things to look as normal and not suspicious as possible in case of any questions. this is a REALLY big risk for me but i think it's worth it.

anyhow, my OB (the only one in town who takes Medicaid) who is usually reasonably cool is FREAKING that i haven't had a rogham shot at 34 weeks. i said i'd go in Thursday. haven't heard of any really ill effects from getting them but how do you feel about them? what's been your experience?
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Old 08-20-2007, 06:58 PM
 
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I've been researching Rhogham in recent months and here are two sites that have been helpful to me:

http://nccn.net/%7Ewwithin/rhogam.htm

http://www.unhinderedliving.com/rhogam.html

In my opinion, it is not safe to receive the Rhogham shot during pregnancy. If it must be had it would be better to receive it after pregnancy - in my opinion.

Good luck to you whatever you decide!

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Old 08-20-2007, 07:28 PM
 
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Originally Posted by thebarkingbird View Post
anyhow, my OB (the only one in town who takes Medicaid) who is usually reasonably cool is FREAKING that i haven't had a rogham shot at 34 weeks. i said i'd go in Thursday. haven't heard of any really ill effects from getting them but how do you feel about them? what's been your experience?
is your ob freaking just b/c of you not getting it at 28 weeks (which is standard), or b/c something else has happened to raise your risk of isoimmunisation? (a fall, accident, etc). If its just b/c you are 34 weeks that seems to be pretty unreasonable. They give it to you again after birth anyhow, so I decided to skip the initial one (got the thumbs up from the mw last time to do it this way too). It is a vaccine of sorts, a blood product, so it certainly carries its risks and I have had trouble finding out exactly what is in them in terms of preservatives and other chemicals. I read the package insert once, but had trouble translating all of the scientific terms. I got it with my first twice (hospital birth) and she ended up having my same blood type....so I didn't do it at all with my 2nd (UC) and she did end up having positive blood....BUT I got my titers checked early in this pgcy and found I had no isoimmunisation against positive blood, so all is well. Generally it should go this way, but rarely, very rarely for mysterious reasons, there is blood mixing....more often it mixes BECAUSE of interventions (aggresive extraction of the placenta, etc). In any case, the risks to future babies should I ever become isoimmunised against positive blood are serious enough for me to get an eldon card, type the cord blood at birth and go get a shot after the birth if the baby has positive blood again.

hth.
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Old 08-20-2007, 07:32 PM
 
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Well, to state the obvious, it's a human blood product with all the risk that entails.

There is no chance of it benefiting you *unless* something causes a bleed where your and your baby's bloods mix *and* your baby is rh+. They can find out your baby's rh status before birth through CVS and amniocentisis *but* both procedures carry a risk of mixing mother and baby's blood. If I were rh- with an rh+ partner I still wouldn't do prenatal rhogam and would plan my birth as to minimize chances of bloods mingling.

That being said I think every rh- woman should investigate rh sensitization rates of women not getting the biological and those for women receiving the biological (especially the *nature* of their care received), what causes mixing of the blood, and then the risks associated with the shots. You know how they always say post-partum rhogam is only helpful to future babies? Well that's only true if the current baby is rh+ *and* your bloods mixed during birth *and* the future baby is rh+ *and* your blood mix *during* that pregnancy.

~BV

Edited to add:
I didn't realize this was on the UC board. I'd definitely decline prenatal rhogam. You won't be having cytotec or Pitocin in your labor, there will be no fundal pressure, forceps, episiotomy during the birth, and you're not crazy enough to do cord traction or manually remove your own placenta! If you are concerned about mixing blood at birth and getting Rhogam post-partum, get an Eldon card and test the cord blood. If the baby's rh- you're free and clear and if not you can then decide whether to go in for a Rhogam shot.
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Old 08-20-2007, 07:47 PM
 
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I had it w/ my 1st (hospital baby). I didn't w/ my UC baby and wouldn't in the future.

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Old 08-20-2007, 07:52 PM
 
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Quote:
Originally Posted by bryonyvaughn View Post
You know how they always say post-partum rhogam is only helpful to future babies? Well that's only true if the current baby is rh+ *and* your bloods mixed during birth *and* the future baby is rh+ *and* your blood mix *during* that pregnancy.

~BV
I've read up a lot on it. You could, on rare occasion get isoimmunised during pgcy or birth (birth being more likely) if you are rh- and the baby you are carrying is rh+. This could affect all future babies in utero that are also rh+ (mom's antibodies against rh+ blood would possibly attack the fetus, but then again, it wouldn't necessarily cause a serious problem). Your blood doesn't have to mix with the 2nd rh+ baby...but if it did, you would just have more antibodies, and that wouldn't be good. In bad cases the baby could become severely anemic and need a blood transfusion after birth. Afaik, once you develop antibodies, you can't reverse it, so the goal would be to avoid this happening. UC is the best way to go for this!

*edited to fix typo
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Old 08-20-2007, 08:10 PM
 
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For me personally, I am really happy that I am rh+ and don't have to make the decision about whether or not to get rhogam...

