28 Week Rhogam (A little long)

LadyTyler

I am O- and my husband is AB+ so of course we've been advised to get the 28 week Rhogam shot. I am 100% comfortable with the one after birth, just wondering about the 28 week one. Also, this is our first baby and I've never been pregnant before, so no worries about already being Rh sensitive.

1.) Why 28 weeks? There were 28 previous weeks where something could have unknowingly happened and I'm already sensitized.  Also, for how long in the future does it protect? In the UK they give it again at 34 weeks, which makes me wonder if it doesn't last till birth anyways. Do they know how long it provides protection?

2.) It is rather expensive. If it was 100% clearly necessary, I wouldn't be thinking twice about it. But I'd rather not spend several hundred dollars on something I don't need.

3.) We don't think we would like to have another child. I would feel comfortable waiting and testing to see if I have been sensitized and making any future pregnancy decision based on that, honestly. Are the chances of being sensitized with the post-pregnancy shot that high?

I am not worried about the safety of it, just the necessity. Between our awful insurance where we'd pay a lot of the cost out of pocket and just disliking unnecessary medical interventions, I've been thinking a lot about this but struggling to find solid information.  Thanks for any advice you ladies have! 

meg193

This is my understanding of the whole thing.  Typically the mother and the babies blood does not mix.  The placenta acts as a barrier between the two and takes nutrients and oxygen from the mother.  This is why you haven't needed Rhogam yet.  During birth there can be mixing of the babies blood and the mothers blood.  If the baby is Rh positive, the mother can make antibodies against it.  By giving it at 28 weeks (or even 34 weeks in the UK) you essentially already have Rhogam on board when this happens which makes you less likely to make antibodies against the next baby than if you were to get it only after delivery.

jb2rn

I am surprised you have to pay for it, I thought you had universal health care?

I did not have to pay for it, but I did it anyway. It was at 30 weeks I think, maybe 31? Mostly because my MD forgot about it before then. It's given around that time in case of pre term birth, so your body has enough time to create antibodies.

Do some reasearch on RH sensitization in newborns. It can be very dangerous and even kill an infant.

This may be our only child as well (I am 35 and have some fertility issues, so it might not be my choice) but I certainly don't want to take that risk in case I get ooops pregnant or we decide we want another.

star173

1.) Why 28 weeks? There were 28 previous weeks where something could have unknowingly happened and I'm already sensitized.  Also, for how long in the future does it protect? In the UK they give it again at 34 weeks, which makes me wonder if it doesn't last till birth anyways. Do they know how long it provides protection? It's supposed to last 12w, which would then have you protected until you deliver. If something happened earlier (bleeding, trauma to your belly), they could do a blood test to see if your and baby's blood mixed, then you would get the shot- or they would just give the shot earlier as well.

2.) It is rather expensive. If it was 100% clearly necessary, I wouldn't be thinking twice about it. But I'd rather not spend several hundred dollars on something I don't need. According to my OB, the risk is so unbelievably minimal that you would be sensitized TWICE during the pregnancy, and the risk is to future children, but getting the shot after delivery should take care of that. In fact, they used to do only that, but from my understanding, the makers of rhogam are the ones who decided it should be given during pregnancy as well. I'm not a conspiracy theorist by any means, but it does make me wonder about their motives, since they would double their sales that way.

3.) We don't think we would like to have another child. I would feel comfortable waiting and testing to see if I have been sensitized and making any future pregnancy decision based on that, honestly. Are the chances of being sensitized with the post-pregnancy shot that high? You can get the shot after delivery, and/or have a test done (howard-becke, I think) to see if your blood has been sensitized.

Good luck!

 

LadyTyler

jb2rn:

I am surprised you have to pay for it, I thought you had universal health care?

I did not have to pay for it, but I did it anyway. It was at 30 weeks I think, maybe 31? Mostly because my MD forgot about it before then. It's given around that time in case of pre term birth, so your body has enough time to create antibodies.

Do some reasearch on RH sensitization in newborns. It can be very dangerous and even kill an infant.

This may be our only child as well (I am 35 and have some fertility issues, so it might not be my choice) but I certainly don't want to take that risk in case I get ooops pregnant or we decide we want another.

We live in the US, so definitely no universal health care--I desperately wish we did though!  And with our insurance we pay 30% or more for each procedure, which really adds up fast.

I do know about RH sensitization, and it is a concern for sure, in the situation I am sensitized and have another baby but I was also trying to figure out the odds of this happening vs how expensive it is.  We can't afford to have every procedure without thinking about cost, unfortunately. An accidental baby is a definite consideration in this however. Luckily they also have some treatments for fetuses with sensitized mothers though, even if not ideal.

LadyTyler

star173:

1.) Why 28 weeks? There were 28 previous weeks where something could have unknowingly happened and I'm already sensitized.  Also, for how long in the future does it protect? In the UK they give it again at 34 weeks, which makes me wonder if it doesn't last till birth anyways. Do they know how long it provides protection? It's supposed to last 12w, which would then have you protected until you deliver. If something happened earlier (bleeding, trauma to your belly), they could do a blood test to see if your and baby's blood mixed, then you would get the shot- or they would just give the shot earlier as well.

2.) It is rather expensive. If it was 100% clearly necessary, I wouldn't be thinking twice about it. But I'd rather not spend several hundred dollars on something I don't need. According to my OB, the risk is so unbelievably minimal that you would be sensitized TWICE during the pregnancy, and the risk is to future children, but getting the shot after delivery should take care of that. In fact, they used to do only that, but from my understanding, the makers of rhogam are the ones who decided it should be given during pregnancy as well. I'm not a conspiracy theorist by any means, but it does make me wonder about their motives, since they would double their sales that way.

3.) We don't think we would like to have another child. I would feel comfortable waiting and testing to see if I have been sensitized and making any future pregnancy decision based on that, honestly. Are the chances of being sensitized with the post-pregnancy shot that high? You can get the shot after delivery, and/or have a test done (howard-becke, I think) to see if your blood has been sensitized.

Good luck!

 

Thanks for such a thorough answer!

We will definitely get the post-delivery shot if needed and I do plan to see if I have been sensitized, so we know if it is a concern.

I was finally able to find some numbers today stating that the likelihood of being sensitized is under 2% before labor, so I think I feel more confident that I won't be getting the 28 week one. For the cost, it doesn't seem worth the small reduction in risk in our situation.