[xmasbaby7]

What is your course of action? Just learned yesterday I am neg and DH is pos.

I am still reading about this, but I KNOW we will refuse any Rhogam injections before brith. We may or may not do it after birth if the baby is tested pos.

Since 2001, the FDA forced the manufactuer to pull thermisol(mercury) from it, but it is still creepy to me.

Anyone else found encouraging data to do nothing or little?

 

[BensMom]

With DS I had the 28w shot (full of mercury

) and the post partum shot. I personally feel like the Rhogam and the flu shot that I had during pregnancy, both with Thimersol, contributed to my sons special needs.

That said, I am declining the 28w shot for this pregnancy and will take the post-partum shot if the baby is pos. (DS was pos) I feel better about it now that it is mercury free, but am not convinced of the necessity of the 28w shot.

I do plan to have one more child after this so hopefully this will be my last Rhogam shot.

(Oops, sorry for barging in. Just saw the link from the main page!

: )

 

[Spark]

I'm Rh- and have done a ton of research. Have I got an ear... or eye full for both of you. I just don[t have time to type right now. I'll be back prolly later on. Jenn, thank you for "barging" in. I think we lose out on a lot of good information by not posting to everyone. Glad to hear your POV.

 

[Jeanne_L]

I also am Rh negative, and my partner is positive. From what I've been reading, usually the first pregnancy (which this is for us!) is not a problem. In Ina May's Guide to Childbirth she says that in her practice they do not advise women to accept Rhogam prenatally unless there has been a traumatizing event. She also mentions that only 10% of neg women having pos babies will become sensitized and need the Rhogam within 72 hours after delivery (if they plan to have more kids). Unfortunately, there's no really good way to know if you are in that 10% or not.

Another interesting ('though not terribly surprising) thing from this book is that prenatal Rhogam is fairly controversial in many countries outside the US... but is standard procedure for most Rh neg women here...

:

 

[iris0110]

I am RH-, dh is positive and so is ds. This is my third pregnancy. I have been tested and I am not sensitized as of now. I will not be getting prenatal rhogam unless something really traumatic happens (I am in a wreck, or fall, or have unexplained bleeding, ect). I will get the postnatal rhogam if baby is positive. I do think we would like more children, if we were going to be done after this baby I wouldn't bother. I am thinking about UC though so that may complicate things. Does anyone know how acurate Eldon cards really are for blood typing?

 

[Spark]

Alright, I'm back with some finger typing time!

The decision of how to handle Rh- mamas with Rh+ papas is a challenging one. I really believe that research and listening to your heart is the best solution. Make sure you do your own research, because it's important to take responsibility for your own learning. This is just the most basic and simplified research that I found and managed to hold onto after 4 years has passed since researching it.

First off, learn what RhoGam is -- RhoGam is a human blood product. It's created by sensitizing Rh- senior citizens to Rh+ blood and then harvesting their blood. There are quite a few who ethically object to this because of some rather harsh treatment these typically near or at poverty women are subjected to. Others object because as recently as in the last 5 years the UK's RhoGam supply became tainted with a blood borne disease. Recently we have had pretty safe RhoGam available in the US.

RhoGam was first introduced in the late 1960's almost as a response it would seem to the medicalized birth practices that were strongly entrenched in American life. Before RhoGam a woman could not give birth to more than one or two Rh+ babies. She would suffer miscarriages. Before medicalized birth, however this was not necessarily a problem.

As birth became strongly rooted in the hospital so did medical ideals for handling the 2nd and 3rd stages of labor. These ideals were not supported by lay midwives or historical birthing records. This includes things like clamping or cutting the cord immediately after the birth of the baby (shown to increase the likelihood of blood from the placenta crossing the barrier into the mother's system), tugging or pulling on the cord (similar increase noted), rushed 3rd stage of labor (may result in poor separation of placenta from the uterine wall, thus increasing likelihood of bloods mixing).

At first RhoGam took care of a lot of Rh sensitivity, not all, but a lot. It was given only after Rh- women gave birth. Medical technology rapidly expanded over time, but despite routinely giving RhoGam to Rh- women, Rh sensitivity was still commonly occurring. But, certainly something with the routine medicalized birth was not the culprit, nooooooo noooooo there was a problem with women's bodies becoming sensitized. So, RhoGam has most recently been recommended during the 2nd trimester to prevent possible sensitization. Even with this safety net, women who have received both shots are still being sensitized. RhoGam is not 100% effective.

