Please please don’t let this devolve into a “If you don’t get a Rhogam shot then you’re a baby killer” / “If you get a Rhogam shot then you’re a shill for the man” type of pissing contest.
I want hard numbers. Facts. Statistics. Every time I try to find simple data all I get are opinion articles, slanted viewpoints, and drug company propaganda.
Where can I find data regarding fetal deaths associated with the negative/positive blood type disorder (?) before Rhogam was introduced so that I can compare that to data regarding fetal deaths associated with the negative/positive blood type disorder (?) after Rhogam was introduced? Possibly nationwide statistics instead of carefully selected samples that serve the motives of the person doing the study?
I understand what the shot is supposed to do. What I want is a big ol’ pile of numbers showing what it actually HAS DONE as it has been implemented by the medical community.
I can’t find this data anywhere, so I’m asking for the help of the Dope. Some of you have access to (or just know where to find) some of the best information out there. Please help if you can
I do not need an answer fast, our decision regarding additional children has already been made, but I am so sick and tired of hearing the opinions of doctors voiced as fact in an authoritative manner when the people they are advising are not in the best position to be making snap decisions.
So doctors are not authorities on medical matters now? :dubious:
You can get the first page for free here, and it seems to be only a two page (at most) article. That page may not have all the actual figures asked for, but I think you can infer quite a lot about the situation from it.
I know nothing about this, but I note that according to the Wikipedia page the risks are negligible, and there is nothing to suggest otherwise even on the Talk page. Are we seeing the early stirrings of a whole new anti-vax scare here?
I’ve been an OB-GYN nurse for over 20 years, 15 of them dealing exclusively in complicated pregnancies and have never met anyone who knowingly declined a Rhogam shot. Could I ask why you would make this decision?
The opinions of doctors should not be presented as fact in an authoritative manner. This is a non-debatable point. This is why many people seek multiple opinions on serious health issues. Opinions vary, and are influenced by a doctor’s individual perception of the data they have (or lack of data). Any doctor who presents his/her opinion as the absolute fact of a matter without data to back it up has their opinion disregarded by me. If the actual numbers are X% of (whatever), but it is presented as 100% definitely going to happen (whatever) because of any reason, then I call bullshit and I’m irritated that it’s permitted. I’m doing my due diligence and seeking facts to offset these varying opinions.
No, there is nothing stirring that will become an anti-vax anything. I asked for facts. Plain and simple.
From what I understand (so far), the Rhogam shot is derived *directly *from blood.
Jehovah’s Witnesses do not accept blood; fractional blood products are sometimes accepted depending on the individual’s conscience.
My wife and I are Jehovah’s Witnesses, and since we have opposite blood types (which makes the Rhogam shot an issue) we’re going to be one-and-done with kids, to eliminate risks with future pregnancies.
The girl we have is perfect, healthy, and beautiful. We don’t have any desire to push the envelope of risk. We’re also happy to have a family of three
I’m not interested in a religious debate, or an ethical one. I just want some hard data to educate myself on the Rhogam shot, what brought it about, and how it’s been performing since it’s introduction relative to it’s intended performance as a baby-saving measure. There’s lots and lots of things that are done every day automatically without any question as to their necessity, simply because it is understood to help mitigate some risk of something. I’m not usually one to debate these, unless it impinges on my life, my wife’s life, or now my baby’s life. As any good parent would do.
Nobody should ever accept what they’re told without understanding what it is - unless you have absolute 100% faith in the person/organization telling you. When it comes to the medical community, given the wide range of varying opinions and subsequent differing health outcomes, I do not have 100% absolute faith. I trust the intentions, but I will do my own homework to make sure that the goals of the doctor coincide with my own.
Thanks for that link by the way. I appreciate it, and I did read it. Seems like an awful short page though if it’s only a two page article. It’s like a 5th grade essay in length
It is a blood product, and whenever I’ve ordered it I’ve given the same spiel I give whenever I give blood products. The difference from, say, pack red cells, is that it has no cellular material. It’s highly, highly purified, so the infection risk (which I know a lot of people are concerned about) is incredibly small.
