Declining the 28 week RhoGam?

jhunter89 · April 2012

Hey Ladies, I'm A- and DH is O+ (heterozygous) so we have a 50/50 chance of me actually needing the RhoGam shot at all. I'm all for it after birth if she's positive, but i'm debating with myself whether or not to get the 28 week shot. My midwife said the risk of being sensitized before birth if there are no other risk factors (bleeding, placenta previa, manual version, amnio, etc) are 'hypothetical.' I obviously want to protect myself from being sensitized for future babies, but, I don't really like the idea of getting an uneccesary shot.

Did anyone else decline the 28 week shot and just do the one after birth or after a blood test confirmed that LO was positive?

redheadinlove · April 2012

I haven't done any research on this whatsoever so please take that into account.

All I know is I have friend who has three beautiful children and has also had 3 miscarriages since the last one because of this. It hurts /me/ to see her go through this and not be able to finish her family. It's not a risk I'd be willing to take. Now I may be missing some big piece of information because as I said I haven't done any research on it and know very little (it didn't apply to us), but thats my current opinion

jhunter89 · April 2012

From what I understand, the biggest risk of having complications with future babies occurs after the baby comes, not the 12 weeks before which is what the 28 week shot is for. I'm all for the post-delivery shot if needed. I guess i'm just cautious of getting a shot of a blood product if it's not necessary. From what i've read, having the 28 week and post delivery shots takes the risk down to 1% whereas just the post-delivery shot takes it down to a 2% chance of sensitization. So, it does help a little, just trying to work through if the pros outweigh the cons for the prenatal shot.

tokenhoser · April 2012

Are there cons?

I haven't looked into this as it doesn't apply to me, but I find sometimes some people get so into refusing and being suspicious of everything that it becomes as habitual as accepting everything. Halving your risk sounds like a reasonably important benefit to me.

amber323 · April 2012

My mom had four miscarriages because of being a negative blood type so when I found out I was negative there was no way I'd ever decline the shot, there's always a chance something could happen and there are no negative effects of the shot

fryrat · April 2012

I am A- as well. I did not decline it. If ANYTHING happens that makes the placenta detach even a little, you may not even know it happened, but your blood and baby's blood just mixed. You'd be doomed and never know why.

In reality, even though it's a "super scary blood product", it's just like an antihistamine. It prevents your body from making the cells to fight it off. You wouldn't skip your allergy meds when going outside (when you may or may not encounter ragweed) just because you don't like taking pills... Same concept.

jhunter89 · April 2012

I'm not super against it, just trying to decide if it's worth it and I will definitely be getting the post-delivery shot if she's Rh+ as well as if I end up with any abdominal trauma etc.. As for the cons, you can take them with a grain of salt, this is just what a Google search brought up:

Rhogam is a class C drug which means "Animal studies have shown an adverse effect and there are no adequate studies in pregnant women OR no animal studies have been conducted and there are no adequate studies in pregnant women." drugs.com

While Rhogam is highly moderated, there is always a slight risk (as there is with any blood product) of blood born pathogens.

Rhogam does have a failure rate and the body is made to keep maternal and fetal blood separate, it's not something that happens every time, especially when the mother is low risk and is able to have a gentle, med-free birth.

While Rhogam no longer uses mercury, i'm not sure of what other additives may be included in the serum.

The Rhogam shot only protects you if the amount of blood that has been mixed is less than 15ml and the micRhogam is less than 2.5ml and is only truly effective if administered within 72 hours of the blood mixing.

So, with all that being said, i'm not saying Rhogam is bad at all and if our LO is Rh+ I will definitely be getting the post delivery shot. My question is only regarding the 28 week shot since the risk of blood mixing in the absence of bleeding/trauma/amniocentesis/manual version etc. is extremely low and I would like to keep my pregnancy as free from unnecessary medication as possible.

jhunter89 · April 2012

fryrat:

I am A- as well. I did not decline it. If ANYTHING happens that makes the placenta detach even a little, you may not even know it happened, but your blood and baby's blood just mixed. You'd be doomed and never know why.

In reality, even though it's a "super scary blood product", it's just like an antihistamine. It prevents your body from making the cells to fight it off. You wouldn't skip your allergy meds when going outside (when you may or may not encounter ragweed) just because you don't like taking pills... Same concept.

I wouldn't say you're doomed, from what i've read, you do need extra monitering and the risk of miscarriage is increased, but there are lots of sensitized mammas out there having healthy babies too.

And I would question taking allergy pills while pregnant if I didn't know how it would affect me or my baby.

webMistress0609 · April 2012

tokenhoser:
Are there cons?
I haven't looked into this as it doesn't apply to me, but I find sometimes some people get so into refusing and being suspicious of everything that it becomes as habitual as accepting everything. Halving your risk sounds like a reasonably important benefit to me.