Non Practicing Midwife, going back to school! Mamma to my 3 loves, living each day to the fullest.
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Old 08-20-2007, 08:12 PM
 
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Well, to state the obvious, it's a human blood product with all the risk that entails.
Bingo! Ask your doctor why he is freaking out about giving you something without discussing all of the risks before? Rhogam can contain mercury; the reserve stocks were not recalled, so if you do get the shot read the ingredients.

Do you have a Duffy factor in your blood? Is your DH Rh- also?

The shot during pregnancy is for your next baby, not this one. You can wait until after delivery, test the cord sample, and wait for the results, getting the shot within 72 hours. That is what I am suggesting.

"The great enemy of the truth is very often not the lie, deliberate, contrived and dishonest, but the myth, persistent, persuasive and unrealistic."
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Old 08-20-2007, 09:22 PM - Thread Starter
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thanks. this is all good advice. i guess i didn't think about researching this until today. i'm new to actually doing self care and taking more responsibly for my and my family's health. it's exciting but it's starting to feel a bit overwhelming! sure am glad i found this place. i've looked at some of the linked info and am finding it informative.
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Old 08-20-2007, 09:33 PM
 
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Rhogam (the brand name, most common one used in US) is now completely preservative-free. Of course you can check the actual label to be sure you don't have an old lot, but since these things expire fairly quickly you shouldn't have to worry about preservatives now.
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Old 08-20-2007, 09:42 PM
 
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Originally Posted by rixafreeze View Post
Rhogam (the brand name, most common one used in US) is now completely preservative-free. Of course you can check the actual label to be sure you don't have an old lot, but since these things expire fairly quickly you shouldn't have to worry about preservatives now.
That's great to know! Thanks Rixa.
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Old 08-20-2007, 10:10 PM
 
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I always decline during pregnancy. Last I checked (4 yr ago) it still had thimerosol in it too. After baby #1, I didn't need it anyway. After baby #2, I needed it and decided it was worth the risk after the birth. After these babies (#3 + 4), I didn't want to poke them after birth to determine if I needed it or not. If I do want more children, I'll just have my antibodies checked if need be. Their birth was complication-free, so even if one is rh+, it's probably not a problem.

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Old 08-21-2007, 02:13 AM
 
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my OB... who is usually reasonably cool is FREAKING that i haven't had a rogham shot ...
Is he upset because you have had your titres drawn and they are up? Is there a specific reason why he is upset?
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Old 08-21-2007, 02:52 AM - Thread Starter
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well, i was seeing midwives first and then they refused to see me anymore because in this state past psych illness contradicts out of hospital birth. apparantly the board is pressing down on them.

then i was seeing a "high risk" ob because he was their backup and though i wasn't high risk he was ,ironically the least invasive ob in town. then he moved!!

now w/ doc #2 and she says she can't find all the labs that i gave her copies of! she's a neat doc but her office staff seems a little flaky. she had me do a SECOND GD screen today too even though i told her i'd already had one and remembered exactly what my blood sugar was.

mostly i think she's one of those people who will participate in a fairly non invasive delivery but you gotta jump through hoops for it.

i wish wish wish it was an option for me to just finish out w/o any more ob care. basically she wants her own labs done. my blood work all looked fine and the new doc hasn't done any. i think she's just frustrated that i'm not all concerned about this and takes that as a sign of ambivilance about self care.
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Old 08-21-2007, 02:55 AM - Thread Starter
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she didn't "make me" just strongly suggested it and honestly, i'd rather not fight it as i know i likely won't be going to her for the actual birth. as obs go she's pretty cool just not like the last guy who was a perfect fit and would likely not have raised an eyewbrow if i;d called to say we just ended up not making it the hospital.
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Old 08-21-2007, 02:55 AM
 
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IMO it's not safe to get *any shot* during pregnancy. The only way I'd get anything was if I really really needed one to stop PTL or something. Otherwise, no.
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Old 08-21-2007, 04:16 AM
 
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I'm RH+, so I can't comment from personal experience. But my mother had four UCs and is A- blood type. She went to an OB for her first pregnancy and they checked her blood type. They told her that though she was A-, she had a special "subtype" or something that meant she didn't need Rhogam. She didn't know what this meant, but never had any problems, even though three of her four children are RH+. I wonder if you could find information about this somewhere?
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Old 08-21-2007, 12:07 PM
 
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They told her that though she was A-, she had a special "subtype" or something that meant she didn't need Rhogam. ...
That is the Duffy factor or DU.

I have that. It is an acquired, inherited compensation for the Rh factor.

There are several ways to type blood, not just Rh. There are A, B, O, AB and many other types as N, M, and many others.

There are incompatibility factors that occur with A, B, AB, and O which are rare, but when the incompatibility happens, it is devastating, and yet, doctors do not seem to be too concerned about these.

"The great enemy of the truth is very often not the lie, deliberate, contrived and dishonest, but the myth, persistent, persuasive and unrealistic."
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Old 08-21-2007, 04:46 PM
 
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Many UCers will remember that in 2005, Jeanine Parvati Baker, a notable UCer, writer and teacher, died due to Hep.C that was contracted from a rhogam injection after her first birth (and only hospital birth). I don't know much about the current risks, but her fatal illness stands out because of all she did for UC. If it were me, I would wait till after the birth to see if I felt like I needed the shot.
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