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Rh- and Rhogam Shot

by Sarah DJ
(Illinois)

Kristen,

I read this (http://www.vegfamily.com/vegan-pregnancy/prenatal-rhogam.htm) article about your Rh- blood type and refusal of the shot for your first three children.

I am not at all comfortable accepting it, and my midwife has presented it as what we should do at 28 weeks and after the birth.

I am pregnant with my first, and planning to refuse the 28 week shot. We are planning a natural, home birth. However, a lot of sources scare you into thinking you’re pretty much killing the offspring that may follow.

My thinking is that if my current baby is born and turns out to be Rh+, then perhaps I’ll take the post-birth shot. However, I found one real-life story online from a woman that got it before and after the birth of her first, and it didn’t work. Her body attacked each of her subsequent pregnancies anyway.

I see you made the decision to not take it at all, ever. What was your experience with this? Are all of your children your negative blood type? Have you ever developed any antibodies against the positive, or experienced any of their “other situations” in which they want you to get it (accident, miscarriage, etc).

I am so grateful for the article you wrote for VegFamily, and look forward to your reply. Any other resources you’re aware of in being against the shot (I can find plenty that are for it) would be greatly appreciated.

Thank you so much!
~Sarah

Answer:

Hi Sarah,

I’m glad you found the VegFamily article helpful – out of all the guest articles I’ve written, that’s the one I get the most feedback on!

I like knowing that other women are thinking and questioning things for themselves.

I have declined prenatal Rhogam with all of my pregnancies – however I did have the post-birth shot after my three babies. I didn’t have it after my fourth baby because he’s rh- (I was very surprised by that).

I opted to have the shot after birth because at that point there are not the same risks to my child that there were when he or she was in the womb.

Rhogam does occasionally fail but it’s very, very rare for that to happen. All safety risks aside, the shot is very effective and has a proven record of working well. It’s not like other vaccinations (such as pertussis) that have a low effectiveness rating. You may hear from a woman or two, such as the one whose story you read – that it did not work for, but it’s going to work for almost all women.

That’s why doctors are so eager to have women get it, and why it’s one of those things that requires real thought and research on the part of us rh- women.

It’s pretty unlikely that you’ll become sensitized during pregnancy, but it can and does happen. It’s also unlikely that you’ll become sensitized after a gentle, natural birth – but again it can happen.

As I said above, for me the risks of using a human blood product during pregnancy were not acceptable, but postpartum that was acceptable because I knew my current baby was safe – and it could help protect future babies.

I have not been sensitized even while refusing the prenatal shot and haven’t had any ill effects from getting the postpartum shot.

It really does come down to personal choice, and you’re going to hear arguments on both sides of the debate.

Did you read the article I’ve written here on my site?

Rh Negative / Rhogam Info – I have a list of links for more info at the bottom of that post. That should give you more food for thought.

Please feel free to comment and add more questions if I haven’t addressed something or if you want me to clarify something.
Comments for
Rh- and Rhogam Shot

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Feb 09, 2010
Rating
starstarstarstarstar Rhogam Didn’t work for me
by: Erika

Although I had tested negative for having antibodies against positive blood throughout pregnancy, the rhogam did not work on me. I am one of the rare cases I see in the comment posted. I never had any of the usual reasons this happens DURING pregnancy, so the only chance of this happening to me was that I had exchange bleeding late in my pregnancy that was unknown.

I now have seen several specialists that say if I choose to have a second child, it would be very high risk. Almost 100% chance the baby would need a blood transfusion in utero!! This is such a heart wrenching situation because I would not be able to handle losing a baby in pregnancy nor after. My advice is to get the shot…although it did not work for me, if it does work for you, at least you know there would be absoluetly NO complications in any other pregnancies. I on the other hand was one of the “EXTREMELY RARE” who now has a vey hard decision to make. Whether to conceive again or not. At least most women will not be like me and have this happen. If you already had your baby, congratulations (I did not look at the date on this post!) Erika
Feb 20, 2010
Rating
starstarstarstarstar Shot did not work for me…theres not to many of us
by: Tammy

I am in the same boat as Erika, we are a rare few!!
I received my rhogam shot at 28 weeks pregnant and during labour the doctors kept testing my blood. I knew something was wrong when they tested it for the third time. It was because my body had already started producing antibodies. It alarmed them because it hadn’t happened in this hospital in 16 years. It did not affect that pregnancy, but now i am faced with the heart ache of not being able to have more children with out many complications and a high percentage of loss. I was tested a year after the birth of my daughter and my antibodies were still high.
May 14, 2010
Rating
starstarstarstar Help!!! Don’t know what to do…
by: Anonymous

