Pregnancy After Abortion: RhoGAM & Risk Assessment - What to Do

Question
I just learned I am pregnant, no more than 5 or 6 weeks, I last menstrated 5 1/2 weeks ago and have tested pregnant.  I have A- blood, and underwent an abortion about 2 years prior, receiving a Rho Immune Globulin shot.  I don't have health insurance, and will be on emergency medi-cal, so I want to ensure I get proper treatment to have a healthy child now. I am slightly more concerned as during the first pregnancy (terminated at 5 to 6 weeks) I had strong breast soreness and regular nausea.  Now, I am experiencing only the faintest nausea-no vomiting, and no breast soreness.  (I am feeling very particular in food preferences, and mild headaches)  When should I receive the Rho Immune Globulin, what else should I know right now, and why do I have minimal symptoms?

Answer
Dear Elizabeth,

The lack of symptoms for this pregnancy is not necessarily abnormal. Every woman and every pregnancy is different. Some women have an abundance of pregnancy symptoms (mostly related to the increase in hormones) and some have none at all. The same woman who had a "miserable" pregnancy the first time may have a completely symptom-free pregnancy the next time around. It is completely random or luck of the draw.  :-)

The fact that you had RhoGAM with the first pregnancy/abortion was exactly appropriate. Sensitization usually doesn't happen until after the birth of an Rh-positive baby. Therefore, in most cases Rh incompatibility is not a problem during a woman's first pregnancy and delivery of an Rh-positive baby. However, later pregnancies and deliveries may be affected unless the mother is treated with Rh-immune globulin (RhoGAM) after EVERY birth, miscarriage, and abortion.

Most often, the woman who is Rh-negative and carrying an Rh-positive baby will not begin producing antibodies until delivery when blood would potentially be mixed. However, the first dose of RhoGAM is typically given as an extra precaution around the 28th week of pregnancy. This can prevent rare cases where a woman would start producing Rh antibodies months before delivery.

However, the fact that you have had an injection of RhoGAM with the past abortion will be at least 95% effective in preventing sensitization for you and protecting this baby. In a rather simplistic way, each subsequent pregnancy will require the RhoGAM injection protocol to protect the pregnancy AFTER that.

I hope that this has helped you and answered your question. I wish you well.

Happy Halloween and make sure that WOMEN'S voices are heard by voting!!

Brenda