I'm Rh- and I have a Rh+ partner and two Rh+ children. I am not Rh sensitized. And, I have never received RhoGam. If you asked a RhoGam exec about me, they'd probably say that I'm just very lucky, but I don't think luck has anything to do with this. I think it's more about understanding the risks of sensitization and either catching your own baby or having a care provider who is knowledgeable about proper handling of 2nd/3rd stages in preventing sensitization.
1. My babies cords are never clamped or cut until after the placenta is fully delivered.
2. There is no tugging or pulling or clamping the cord.
3. There is no pressure to deliver the placenta in some set standard of time (my son's placenta took about 45 minutes to appear after his birth & my daughter's placenta took about thirty minutes as I recall).

I should note, I'm talking about normal healthy pregnancy and labor. If I experienced trauma during pregnancy or labor that would indicate the need for RhoGam, I certainly would accept the shot.

And, so, that's what I learned and that's my story. Just information. You need to decide what feels true to your heart and what your situation calls for.

 

[Spark]

Quote:

Originally Posted by iris0110 Does anyone know how acurate Eldon cards really are for blood typing?

If you wanted to only get RhoGam for positive, don't rely on the Eldon. It's not accurate enough for that.

You can do a search in Homebirth or in Midwives and Doulas for Eldon and see some pretty strong statistics. If you're really committed to taking RhoGam, only for a Rh+ baby, you'd need to do a proper blood test.

 

[bri276]

I'm RH- and pretty sure DH is + (just based on his ethnic background). I had two previous miscarriages, so this wasn't my first pregnancy, plus I had unexplained bleeding at 14 wks. I chose to get the Rhogam. But I can totally understand not wanting to.

 

[xmasbaby7]

Thanks so much!

I like my "wait and see after the birth" approach. That feels right. If I have a home birth as planned, I will be less likely to get the shot.

 

[liseux]

I unfortunately got sensitized after a traumatic shoulder dystocia delivery.

Spark you know a lot about this, but this one statement didn`t sit well with me. "Before medicalized birth, however this was not necessarily a problem."
Actually, before medicalized birth some babies were born blue and severely anemic due to hemolytic disease of the newborn. My husband`s cousin had 5 babies naturally in Chile and 3 were badly affected but are OK now.

The good news is that even if you are sensitized there is an excellent chance of a good outcome but the pregnancy does become high risk. As recently as 4 years ago a sensitized pregnancy was managed almost entirely by doing bimonthly amnios to check for bilirubin in amniotic fluid. Now its managed by bimonthly u/s to measure the velocity of blood flowing through the medio cerebral artery, an effective and much safer way to monitor anemia in the baby. If the baby becomes anemic in utero they can now do intrauterine blood transfusions or deliver early. My third son and only sensitized pregnancy went to term and needed only lights for anemia related jaundice.

Rhogam failed for me, I only took it pp, never in pregnancy for many of the reasons mentioned here. At delivery though, I was given too little rhogam considering I had a pp hemmorhage. If the delivery is at all traumatic and there is any problem with the cord or placenta, make sure they give more rhogam. Luckily now almost all of the rhogam in the US is mercury free, but definitely ask & be sure.

Spark, I agree that in a gentle birth sensitization can most likely be avoided. If I had to do it again I would still avoid prenatal rhogam. One reason why people are still getting sensitized is b/c it only protects against antiD antibodies, the most common. Yet many women get other antibodies that are equally aggressive, like anti e or kell. One really important thing to do is to find out if the baby`s father is homozygous or heterozygous for rh status. If he is homozygous there is no chance you can have a rh neg baby, but if he`s hetero then the baby could maybe be rh neg. There is a blood test where they can take the mothers blood and separate it and find out if the baby is neg or pos & that could mean the whole rhogam thing is a non issue.

 

[Spark]

liseux - I'm so sorry that you're sensitized.

I wish you much health and blessings for any future pregnancies. I've met quite a few women online and IRL that have been sensitized despite using RhoGam. I didn't realize that there are different amounts that should be given for a delivery with trauma. Here I know some homebirth midwives (mine included) will ask their moms to go to the ER to get RhoGam if they choose it. I didn't realize that the ER needs to be informed of birth trauma to adequately diagnose the amt of RhoGam to receive. Very important info! Thank you! By chance did they do the Gaskin Maneuver to help get your babe's shoulders unstuck? http://www.inamay.com/gaskin_maneuver.php Also, I wish you health and happiness in any future pregnancies.

