[Casha'sMommy]

We're newly pregnant with baby #2 and estimated due date of 12/20.
I haven't even had a chance to speak with midwives, etc.
I know I'm Rh negative, however, I've read that you don't really need the rhogam until after baby is born.
Anyone here with first hand experience with this?

TIA
Cate

 

[Kelly1101]

I'm Rh negative, too...

You don't need the rhogam until after the baby on your FIRST baby, I think... but since you've already had one, it would depend on 1) your husband's blood type, and 2) your first baby's blood type.

If your first baby is Rh negative, too, then you don't need to worry about Rhogam until after the baby is born, I THINK (unless there is any kind of trauma). Basically, the Rhogam prevents your body from making anti-bodies in response to Rh-positive blood inside your body. During a miscarriage, abortion, or birth, some of the baby's blood can mix with your body, and your body creates anti-bodies in response.

So, if your husband is Rh-negative as well, you don't need to worry about it. If your first baby is Rh-negative, you probably don't need to worry about it. If your first baby is Rh-positive, then you should get the Rhogam shot before the birth. Your MW should do a screening early, and then maybe one at around 28 weeks, to see if you are already producing the anti-bodies or not (simple blood test).

Basically, you may not even need it, but knowing the blood type of your husband and first baby will help you figure out when and if you do need it-- and your MW will likely be able to give you more exact info in your particular case.

 

[Peony]

Most counties do not offer Rhogam during the pg routinely regardless of what # of pg it is. Course the US has to do everything differently.

I do not use Rhogam during the pg and have refused it after birth depending on the birth as well. I also do not do titers but that is just me. The only book on the subject is Anti-D in Midwifery by Sara Wickham which is an interesting read.

 

[Casha'sMommy]

I'm considering parallel care with an OB for things like this.

We're actually really shocked that we're preggers right now and my brain is all over the place!

 

[dinahx]

I don't think it has too much to do with your last baby, or the number of babies, if you got sensitized with a previous baby it would already be too late.

What it has to do with is the blood type of the father, and whether you have any trauma or bleeding during your pregnancy. If you have trauma or bleeding, IMO I would get it prenatally. No trauma, no bleeding, then you don't need to get it until after birth. A 28 week shot is standard but you can refuse! <3

 

[wbg]

Probably not too relevant, but get your blood group checked again. With my first I was told I was RH neg and had all the standard precautionary shots. With my second my blood results came back as positive! Now as we all know it is impossible for your blood group to change!!! So it turns out someone had made a mistake! Had my blood group checked again and I was definitely positive!!! So my entire first pregnancy I believed I was RH- when I was not!!! Good thing I did not need any transfusions!! Anyway, mistakes like that are very rare but wanted to let you know just in case!

 

[jitterBug mom]

I am rh negative and homebirthing my second child.

Were you given the rhogam shot after your first birth? If not, you may want to have a blood test done to see whether or not you have been sensitized already - if so, the rhogam shot will do no good.

Second, have your partner tested, if he is negative there is no reason to get a rhogam shot, because you will have an rh- baby. Your midwives might have eldon cards for blood testing him, or you can buy them online. My husband donated blood to find out his blood type and we were thrilled to discover he is negative and I don't need the shot. If you went to a clinic/ hospital they would give you rhogam anyway, in case you didn't know who the father was (or were lying about it!)

If your partner is rh positive, most hb midwives can administer the shot for you. A small percentage of women do become sensitized while pregnant, which is the reason doctors recommend the 28 week shot. However, many women decide to wait until their baby is born, then test the baby's blood type and get the shot only if the baby has a positive blood type. Even though it no longer contains mercury, it IS a vaccine. I would probably have gotten the shot if my partner had a positive blood type, but only after the birth.

One warning: my midwifes are able to get rhogam sent to the pharmacy for moms, but not all insurance companies will cover it if done that way - I would have had to pay over $300 for one shot out of pocket.

Hope that makes sense .. really, it sounds complicated but your midwifes have surely dealt with this before and will have good advice for you.

 

[Casha'sMommy]

I am rh negative and homebirthing my second child.

Were you given the rhogam shot after your first birth? If not, you may want to have a blood test done to see whether or not you have been sensitized already - if so, the rhogam shot will do no good.

Second, have your partner tested, if he is negative there is no reason to get a rhogam shot, because you will have an rh- baby. Your midwives might have eldon cards for blood testing him, or you can buy them online. My husband donated blood to find out his blood type and we were thrilled to discover he is negative and I don't need the shot. If you went to a clinic/ hospital they would give you rhogam anyway, in case you didn't know who the father was (or were lying about it!)

This is exactly what we're planning to do!
DH is going to donate blood to determine his blood type and we'll take it from there.
I did mention that my brain is all over the place, right?

