Friday, December 21, 2007

don't be negative

That's B-, my blood type.

When I first visited the doctor at about week seven of my pregnancy, he told me that since my Rh type is negative I'd receive a Rhogam shot after 24 weeks, and then another one after I gave birth. I filed this information on a growing mental list of fascinating and unknowable pregnancy mysteries. I hadn't, at that point, even begun to consider all the ways I might disagree with the medical establishment about what is and is not necessary during pregnancy... but given my disposition in general I should've known I'd have to butt heads at some point.

My doctor in Japan said the same thing about the Rhogam shot, but since I wouldn't be seeing him beyong my 23rd week, it wasn't on my mind at all while I was in Kyoto.

So I looked into it a little more with my best friend (who happens to be in medical school and could look it up in her pharmacology database) before I went for my routine prenatal earlier this week. I was prepared to ask a few questions about it, but still didn't have much by way of analysis. Doc said the risk of my blood mixing with the baby's blood is higher during the third trimester, so they advocate the Rhogam shot to prevent my body from developing antibodies in case the baby turns out to have Rh-positive blood. Like a reverse vaccination.

What are the risks that necessitate the shot in the third trimester? Doc didn't elucidate. In the clean efficiency of the examination room, in the strange hypnotic power dynamic between doctor and patient, I lost what resolve and reservation I'd had. I figured he knew what he was talking about and scheduled a shot for the following week. He also recommended that I get a flu shot, which I accepted on the spot with little thought or hesitation.

Then my mother-in-law, who is a nurse, sent me an article about how Rhogam shots contain mercury and do, in fact, warrant some reservation. Since she is usually one to do things by the book, I took it with that much more weight. The article offered information not only about the mercury, but about the controversy of the shot and whether its benefits are significant enough to offset its potential risks. I looked at some more articles about Rhogam, and found myself suddenly mired in a glut of conflicting opinions and fretting about the statistical hall of mirrors I had so casually entered into.

I also read that the flu shot has the highest mercury content of all vaccinations.

I felt like I'd been duped. Some sources will tell you to ABSOLUTELY get a flu shot during pregnancy, and others will tell you not to bother. But mercury-based preservatives? Isn't this about health?

Apparently there are mercury-free versions of Rhogam (under different brand names) that I could insist upon, but by that point I felt disillusioned and disempowered. I skimmed more online articles, drilled recently pregnant friends and relatives about their choices, scoured my midwifery books, but eventually I saw that none of that could assuage the uncertainty. I would have to make up my mind and choose for myself. I would have to assert myself, based on scant research and copious intuition, and enter into this bright confusing world of mother and nuturer and choice-maker.

I cancelled the Rhogam shot.


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