Q: I am concerned about the safety of the Rhogam injection, most especially when given during pregnancy. I have no information that makes me concerned; I guess it's just my natural way of questioning *any* kind of injection or intervention. Does anyone know of a reason why we as midwives/moms should be concerned?
-Elaine Friesen
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As a CNM practicing for many years, I have had several mothers ask about the safety or necessity of the Rhogam shot. I assure them that it is produced and that it is closely monitored. I discuss with them the greater risk of current or future pregnancy complications by *not* taking the shot. They usually want to do what's best for their baby and get the shot.
-RufusCNM@aol.com
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I am assuming that you are referring to Anti-D, given to rhesus negative women when the partner is rhesus positive, leading to a rhesus positive baby. There are associated dangers with this vaccination as it is made of human blood products, obtained from a pool of rhesus negative male donors. However, the risks far outweigh the benefits of the mother being prevented from developing antibodies and being unable to have any normal pregnancy with a rhesus positive baby. I am Rh neg and recently had an early miscarriage because it was prior to eight weeks gestation and I did not have the vaccine. This is usual practice in New Zealand as the placenta was not fully formed and no fetal blood cells would have been able to enter my system. A fabulous way of avoiding lots of these vaccinations is to avoid or minimise interventions during pregnancy i.e., amniocenteses.
-Karen Blake
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I am Rh negative and my husband Rh positive, therefore the Rhogam injection was an issue for me. With my first pregnancy, I did not give it too much thought until after the nurse gave me the injection of Rhogam at 28 weeks. After receiving the injection it was as if a light went off, and I realized I had just received a *blood product*! Foolishly I had not read up on Rhogam nor asked to read the package insert before the injection. My concern was HIV.
So I did some investigating to see whether or not my concern was justified. What I discovered from calling the American Red Cross, inquiring into the procedure used to make Rhogam and speaking with other people who had some background in blood products is that, first of all, there has never been a documented case of HIV transmission from Rhogam, and Rhogam has been around for quite some time (I want to say 30 years or so, but I am not certain.) Second, if I remember this correctly, Rhogam is made from blood plasma, not the whole blood product. And third, the plasma used to make Rhogam is heat treated which would, in theory, kill any HIV present.
This is the information as I recall it. I would advise you to double-check this information with a knowledgeable source in case I have recalled something incorrectly.
Two suggestions I would make to any pregnant Rh negative woman: 1) Have the baby's father's blood type checked before submitting to the Rhogam injection. If the baby's father is Rh negative, there's no need for Rhogam. 2) Type the baby's blood after birth (cord blood). If the baby is Rh negative (like the mother), there is no need for the postpartum injection.
-Dianne Oliver
Reprinted from Midwifery Today E-News (Vol 1 Issue 48, Nov 26, 1999)
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