I had 12 miscarriages before I got pregnant with my daughter… They never tested me, until her, for being rh-. I got my first shot when I was 3 months pregnant because the placenta wouldn’t attatch to my uterus. Now I have a beautiful 4 year old and I’m pregnant again. I don’t have insurance right now and I don’t know what I should do. Go to the hospital, have them do a test and get a shot? Or just wait and hope for the best… I don’t want to be on bed rest for another 9 months, but what else is there to do?

Kristen’s Reply:

I don’t think that being on bed rest will do much for an Rh issue – for placenta problems it may be warranted.

Rhogam is usually given at 28 weeks, or like in your situation, where there’s some sort of trauma that could cause the blood to mix. If you’re worried there’s something going on with this pregnancy I would get help immediately.

Otherwise, you should get the shot during the normal course of your prenatal care if you want it – it’s standard for women who are Rh-. You don’t need any tests done, really, if you already know that you’re Rh-.

If you are in the US, Medicaid pays for a Rhogam shot – if not, inquire with your doctor as to what kind of assistance your country gives. That could be an option for you.

It’s harder for me to answer questions in the comments section – if you’d like to click “Ask a Question!” on the left-hand buttons I can answer the question with better formatting and the answer will go personally to you.
Jun 29, 2010
Rating
starstarstarstarstar rhogam failed for me too
by: Felicia

I had the testing done for the antibody and it came up negative (a couple weeks before the shot)and then at 28 weeks i had the shot, my doctor decides to check again after the shot and now i have the antibodies even though i had the rhogam shot?? I did not have any complications during the pregnancy other than this (no bleeding, injuries, etc.) So i am wondering why my blood already mixed with the babies blood…I have to go tomorrow for another test to see how much is in my blood now so we know what to do, I am now 36.2 weeks prego so the baby is almost full term so hopefully everything will be fine. Good luck to everyone that is going through this also.

Kristen’s Reply

Hi Felicia,

Do you know why your doctor wanted to test again? Does he usually give a 36 week shot?

Is it possible that the antibodies his test is picking up are those from the shot? The effects of the shot last about 12 weeks.

Even if you were sensitized in this pregnancy, it most likely will not effect your baby so I would not worry a lot right now.

I would have the test done (is the indirect-coombs what you had done?) again after your pregnancy – maybe after your baby is three months old or so. Certainly before another pregnancy.

There are times when blood mixes during pregnancy, though it’s pretty rare. Car accidents, bad falls, and certain prenatal procedures can make it more likely.

I would ask your doctor to test again after this pregnancy is finished and go from there.
Jul 01, 2010
Rating
starstarstarstarstar rhogam fail…?
by: Anonymous

Hi Kristen,
I had the shot at 28 weeks and before I had the shot I was tested about a month or two before and I was all clear (no mixing) then at around 34 and a half weeks he wanted to test again to make sure I had no antibodies (I don’t know why). I asked him if I had the rhogam already if it would interfere with the results and he said no..? He said that he wanted to check because I had been pregnant so many times and the shot is not 100% even though it is very accurate. So now my question is if I had the shot if it did actually make the results like that? he said no so now i am confused….If anyone knows for sure 100% what the answer is can you please let me know? thanks in advance

Kristen:

Felicia I think you should ask for a re-test. Like with any test you can probably get a false positive. Blood tests are never pleasant but they are simple so you can get another done and it may ease your mind if you did get a false positive or if the Rhogam was influencing things.

I know that the Rhogam-introduced antibodies are supposed to stay in the system for about 12 weeks so it seems to me that they could cause a false positive. But I’m not a doctor or medical expert so that’s just me – a repeat of the test should be an easy request, though.
Jul 03, 2010
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starstarstarstarstar dont see my last post
by: Felicia

not sure if the post I made went through (the second one)because I don’t see it just wondering if you seen it Kristen and also I hit the unsubscribe link by accident (lol) so here I am posting again so I can get commented back, thanks again!