This.

But you're disagreeing with everyone who's telling you to get the shot or the risks involved with not getting it, which is pretty much everyone who's responded. So it sounds like you've already made up your mind.

I think declining it is silly. The risk/benefit ratio is clearly in favor of getting it.

jhunter89 · April 2012

webMistress0609:
tokenhoser:

Are there cons?

I haven't looked into this as it doesn't apply to me, but I find sometimes some people get so into refusing and being suspicious of everything that it becomes as habitual as accepting everything. Halving your risk sounds like a reasonably important benefit to me.

This.

But you're disagreeing with everyone who's telling you to get the shot or the risks involved with not getting it, which is pretty much everyone who's responded. So it sounds like you've already made up your mind.

I think declining it is silly. The risk/benefit ratio is clearly in favor of getting it.

People wondered what the cons were, I wasn't sure, so I found what I could from reputable sites and posted it, that's not disagreeing. Though I think I have decided what I think will be best for me, I totally respect everyone's opinions and what they feel they are most comfortable with whether that means they get the 28 week shot or not.

wheelsonthebus · April 2012

I had also heard that the odds of blood mixing before birth were very low. I had a test late in my pregnancy and it was confirmed that the blood had not mixed. While I was in labor they did a test and it had mixed. I was lucky to have gotten the shot. I'm not sure what these tests were or how it happened, but this is what I was told. DS ended up having a positive blood type and he ended up with severe jaundice after birth as well because of the mix.

tngrl3 · April 2012

For what it's worth as medical person thought I would throw in my thoughts. First let me say I'm B+ so I don't have to make this decision personally. A Category C drug classification is basically worthless. It really means the effects of a drug haven't been studied, because well what pregnant woman signs up for a drug trial and puts her baby at risk? Rhogam has what is considered an established safety profile as it has been used on millions of women and the small risk of potential side effects are significantly out weighed by any potential risks. I guess my thought is what if you had some spotting early on and you didn't notice, or you had some minor abdominal stress and the placenta had a small bleed that went undetected. What if the blood did mix? Are you willing to take that chance? I have given this shot to hundreds of women in the ER with threatened ABs. I have never known one to decline or of any side effects. I respect your desire to not expose your baby to unneeded drugs, but if there was a bad outcome because you decided not to have this shot, would you be able to live with that?

rica21483 · April 2012

My husband and I are debating this, as well. Unless my MW has something to say that will change my mind, I think I will be declining the 28 week shot. Although the shot itself is thimerasol free, they still use aluminum and other ingredients that I don't want my child injected with. I don't want to potentially harm this child for the sake of having other children. Also, Rhogam is manufactured by johnson & Johnson, a company that I don't trust. Do what you think is right.

DebateThis · April 2012

tngrl3:
For what it's worth as medical person thought I would throw in my thoughts. First let me say I'm B+ so I don't have to make this decision personally. A Category C drug classification is basically worthless. It really means the effects of a drug haven't been studied, because well what pregnant woman signs up for a drug trial and puts her baby at risk? Rhogam has what is considered an established safety profile as it has been used on millions of women and the small risk of potential side effects are significantly out weighed by any potential risks. I guess my thought is what if you had some spotting early on and you didn't notice, or you had some minor abdominal stress and the placenta had a small bleed that went undetected. What if the blood did mix? Are you willing to take that chance? I have given this shot to hundreds of women in the ER with threatened ABs. I have never known one to decline or of any side effects. I respect your desire to not expose your baby to unneeded drugs, but if there was a bad outcome because you decided not to have this shot, would you be able to live with that?

Not a medical professional but ditto on the threatened abortion in the ER bit. I just spent Monday night in the ER for passing a blood clot. My official DX was "suspected subchorionic hemorrhage and threatened abortion". What's the first thing the ER doc did? Run my blood type to see if I needed Rhogam. You don't always know if there has been a bleed from the placenta, or spotting, or a potential blood clot that just hasn't been passed yet. Bleeding during pregnancy affects 25% of all women and a lot of the time you just have no idea it happened.

Moreover, ACOG recommends Rhogam as the standard of care starting with the shot at 28 weeks - this board routinely suggests that women follow ACOG standards for pregnancy, management of labor, and inductions - this is no different.

rica21483 · April 2012

I just thought of something else... From research I've done, most countries only give the post partum dose. I believe the US, Canada, maybe England, are the few countries that give both doses.

DebateThis · April 2012

rica21483:
I just thought of something else... From research I've done, most countries only give the post partum dose. I believe the US, Canada, maybe England, are the few countries that give both doses.