 

[nashvillemidwife]

Quote:

Originally Posted by Casha'sMommy Anyone here with first hand experience with this?

Yes, I know of 3 people who have become sensitized in their first pregnancies without any risk factors (trauma or bleeding), and the consequences were significant to future pregnancies. The risk is small and it is your decision to make after you've weighed the odds and risks and benefits, but don't let anyone tell you that the risk does not exist or you simply don't need it. You have a right to base your decision on accurate information.

Please feel free to pm me if you have questions about the validity of the information you receive.

 

[Relynn]

I highly recommend Sara Wickham's book Anti-D. Also, do a search on rh factor and you will find lots of info. Sometimes, a person can be rh+ and still be able to make rh- babies. I'm rh- and dh is rh+. Our fourth child is rh-. No one told me this was possible until I read the Anit-D book.
HTH
Rebecca

 

[dinahx]

Also, make sure you get the shot in a timely manner. Several mothers on here have had their shot admin hopelessly bungled by their medical professionals. It should be within 24 hours of any trauma, or of any birth, abortion, or m/c. You can wait 72 if you want, but why wait? Several mothers on here have had medical professionals make them wait even longer!!!

Also, to be clear for everyone, it needs to be given within 24 hours of the FIRST day of any bleeding or m/c, not the last. It is crazy how many people don't know this and I actually had to FIGHT with my midwife to get Rhogham in time after my recent m/c.

 

[abc123xyz]

I am Rh- and researched this heavily in my first pregnancy. Basically, you don't need to do prophiilactic rhogam at all ever. The reason they do it that way medically is because many many women are not in touch with their bodies and quite honestly, not responsible pregnant women. Many women know nothing about pregnancy and birth that they don't feel they need to know. So, in the event you fall off a ladder or get in a minor fender bender while pregnant, the rhogam that would already be in your system in said to aid benefits in those events. However, if you are responsible, there is no good reason to take it prior to birth. If you have some sort of accident that would cause trauma, then by all means, have it. It is what's best. But if you have a trauma free pregnancy, there would be no reason to get it while pregnant. And if you have a trauma free birth, there's really no reason to take it at all. From the research I have read, most homebirths are relatively non invasive leading to minimal bleeding and no risk for any problems with sensitization regardless. Another thing to note is that rhogam metabolizes and wears out in 3-4 weeks (sometimes a little longer) after being administered so that's why they typically give 2-3 doses. Seems excessive for "in case" circumstances!! Before taking it, however, I would blood type baby with some cord blood to know for sure if you need it. With my first, he is Rh- and so we didn't have it. Since I have researched more now, I likely won't take it at all with the next baby's birth no matter what the blood type is. Unless I have some major trauma. I do have a prescription for it just in case or you could goto the ER and have it within 48 hours of birth not 24. Reasons to wait is to get settled and taking care of your baby before loading up and heading to the ER...thats' why I would wait. If you have it on hand, take it asap! In a hospital setting, they will try to pressure you into taking it and tell you irresponsible you are for not having it during pregnancy but so what?! (we had a hospital transfer with our first and I have BTDT) Good luck!!!! Many people have different opinions on this matter...I say stick to the reasearch and chat with your midwife about their recommendations. I know what I feel, what I have found, and what my midwife believes and my level of comfort and faith is such that we feel comfy not having it. You have to find YOUR level of comfort and go with it. That's what is important. There is no reason to be stressed about it!

 

[nashvillemidwife]

Quote:

Originally Posted by jkseawell Basically, you don't need to do prophiilactic rhogam at all ever.

Rhogam is always prophylactic. The purpose is to prevent becoming sensitized, not to treat it. Bleeding or trauma puts you at higher risk for becoming sensitized, that's why you give it then, to prevent that from happening. Also, women do become sensitized during pregnancy without bleeding. It's not likely, but it does happen. Telling women otherwise is a lie.

Quote:

Another thing to note is that rhogam metabolizes and wears out in 3-4 weeks (sometimes a little longer) after being administered so that's why they typically give 2-3 doses.

No, it wears off in 12 weeks, which is why it is given at 28 weeks and a birth: 28 weeks and at birth. 28+12 = 40.

