Rh Factor and Miscarriage: Understanding Rhogam and Antibody Concerns

Question
I am 21 and had two miscarriages prior to the birth of my daughter who had a high bilirubin and was born five weeks early. I am Rh negative. I just had a third miscarriage at nine weeks pregnant. I had Rhogam with my daughter and with this past miscarriage. But if I am carrying the antibodies, could this have caused the miscarriage. I was told by my midwife that I have to wait ten days to have the test to determine if I do carry the anti-rhesus antibodies, since I just had the miscarriage.Would this explain my daughters high bilirubin at birth? And my miscarriage? PLease help. My husband and I want other children and are scared that this might mean it is not possible for us.

Answer
If you have Rh Negative blood type, youo must have RhoGam after each pregnancy (even miscarriages) in order to prevent your body from developing Rh antibodies. Rh antibodies can cross the placenta and cause erythroblastosis fetalis (blue baby syndrome) which can cause the death of a baby at term. Rh antibodies will not cause a miscarriage. A high bilirubin at birth is normal and is due to failure of congugation of bilirubin by the newborn. It usually takes a few days to congugate the bilirubin. If the baby does not conjugate the bilirubin, we usually place the baby under the lights and all is fine.