Not true. Antenatal administration of a Rhogam-type drug is routine in most "first world" countries at this time per NIH. For specifics, I'm finding Australia, NZ, and Japan in addition to US, Canada, and UK.

cwm11985 · April 2012

Have you looked at the Rhogam website at all? I'm not declining it, I have to go in a few days to get it actually. Every single thing in life carries risks...walking out your door carries a risk. To me, there is no justifiable reason to not take the 28 week shot.

caralck · April 2012

It's really more to protect your future pregnancies. If this is your first, then this is when your body gets sensitized to the Rh factor and could develop antibodies. For any future babies with Rh+ blood type, your immune system will then attack that baby's blood and cause hydrops fetalis. So while this baby would likely be safe, it could make it difficult having successful future pregnancies. You should think about your future children. If you're going to be "one and done" and know that without a doubt that you don't want more kids, then I guess there's no reason to bother doing the shot until later. I'm rh+ and so don't have to make this choice but honestly, if I were rh-, I wouldn't hesitate to get the shot. Many drugs are category C but as a PP noted, many times its because the studies can't be done for ethical reasons. Maybe way back when such things in medical research weren't debated, they would do a study where some women weren't given rhogam and others were, but these days, no review board would allow such a study to occur and I would personally need to see a randomized control study saying that there's no significant increased risk in not getting the shot at 28 wks (or anytime there's heavy bleeding in pregnancy) before I would even consider not doing it myself.

MrsFelts · April 2012

I am O-. When I had a natural miscarriage in October I was very glad to have received RhoGam 2 weeks earlier because of lots of bleeding. When I miscarried 2 weeks later at about 12 weeks the placenta came off the uterine wall and it was confirmed that my blood mixed with the baby's. The shot had absolutely no side effects that I noticed. I'm not willing to sensitize myself and possibly cause myself to experience another miscarriage down the road. I'm normally not a fan of any kinds of shots are artificial drugs, but this is one I'm not going to turn down. If I can reduce my risk for having to experience another miscarriage down the road with a simple shot I'm willing to do it. I'll be getting it at 28 weeks and after delivery.

funchicken · April 2012

I'm A- and DH is O+ and both of my DD's have been RH+. Personally, I wouldn't risk the possibility of sensitization if I were planning on having more than one child.

katiewhompus · April 2012

I'm A-, H is O+ (I think, I know he is +) and I absolutely received the Rhogam shot at 28 weeks. I also received it at 7 weeks due to a SCH and bleeding, then after delivery to protect future pregnancies. The risk to my current (at the time) or future pregnancies was not worth skipping the shot. DD is B+.

epona3 · April 2012

jhunter89:

Rhogam is a class C drug which means "Animal studies have shown an adverse effect and there are no adequate studies in pregnant women OR no animal studies have been conducted and there are no adequate studies in pregnant women." drugs.com

Yes, but it's been used very effectively since the 70s. I think it's proven itself.

While Rhogam is highly moderated, there is always a slight risk (as there is with any blood product) of blood born pathogens.

I think this risk is MUCH MUCH smaller than the risk of potential harm to the baby (and future babies) from NOT getting it.

Rhogam does have a failure rate and the body is made to keep maternal and fetal blood separate, it's not something that happens every time, especially when the mother is low risk and is able to have a gentle, med-free birth.

Then if it fails (which is rare) it's not any worse than not getting the shot, which you're already considering. Also, I had a med-free birth, but I wouldn't necessarily call it "gentle."

While Rhogam no longer uses mercury, i'm not sure of what other additives may be included in the serum.

This seems like you're really digging here...

The Rhogam shot only protects you if the amount of blood that has been mixed is less than 15ml and the micRhogam is less than 2.5ml and is only truly effective if administered within 72 hours of the blood mixing.

So, it might not REALLY be effective? It's still better than nothing.

I am RH- and DH is RH+ (DD ended up being RH+ also) I am definitely glad I got both rounds of the shot, and I will again. There were no side effects to it for me, and I also did some research before getting it. I feel like it has been in use for a long time and there have been no serious problems associated with it (for mother or baby), so the pros greatly outweigh the cons.

cpmich · April 2012

my blood type is negative and i would never decline rhogam if pg. lets put this in pure laymans terms. you may not know if your blood mixes in time to do anything about it. if you are negative and your baby is positive your body will attack the babys blood because it sees it as an intruder or toxin unless you have rhogam. i did my research... to me this is an easy one... and i am a true hippie mom who tries to keep holistic and organic as much as possible...

sorry about the formatting... droid.

Want a personalized experience?

Declining the 28 week RhoGam?

Re: Declining the 28 week RhoGam?

Choose Another Board

Search Boards