 

[abc123xyz]

I don't like to argue points via forum but Rhogam is not always prophylactic...if you are taking it post birth, it is preventative for the "in case" scenario. The only way to become sensitized it to have a mixing of the mother's blood with the baby's blood. Any other way would make no sense...So, mixing of blood is the only way to cause sensitization and in turn, needing the shot upon that circumstance. I would definitely take it if I had trauma or bleeding that I was aware of. The shot only reduced the risk of sensitization from 2% to 1% (i have the product insert in front of me) and the shot does lose effectiveness in 3-4 weeks but needs to be administered within 72 hours of a trauma. If you have it at 28 weeks and you fall or get in an accident two weeks from then, you will need it again! (see below *****) It is strictly given as a preventative measure in case something goes wrong during labor and delivery. Here are some sites for better and further info! Also, the site for rhogam says if you are pregnant or plan to breatfeed that you should consult your dr. to see if the benefits of the shot outweigh the risks to the baby.
http://www.vegfamily.com/vegan-pregn...tal-rhogam.htm
http://www.moondragon.org/mdbsguidelines/rhneg.html
http://www.vaccinetruth.org/rhogam.htm
http://www.unhinderedliving.com/rhogam.html
http://www.naturalbirthandbabycare.com/rhnegative.html *****

Honestly, that is all that I feel necessary to post. I have done my research and am supported by my husband and my midwife. I feel totally confident in my decision and everyone will have a different opinion and that is their right. I can only go on fact not opinion and the facts tell me that I need to be causious of this avenue of medicine.

OP-->you need to do what is best for you and your family. do the research and see where you end up on the issue. No one can tell you what is best. Just like no one can tell you where to birth your baby...everyone's experience is different, everyone knows someone with an adverse outcome, everyone has a different level of comfort and opinon. That is life! You are not wrong one way or the other! Good luck to you. Any further comments to me personally on this topic would be best dealt with via PM! Thanks!

 

[dinahx]

This research you posted is so outdated! Rhogham no longer contains Thimerisol. Also, the risk of being sensitized after the birth of a + child if you skip the shot is 13%, from the package insert. If you take the shot after birth of a + child, the risk is 1%, if you take the shot at 28 weeks AND after birth, the risk is .1%

Clearly the biggest gains are with the after birth admin, but some women will still somehow get sensitized despite this. Hence the 28 week shot.

For me the biggest issue is post m/c post abortion admin. This is what medical providers often fail to provide/understand. Clearly if you don't want any more children, go ahead and don't get the shot, kwim? There is an 87% chance you'll be fine. However some of us need more of a 'sure thing' than that.

 

[nashvillemidwife]

Quote:

Originally Posted by jkseawell I don't like to argue points via forum but Rhogam is not always prophylactic...if you are taking it post birth, it is preventative for the "in case" scenario.

That's exactly what prophylactic means. Rhogam is always prophylactic. It is not a treatment.

Quote:

Originally Posted by dinahx This research you posted is so outdated! Rhogham no longer contains Thimerisol.

Just wanted to emphasize that. If you don't believe us, you can read it for yourself at the FDA website.

Quote:

Clearly if you don't want any more children, go ahead and don't get the shot, kwim?

Unless you'd like to be able to receive a blood transfusion to save your life some time on down the road...

 

[dinahx]

A blood transfusion with positive blood? No thanks! <3 I guess I should be banking my own blood, but I don't want to accept positive blood.

 

[dinahx]

Quote:

Quote: On April 16, 2001, Ortho Clinical Diagnostics was approved by FDA to produce RhoGAM without thimerosal, and at that time, Ortho agreed to distribute only thimerosal-free product to the US market. The product has a 2-year dating period, so there is no longer any RhoGAM that contains thimerosal that is still in-date. From that FDA link

I got Rhogham 5x once for a termination at 6 weeks, once for trauma/spotting over 2 weeks (subchorionic hematoma), once for the 28 week because of the hematoma, and after birth, then after a m/c.

Women in the PAST got Thimerisol during my pregnancy, and that is a great crime and tragedy and undoubtely contributed to the body burden of their neonates. Additionally, IMO, that body burden (remember our grandparents were exposed to mercury that is still present in us) undoubtedly contributes to neurological symptoms, including Aspergers and the whole Autistic Spectrum.

However I did not get a shot with Thimerisol, I triple checked every time this has been administered. Actually scratch that, after a termination before my DS, I probably did get thimerisol. Also during that time I got a Tetanus and Hep B shot (2) which definitely contained Thimerisol. :shock: I definitely have gotten a lot of mercury in my day.

However, the shot now does not contain that. Who knows what else it contains, 4 sure, but I make the choice because I don't want an interventive pregnancy. Maybe it is wrong, I will have to rethink it!

However, my one beef is that it should be given in miscarriages STAT if the woman wants it, so that she has another chance, and that if it is given, don't dilly dally and give the woman the risks while lessening the benefit.

 

[nashvillemidwife]

Quote:

A blood transfusion with positive blood? No thanks! <3 I guess I should be banking my own blood, but I don't want to accept positive blood.

Yeah, I was in a hurry when I typed that. It's not really a big deal any more. I'll dig up some more information tomorrow.

 

[Defenestrator]

I know of one person in my community who was A- and received an O+ blood tranfusion in an emergency because they didn't wait for typing. It can happen.