Quote:

Originally Posted by liseux Spark you know a lot about this, but this one statement didn`t sit well with me. "Before medicalized birth, however this was not necessarily a problem." Actually, before medicalized birth some babies were born blue and severely anemic due to hemolytic disease of the newborn. My husband`s cousin had 5 babies naturally in Chile and 3 were badly affected but are OK now.

The research that I was referring to indicated that while sentization did happen, it was not as prominent before the routine practice of cord clamping/cutting before the placenta was delivered, pulling on the cord, overly-managed placenta delivery, etc or the "medicalized birth" as I called it. Hemolytic disease was first diagnosed in the late 1800's, but it was a very rare condition, rarer than after "medicalized birth" according to one source (even with routine use of RhoGam argued another researcher). I'm not familiar with Chilean birth practices, so I don't know if your husband's cousin experienced cord clamping, cutting, etc etc etc. From my limited understanding of South American birth, in the industrial centers, they tend to be pretty C-section happy and rely heavily on technology. (again, I haven't researched this heavily, it's just from hearing about the Brazilian billboard that promotes C-sections with the words "Keep your vagina honey moon fresh" and then this article that I came across http://www.stolaf.info/courses/2003sem2/Women's_Studies/399/Projects/Coates_Research/index.htm )

I wish everyone to find the decision that is right for them. I know that avoiding RhoGam all together like I do is not always a very supported decision. I encourage you each to do your own research and listen to your heart. Again, though if you are considering relying merely on Eldon Cards to diagnose your baby's blood type, please be warned these are not accurate enough to do that.

 

[kir]

This issue of taking RhoGam as early as 28 weeks was just introduced to me, so i am glad to see this thread. I had heard of receiving the treatment IF baby is born positive (I am B-), but not earlier. I am glad to have this information, b/c i have had no trouble up til now, so i see now reason to do an early injection.

And the way things have been going lately, we don't want more kids after this (but i know that changes when nightly vomiting and nausea ends).

Can you just deal with getting RhoGam later, if/when you decide to conceive again?

I think it's very interesting to know that it's an option not to have RhoGam at all. Good to know.

How can i find out about the mercury content in RhoGam we get here? (Or is RhoGam a brand name?)

K

 

[carolyn_babycakes]

I just want to offer you some encouragement...my Grandma was Rh Negative, and she gave birth to 4 babies...at home. They were all fine, but my dad says he remembers the youngest being really skinny at birth.

Anyway, it can turn out fine.

 

[xmasbaby7]

Kir,

I wouldn't worry about any mercury anymore. All of the injections have been made without mercury since 2001. It never hurts to ask them, though, that the injection is recent.

The pre-natal shot, from my understanding, adds 1% point more accuracy of preventing sensitization that the post-natal. Hardly worth the risk in my opinion, if the mom sufferes any unpleasant reaction while pg.

You unfortunately can't deal with it later and take the Rhogam if you want more kids. You need to take it within 72 hours birth to eliminate any antibodies your body may have begun forming if the two blood types mixed during birth.

Like Spark said, though, the injection isn't 100% effective, and neitther is sensitization guaranteed. I usually take gambles like this, but the thought of dealing with a fetal blood transfusion in a 2nd pregnancy is not appealing.

Tough call, no?

 

[Spark]

Quote:

Originally Posted by xmasbaby7 Kir, I wouldn't worry about any mercury anymore. All of the injections have been made without mercury since 2001. It never hurts to ask them, though, that the injection is recent.

It looks like Kir is in India though. I don't think the mercury has been taken out worldwide. Mercury is cheap and effective for preservation of the drugs. It's still pretty widely used elsewhere.

Kir, RhoGam batches are even sometimes different batch to batch. You can order mercury-free RhoGam if you work with your medical provider. And, hopefully,it's out of all the RhoGam there in India, but it very well might not be. There are list of ingredient on the RhoGam itself. So, your provider shoud be able to find it easily and order some w/o mercury for your birth. I know that providers here were doing that pre-2001.

 

[xmasbaby7]

Spark, you miss nothing! I am so glad you are on my team!

 

[Spark]

Hey, xmas, I'm glad we're on the same team, too!

We really do have a great birth group!

And, in that post you wrote above, you are SO SO SO right. The RhoGam decision is TRULY a tough one!