RE: [ozmidwifery] RE:RH - Anti D

[Kirsten Dobbs]

Coming from New Zealand the whole deal of giving anti d routinely at 28 & 34 weeks is very different to what  guidelines NZ have.  The red cross blood service in NZ have guidelines   http://www.nzblood.co.nz/?t=25 scroll down to use of anti d during pregnancy and post partum.   I am rhesus iso immunized due to a mixing somewhere between 36 weeks and birth, without a visible bleed, but I was told I was a tiny percentage, something like 1 in 1000 woman who become iso immunized, most have a visible bleed and can be given the anti-d. Sara Wickhams book is fantastic and I too believe the pharmaceutical companies get more out of the prophlatic use of anti-d than woman do.   Kirsten   From: owner-ozmidwifery@acegraphics.com.au [mailto:owner-ozmidwifery@acegraphics.com.au] On Behalf Of Tanya Fleming Sent: Wednesday, July 27, 2005 6:55 AM To: ozmidwifery@acegraphics.com.au Subject: Re: [ozmidwifery] RE:RH - Anti D   I can't help but believe that the increased used of Anti-D during pregnancy is a money-making line for the pharmacuetical company's that produce it.  I must admit...i haven't done a lot of research on it.  What i would like to know, is...is the increased use of anti-d in pregnancy resulting in a significant decline in isoimmunisation?  I suppose these sort of studies won't be around for a while, as this is reletively new practise.  My personal belief....being a negative blood group and having had 2 babies before....both negative blood groups....anti-d was not given in pregnancy with these babies.....I would probably choose not to have it with future pregancy's either unless positive baby after birth.   tanya ----- Original Message ----- From: brendamanning To: ozmidwifery@acegraphics.com.au Sent: Monday, July 25, 2005 6:10 PM Subject: Re: [ozmidwifery] RE:RH - Anti D   MM,   When I explain the presently recommended protocol for current management, it doesn't mean that I support or endorse it !  Just providing the basic rationale.   In the local small Mid unit here we have a high proportion of Jehovahs Witnesses as clients. They are predominantly RH Neg (due to intermarriage in a small community presumably). So none of them have any form of Anti D, Rhogam or WinRho (do they still pay blood donors in the USA ?). NONE of them are isoimmunised, despite not adhering to any protocols, and interestingly no-one here ever gave them any grief about declining the Ig, so perhaps instinctually none of us believe it's the 'right ' thing to do !   On the other hand there were thousands of RH Neg women from overseas in the RWH in the 80's & 90's who lost baby after baby to hydrops & other iso- immunisation related path. It was heart breaking for them. How were they different, was it just their previous birth exp in another country or some other aetiology we never understood ? ----- Original Message ----- From: Mary Murphy To: ozmidwifery@acegraphics.com.au Sent: Tuesday, July 26, 2005 4:42 AM Subject: [ozmidwifery] RE:RH - Anti D   Brenda wrote: so long as you have no objections to receiving a blood product, you are following the presently recommended protocol. Many women don’t know that it is a blood product and one that often comes from Canada as we don’t have enough from Australia.  It is really big business.  I attended the launch of the product here in W.A a few years ago and no expense was spared on a dinner for appropriate health professionals..GPs, Obs, Midwives , hospital administrators.  There is nothing mandatory about the new “routine” and many women do not follow it for the above reasons.  It really is a big experiment that women are expected to follow because it is seen to be “best”.  We really don’t know what will happen when all these women get potentially unnecessary blood products in pregnancy. Many of the babies will be Neg blood group.   What goes into a pregnant woman’s body also goes into her baby’s. A good book to read is written by  Sara Wickham “Over the last 30 years, anti-D, or Rhogam, has become accepted as being routinely advisable for rhesus negative women. However, the question remains that - if women's bodies are designed to give birth without intervention for the majority of the time - why is this necessary? Sara Wickham explores the paradox between physiological birth and the routine 'need' for anti-D and highlights some interesting evidence which may explain this paradox. England 2001 “  MI1883 Title: ANTI-D IN MIDWIFERY: PANACEA OR PARADOX? Book by Sara Wickham Price: AU$65.95 (convert currency)    Maybe someone has this book?  I know I read an article by Sara with much the same title, but I can’t track it down.  MM