Conference moira::parenting

    I have 0- blood.  With the first pregnancy it isn't as much of a
    factor.  If you are pregnant with a + factor child and somehow the
    blood from the baby enters your bloodstream then your body will begin
    to create antibodies to fight off the "invader".  I believe the
    antibodies effect the next pregnancy, causing problems in the baby. 
    That is also one of the reason's some states required
    blood tests before you could get a marriage license.
    
    Anyway, the Rhogam shot is to prevent those antibodies from from
    forming and attacking the next occupant of your womb.
    
    sandy

    Hmmm, interesting.  I'm pregnant with two, and I have O Negative blood.
    
    If I weren't in such a rush to get to a funeral this AM, I would have
    asked a lot more questions... But I'm starting my list now, and will do
    some research both on-line and hardcopy tonight.
    
    Thanks for the quick reply!  
    
    

The "Rh" factor is a surface protein on red blood cells.  Some people 
have it (and are referred to as "Rh+"), and some don't (and are 
referred to as "Rh-").  (It's similar to, but distinct from, the more 
familiar "A" and "B" blood types:  if you have the A and Rh 
proteins on your red blood cells, then you have blood type A+; 
if you have the B protein but not the Rh or A proteins, then you 
have blood type B-; if you have Rh but neither A nor B, then you 
would be O+; etc.)

The Rh factor is an "antigen".  That is, the immune system is 
sensitive to it.  If you are Rh-, then you will not normally have 
blood cells with the Rh protein in your blood; if you did have such 
blood cells (for example, from a transfusion), then your immune 
system would recognize them as "foreign", and would attack them.  
(This is why you want to match blood types, including Rh factor, when 
you give a transfusion.)

The Rh factor is a dominant inherited characteristic.  That is, you 
have two Rh genes, each of which can be either "r" or "R".  If your 
pair is Rr or RR, then you will be Rh+; if it is rr, then you will be  
Rh-.  Children get one copy of the gene from each parent.  Thus, a 
child of two Rh- parents, each of whom must have rr, can only get r 
genes from each, and must be rr (RH-) himself.  Two Rh+ parents could 
each have genes Rr, and pass their r genes on to their children, who 
could therefore be Rh-.

The important possibility is that an Rh- (rr) mother and an Rh+ (Rr 
or RR) father could have an Rh+ (Rr) child.  The first such child is 
normally ok -- the mother has never been exposed to Rh+ blood cells 
before, so she hasn't produced antibodies against the Rh protein, so 
there is no problem.  However, it is common during labor and delivery 
for a bit of the infant's blood to get into the mother's blood 
stream.  Now the mother's immune system sees the Rh+ blood cells, 
recognizes them as foreign, and starts producing antibodies against 
them.  Still no problem -- the mother now has anti-Rh antibodies in 
her system, but there's nothing for them to attack, so they don't 
cause any trouble -- until the mother becomes pregnant with a 
*second* Rh+ child.  Whole blood cells are not normally exchanged 
between the mother and fetus (except during birth), but antibodies 
are much smaller, and the mother's antibodies *do* normally make 
their way into the fetus's blood stream.  

So, we now have a mother with anti-Rh antibodies in her blood, which 
are making their way into the blood of her Rh+ child, where they 
attack the fetus's blood cells -- big trouble!

Rhogam is an injection which can be given to such a mother 
immediately after the birth of each child. I don't understand the 
details, but I think that the way it works is that the Rhogam 
injection contains concentrated anti-Rh antibodies (the same ones 
that would cause problems if the mother were to make them herself).  
The Rhogam antibodies seek out and bind to the Rh factor protein on 
the Rh+ fetal blood cells that have gotten into the mother's blood 
stream.  That keeps her own immune system from recognizing and 
reacting to them, so the mother does not become sensitized to the Rh 
factor protein, does not produce anti-Rh antibodies of her own, and 
therefore does not attack the blood of her next child.

	-Neil

    But, it's only a problem if the father has Rh+ blood, if he's Rh- then
    there is no issue.
    
    /Susan  (also Rh- with an Rh+ husband)

    Also, I believe it's a important to remember that it's a problem with a
    subsequent *pregnancy*.  If the first pregnancy ended with an abortion or
    miscarriage the woman should still receive the Rhogam shot.
    
    sandy

    hmmm.. I'm a bit confused.  My husband has B+ blood, I have O- blood. 
    Our daughter, who is 6 months old, has B+ blood.  I don't remember
    receiving any injection in the hospital.  What does this mean when I
    become pregnant again??
    
    Holly
    

    Hi Holly,
    
    Give your obstitrician a call and have them check your charts. It's
    something you really need to talk to the doctor about.  If you didn't
    have a shot then your next child *could* be a risk, so you should go
    into it knowing possible risks.
    
    sandy

    
    	I'm A-, my husband is O+, and both kids are A+.  
    	Typical intervals for the Rhogham shot are at 28 weeks gestation,
    	and again within 72 hours of delivery, miscarriage, or abortion.
    