From Kristen:

There’s a comment showing up from “anonymous” – is that yours Felicia? If not, your comment isn’t showing up at all – could you post again?
Jul 08, 2010
Rating
starstarstarstarstar had inderect coobs test
by: Victoria_victoriabrothwell@gmail.com)

I had the indirect coombs test done then 5 min later I had the rhogam shot the called me the next morning and told me that I was positive for an antibody. they ran my blood again and it came out fine the 2nd time. I have also had the rhogam shot at 28 weeks with both my girls and after birth. I’m pregnant again with a little boy and had it again at 28 weeks and will again after he is born. I strongly advise that anyone that is rh- get the Rohgam during and after you have your baby’s so you don’t but your baby at harm.If you have anything else to talk about just email me at victoriabrothwell@gmail.com be glad to talk.
Jul 10, 2010
Rating
starstarstarstarstar HI again!
by: Felicia

yes, actually that is my post…lol sorry I didn’t notice I forgot my name
Jan 07, 2011
Rating
starstarstarstarstar Rh sensitized?
by: Kristy

I’m not sure if this link is still active but I found it today while doing some research. Here is my situation. .
I am Rh negative and got the Rhogam shot at 28 weeks and after delivery with my son in Aug 08. I had a miscarriage in Sept. and got the shot after that. At my first prenatal blood work, it showed up that I’ve been sensitized. My doctor told me not to worry and that it was probably showing up because the Rhogam shot was still in my body.

Well,l I just had another blood test on Monday and it’s still showing up in my blood. I got the shot 20 weeks ago now and my dr. said there’s a chance that it’s still from the shot and we’ll retest at 24 weeks (I’m currently 16). I’m very worried. From what I’ve read, if I am producing antibodies and my baby is Rh positive then it is attacking the baby and making it very anemic. There is a wide range of things that could happen from this. My dr. told me that there’s nothing to worry about yet. Easier said than done!

Sorry for the long explanation but I’m wondering if it’s possible for the shot to still be showing up in my blood tests? You seem to know a lot about this topic. Thanks!

Answer:

Hi Kristy,

Rhogam generally “sticks around” for about 12 weeks, but it can be longer. I would strongly recommend that you ask your doctor for a referral to a perinatologist to get a second opinion and discuss options. This isn’t to scare you – you’ve already done the reading on your own and you’re worried. You and your baby both deserve a good answer. A perinatologist understands what goes on if you’ve been sensitized far more than a regular OB and can probably monitor your baby for a much clearer picture.

Also, you can have a blood test done now (a blood draw from you – not baby) that will tell you if your baby is positive or negative. In the US this test is analyzed by Lenetix Labs. You can read more about it here: RhD Genotyping. This is something a perinatologist can help you arrange so you know your baby’s status better (and without having to do an amnio).

Again, I urge you to seek a second opinion with a perinatologist, at the very least to truly understand what you are/are not dealing with. Best of luck to you Kristy!
Jan 18, 2011
Rating
starstarstarstarstar Positive b/w for Rh antibodies
by: ML

I too had a miscarriage on Sept 9, 2010 and received the shot right before an emergency d&c. I just got my bloodwork done yesterday and I too tested positive for the antibodies. My dr. said that they would dilute my blood to see how sensitive my blood was and that would determine if there would be some cause for concern. However, everything thing I am reading online says that if you are producing the antibody that it is a bad sign. Does this mean the RhoGAM shot failed for me or is it possible that it is left over from the shot?
Thank!

Answer

Hi ML,

Like I told Kristy, it’s normal for the antibodies to stay around for about 12 weeks or so. It is possible for Rhogam to fail, and it does happen, but it doesn’t happen frequently. I would recommend you ask your OB to refer you to a perinatologist who can help you do further testing and determine a plan of action if you are sensitized… or give you to go-ahead for pregnancy with your OB if you’re not!
Jan 19, 2011
Rating
starstarstarstarstar Thanks Kristy
by: Anonymous

Thanks for the reply. It has been about 18 weeks since the shot. So, this is why I am concerned.
~ML
Feb 11, 2011
Rating
starstarstarstarstar Rh sensitized
by: Annika