Numbers-wise, here is a nice succinct summary from “UptoDate,” a subscription site for physicians:
. The citation is from Bowman JM, “The prevention of Rh immunization,” Transfus Med Rev, 1988 2(3).
As an interesting aside, they used to make it from women who had become alloimmunised, but since there’s been such a dramatic decline in that population, they now purposefully alloimmunise men in order to have a source of the antibodies.
I spend a fair part of my work time during the year helping with intrauterine blood transfusions to the fetus suffering Rh incompatibility complications. I just can’t imagine anyone declining RhoGam for religious reasons and thus leaving the door open to this particular procedure if there was an option to not do so.
I also can’t recall noting that any of the patients whom we have treated with an intrauterine blood transfusion being a Jehova Witness either, but then that information is not usually a part of my role in this procedure. Do JW’s generally decline Rhogam? (I’m hospital based, not clinic based, so maybe they do. I would assume that if they do decline, the incompatables miscarry and don’t make it to my specialty.)
What we generally do for JW infants needing blood when the parents decline is have a judge order the transfusion. That seems to absolve the parents of responsibility and thus lessen their risk of community censure.
If the Rhogam is declined, then the individual’s religious beliefs and conscience wouldn’t permit an intrauterine blood transfusion either, so it wouldn’t be something you’d run into I imagine.
Jehovah’s Witnesses accept/decline blood products (not transfusions, just products) generally on a case-by-case basis as determined by the specific composition of that product relative to the individual’s conscience as to what they are comfortable accepting. We believe that while the transfusion issue is very clear, there is a scriptural principle of each person “bearing their own load” of responsibility before Jehovah God and so it is up to them what they will and will not accept when it comes down to things that require blood for their manufacture, or procedures involving the use of blood.
It does not absolve the parents of anything - if they permit it without strenuous protest then they probably didn’t have a very strong faith to begin with and may have been Witnesses in name only in the same manner as many Catholics tend to be. This is not intended to be an inflammatory statement, just a possible reason for why you may have seen success in doing this.
Is there any further information available regarding the statistics of what happens to the babies of mothers who have become “alloimmunized” (if I’m saying that correctly)?
Like, x% of alloimmunized women experience fetal death, or x% of alloimmunized women carry to term but have babies who require treatment to avoid brain damage?
Those numbers look like it’s saying 16% of RH negative women have a chance of even being in a position that requires the Rhogam shot to begin with. And what % of women are RH negative anyway? So we’re looking at a relatively small portion of the population to begin with. And of these affected women, what percentage actually experience issues that Rhogam would have helped with?
Statistics are a tricky thing. Lies, damn lies, and statistics, as they say. I think most of that comes from a misunderstanding of what they numbers actually translate to for real world risks.
So when a nurse comes in a says “So you declined the Rhogam shot? OK. Your next baby will die.” It makes me want to punch her in the vagina. First off, is that a true statement? No. Secondly, if it were, is that the appropriate way to deliver that information? No. My wife just gave birth, is emotionally drained/filled at the same time, and we’re navigating the world of newbabylandia. It’s like the pro/anti abortion people. Asinine on both sides because of the way they twist numbers to support their views.
There are a few things we test for and treat not because they’re common, but because they’re extremely serious. Like the little heel-stick we do to newborns to test for some metabolic deficiencies. The deficiencies are rare, but the serious consequences–mental retardation and death–are very preventable, so we act on that logic.
I don’t want to be rude, but if your religion is your reason for doing this, then the numbers don’t really matter. I’ve had a number of patients refuse treatment on religious grounds, and I had no expectation of their changing their minds based on statistics. If you were doing it for non-religious reasons, I’d be more strident.
Unfortunately, I couldn’t find anything numbers-wise, but you’re right in that not 100% of babies are killed by the resultant anemia. The chances aren’t good, however. If the mom is alloimmunised and she has an Rh- baby, however, there will be some impact on even the first affected baby–at best, just some jaundice after birth, and at worst, intrauterine death. Every subsequent pregnancy after the first affected one will get worse, and it’s uncommon for an alloimmunised mother to be able to carry an Rh- fetus to term after the first one without intrauterine transfusions.