    	You usually remember getting it, since they administer it into
    	the hip (and it hurts).
    
    

>    hmmm.. I'm a bit confused.  My husband has B+ blood, I have O- blood. 
>    Our daughter, who is 6 months old, has B+ blood.  I don't remember
>    receiving any injection in the hospital.  What does this mean when I
>    become pregnant again??
>    
>    Holly

It means that you should find out whether they gave you a Rhogam shot and 
you didn't notice it, or if there's some other reason (that I can't 
think of) why you don't need to worry.

	-Neil

    I'm also Rh- and was tested for that shot one other time in my first 
    pregnancy. I was in a very minor car accident and I had a blood test to
    determine if there were any antibodies in hthe bloodstream. If there
    had been, I'd ave had yet another shot. 
    I remember asking if they were going to determine the kids' bllood type
    before I got that last shot. They looked at me like I was crazy, but
    they did do it. Seemed to me that if the kids was also negative there 
    would be no need for a shot. 
    My negative s-i-l had an amnio and they tried to give her the shot
    afterwards. But my b-i-l is negative, so she resisted. It took a call
    to her OB to convince them she didn't need one. The OB explained that
    sometimes they push the shot in case the jfather isn't the husband.
    Go figure.
    

    I am Rh- and am pregnant with my first child.  My doctors discovered
    early that I was Rh- and so they tested my husband too.  It turns out
    he is O+ so the possibility of us having a child with Rh+ is great.  I
    was given a Rhogam shot after the 27th week of my pregnancy and was
    told that they will be giving me another shot within 72 hours of delivery
    to prevent my body from generating antibodies which would cause
    problems with any future pregnancy.  The Rhogam shot did hurt for a
    short period of time but it was not that bad.  
    
    I think it's great that now the doctors can give you something which
    will prevent problems for future pregnancies.  Just think about how
    many women in the past probably were never able to have a second child
    because of this problem and never knew why.
    
    Maria

    
    	I believe there's no risk in getting the shot if the
    	father is negative, but it's risky not to get the shot
    	if the father's positive.  Most doctors would rather err
    	on the side of caution.
    
    	Holly, I just remembered, I've received a small wallet card
    	with ever Rhogham injection I've been given. 
    
    

    I remember having the shot during my pregnancy but I really don't
    remember receiving it after Aaron was born (I received it, I just don't
    remember it).
    
    I don't know if you've ever heard of women who had "blue babies".  If I
    remember correctly that's one of the results of a baby being born to a
    mom who hasn't had the shot and built up the antibodies.  The baby
    didn't receive enough oxygen and will have many complications as a
    result of that.  This is all from my (faulty) memory from many years,
    possibly even high school health, I just remember snatches of
    information...
    
    sandy

    
    
    I wouldn't get the shot unless the father was rh + as rhogam is a blood
    product.  As such it does carry some risks.
    
    -beth, with + hubby (one child +, second -)

    I am the second of four healthy children born to my mom who is Rh-.  We
    are all Rh+.  There can be complications if there is a
    cross-transfusion of blood between a baby and you if the baby is Rh+. 
    They had just discovered the factor when my youngest sister was born.  
    
    There are blood incompatabilities that can happen, and it can cause
    major problems with a baby who is also Rh+ and born to a sensitized Rh-
    mother.  The degree of problems varies with each person and each
    pregnancy to a sensitized mother.  Ask your OB if this is your case. 
    First pregnancies are not normally a problem.  Subsequent ones if you
    are sensitized (can be checked with some tests) can be problems.  It is
    one reason my brother and I are 14 years apart, but mom then had two
    more kids without any problems. YMMV.  What may surprise people is this
    isn't the only potential problem. I am O+ and Frank is A-.  My midwife
    is very careful to make sure that my kids have been brought up above my
    heart level as soon as they are out to avoid some serious jaundice
    problems that can happen because of this, if we cross-transfuse and
    they wind up A anything.
    
    meg

    I happened to think of this over the weekend... does this shot have to
    be given in the muscle?  Or could it be given to my via my IV?  I was
    on IV for the next day after Alycia was born.  I was on antibiotics
    because my fever had risen.  I seem to remember something being put
    into my IV, but I'm not sure.
    
    Ugh.. confusion!!
    
    Holly
    

    Hi,
    
    i am wondering if anybody can help me out. I have sufferd four
    miscarriges over the last seven years. My last one was four years ago.
    I am a bit scared to try again as i couldnt handle loosing another.
    They have all been at different stages between 7 weeks and 21 weeks.
    They think it was something to do with my and my partner white blood
    cells. Something like they are different and the babies had his white
    cells and i was rejecting them as foreign. I am no longer with him but
    his blood type is 0+ and so is mine, most of the population is too. I
    would like to hear from anyone who has any information about this.
    There was a trail going on where you get the mans white cells injected
    into you during your pregnancy but unfortunately i dont know the
    results of that. Any input would be a help.
    
    
                            regs,
                                 Wendy