Natural Birth and Baby Care.com

RhoGAM shot - hard choice

by Oksana
(Whistler, Canada)

I am 35 y/o, have Rh-(A), had miscarriage 1,5 years ago and RhoGam shot after that (my husband Rh+(O). I am 32 weeks pregnant now and have a lots of pressure from my doctor and ob/gyn to get RhoGam shot now and after the birth if my baby is Rh+.

I DON'T WANT to have shot before my baby is born and completely agree to have it after if it's needed. But still it's hard to live, thinking if I start develop A/B now it's all my fault because I didn't get a shot. What is the danger for my baby to develop Rh disease before the birth and what kind of alternative treatment do I have (regular antibodies test, how often?). I had 2 A/B screens so far, both were negative.

Thank you,

Oksana

Answer:

Hi Oksana,

In a normal, healthy pregnancy the risk of sensitization is very low. If you experience any sort of trauma such as a bad fall, an auto accident, etc., or if you have invasive procedures such as an amniocentesis, the risks go up greatly (it would be prudent to consider the shot if any of those occurred). But if you're well-nourished and healthy, the risks are really low.

Sensitization in this pregnancy would probably not affect the baby you're carrying right now at all. It tends to cause complications in future pregnancies if it occurs.

Tests for sensitization can be done at any time during pregnancy or after pregnancy. As a general rule, the screen is done only at the start of pregnancy. After that, women are giving RhoGAM and then the doctors let it go, assuming the shot worked perfectly.

Treatment for a sensitized woman involves careful monitoring of the baby throughout the pregnancy and could involve blood transfusions while the baby is in the womb.

You can continue to have screens for the antibody if you wish - many doctors like to give shots or screens at 28 and 36 weeks. You can also request one after your baby is born and you've received postnatal RhoGAM. Your baby should be blood typed and if he or she is Rh+, you will get the shot within 72 hours of delivery. You should be able to have the screen done accurately within a few months after your baby is born.

The choice to have prenatal RhoGAM or not is not an easy one - and it really comes down to individual decision. I can share my experience (which is to decline prenatally and accept postpartum). There are many women who decline all shots. There are many others who accept all and are very grateful for them.

I can't make the choice easier for you or really even ease your mind. I can offer you information to make the choice for yourself, but in the end you must decide which is right for you and your baby based on the information you gather from all sources.

Best of luck to you Oksana!