I found out i had antibodies after my first baby was born. It must have happened during my pregnancy.My doctor told me it was really rare to happen. My doctor said it wouldn’t help to get the Rhogam shot as I was already sensitized. 2 years later I had a my second child,a girl, born when i was 34 weeks pregnant. My second pregnancy was closely monitored by doing regular Doppler scans. She didn’t receive any blood trasfusions before she was born and also not after her birth. She had jaundice and was treated in hospital. She is now almost 4 years old and a very healthy child. My husband and I wanted a third child and after consultation with my doctor we decided to go for it. In 2009 my third child, another baby girl, was stillborn when i was 25 weeks pregnant. I received the same prenatal treatment as with my second pregnancy. She had 4 intra-uterine blood transfusions. The first transfusion when i was 21 weeks pregnant and the last at 25 weeks. Annika died in utero after the last blood transfusion. I was devastated, I still mourn for her. I wish I could have another baby but i am to scared of losing another. Good luck to you all. It helps to know I am not alone.
Feb 11, 2011
Rating
starstarstarstarstar UPDATE
by: Anonymous

Just wanted to update you ladies on my situation. I was retested at 20 weeks and my test came back negative! It must have been the Rhogam shot hanging around for much longer than it usually does. I am relieved and hope the same results for you ML. Thanks for the advice!
Jun 11, 2011
Rating
starstarstarstarstar worried
by: kelci

I was 18 yrs old when I got pregnant. I already knew I was rh- I had the rhogam shot at 28 wks and again in aug of 2010 wen I delivered at 37 wks. My son is rh+. About 8 months after he was born I went to donate plasma and they told me I couldn’t because I have the antibodies. Is this normal? Did the shot fail? Am I going to have this the rest of my life? I am scared this will prevent me from having another child. :(
Nov 18, 2011
Rating
starstarstarstarstar Rhogam Failed me
by: Rachel

I am a rare case as well. I had a perfectly normal pregnancy and gave birth October 11, 2011,& received my shot at 28 wks. I started having contractions at 36 wks but with no change in my cervix, I am now wondering if this was my body treating her as an intruder. She was born and was very swollen. I thought it was due to labor and delivery. But apparently the shot didn’t work and my blood and hers crossed. She was rushed to the NICU and had a jaundice level of 23.5 biliruben. A normal baby is placed under the lights at level 8 biliruben. She ended up having a blood transfusion after they did a IVIG treatment almost immediately after birth. The doctors had not seen anything like this in 25 years. It made me wonder if somebody did something wrong. I was told that I shouldn’t try to have anymore children because it will more then likely happen is all subsequent pregnancies.
Dec 14, 2011
Rating
starstarstarstarstar worried? i am obsessing!
by: Danica

I’d love an opinion! I am currently 32 weeks pregnant. I have known that my blood type is A NEG for a while, but I was not aware that it would be an issue for me in pregnancy, nor did I know about the RhoGAM shot until this past weekend (when I was at 31 and a half weeks.) I began having vaginal bleeding at 31 and a half weeks after having sexual intercourse (first time this has happened.) I rushed to the ER. The ER doctor (who does not deal with OB patients) asked me if I had the RhoGAM shot. I’d heard of the shot but didn’t really know what it was, told him I hadn’t had the shot. So I called my OB doctor the next morning and just to be safe he had me come to the hospital to get hooked up to the fetal monitor and get a sonogram, then get the RhoGAM shot. Everything went fine–sonogram was fine, baby’s heartbeat was fine, and his movement was as well. So I left the hospital feeling good..worry free. Then I read that there is more of a risk with subsequent pregnancies. If this was my first pregnancy, I would not be as worried. However, I remembered that it is not. I have had one miscarriage, I believe I was around 8 weeks pregnant. This was RIGHT before my current pregnancy. Now I am FREAKING out because I am afraid that my miscarriage had something to do with my blood not being compatible with the fetus’. And that my body has already had these antibodies since the miscarriage, and they’ve been attacking my baby this whole time. Oh, did I mention that I am very disappointed in my OB doctor for overlooking this issue? I know it is normal to worry, but I feel that I am obsessing over this and its unhealthy!

Kristen’s Reply

Hi Danica,

It sounds like you got the Rhogam quickly after the bleeding episode to take care of any problems that may have been caused (within 72 hours is when you need to get the shot).

As for your miscarriage with no Rhogam — it’s possible there was no problem, especially if you had an uncomplicated miscarriage. If your pregnancy is going well this time, there’s a good chance there was no issue.

However, you should put your mind at rest now. Ask your doctor to test you for antibodies!! This is a very simple blood test. He just has the nurse draw your blood and the lab tests for the antibodies.

If the antibodies are there, you can plan accordingly. You may want to ask him if your recent Rhogam shot will influence the antibody test, as I’m not sure how much it will influence the results. You can also ask if there is some monitoring that can be done for your baby.

Best of luck to you — I would insist that your OB work with you to bring you peace of mind!

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