The lonely scientist rants.

[rivka]

"[Rh incompatibility] wasn't an issue for all of human history until interventions were performed, like episiotomy and early cord cutting or Cesarians. Again, what gives?"

Okay, I have to get this off my chest here, because if I say it in response to the actual post I'm quoting I'll probably be banned:

For God's sake, isn't some kind of basic education in logic and science required in the schools? Don't people listen to themselves when they talk?

(Okay, never mind, I know the answers to those questions: no, and no.)

Rh factor wasn't even discovered until 1939. For "all of human history until interventions were performed," in that golden age of medical-provider-free natural homebirths in which nothing ever went wrong and there was no maternal or perinatal mortality, there was NO WAY TO TELL if Rh incompatibility existed.

Sometimes your baby was stillborn. Sometimes your baby had heart failure shortly after birth. Sometimes your baby was incredibly weak and sickly, but pulled through. And that was ALL YOU KNEW. It's not like your fellow tribeswomen would've stood around nodding sadly and saying, "Yep, this baby has hemolytic disease of the newborn. Just look at these abnormal red blood cells, which you can clearly see through the microscope I made out of vines and bark."

And even after the invention of the microscope in the seventeenth century... even after the discovery of blood grouping at the turn of the 20th century... people still had no freaking idea why some newborns developed hemolytic disease and died. You could go from one end of the world to the other and never hear a single person utter the phrase "Rh incompatibility." THAT DOESN'T MEAN THAT NO ONE EVER HAD IT.

I'll be the first to agree that there are plenty of screwed-up things about standard medical management of pregnancy and birth. However, I solemnly assue you: Rhogam for Rh incompatibility is not among them. If you are Rh- and your partner and baby are Rh+? Get. The. Freaking. Shot.

Comments

[rivka.livejournal.com]

Oh, yes. Christine Maggiore. It's funny how Mothering didn't put her on the cover again a few years later, when her three-year-old daughter died of AIDS (http://rivka.livejournal.com/354607.html).

Maggiore is what we call a "long-term nonprogressor." Some people, for whatever reason, have immune systems that are successful at fighting off HIV without treatment, year after year after year. The Institute where I work has a whole registry of them, and I know several of them personally. (All of the ones I know are current or former IV drug users, so Maggiore's super-healthy lifestyle isn't as much the answer as she pretends.)

It's too bad her daughter wasn't a long-term nonprogressor.

[naomikritzer]

Oh yeah. Now I remember reading that thread before -- I remember the discussion of Lunchables vs. HIV-infected breastmilk. Egads.

The phenomenon of long-term nonprogressors is really interesting. To expand on Maggiore's "why would undeserving mothers who feed their children Lunchables not lose their daughter, when I lost mine," I can think of a number of gay men of the 1980s who could've made better use of long-term nonprogressor status than Christine Maggiore. Sigh.

[ailbhe]

I read something lately about mothers in undeveloped nations being better off breastfeeding *even if they are HIV+* and was very interested - it was to do with asylum seekers being switched to formula while in the UK and sent back to make do with unaffordable formula and dirty water, I think. I got the impression this was very new advice though.

[rivka.livejournal.com]

This is actually true. Their babies are more likely to develop HIV but much less likely to develop diarrheal diseases etc., so it works out in breastfeeding's favor.

There is evidence to suggest that it's critically important to exclusively breastfeed, and never supplement with formula or solid foods. Once mixed feeding is introduced, the protective factor is lost.

However, it should be noted that the tradeoff only works in developing countries. In the US and Western Europe, whatever the lactivists say, the overall health risks of formula feeding are so small that they are not, not, not worth the increased risk of HIV.

[ailbhe]

Yes, the bit I read was about the damage being done in detention centres in the UK while waiting to send mother-and-baby pairs back to Warzonia, Africa. I think it was Morgan Gallagher's blog, actually.

[naomikritzer]

Was the damage actually taking place in the detention center or after they'd returned to Africa? Because yeah, if your water's not safe, your baby's going to be better off with breastmilk even if you're HIV+ and in fact sick with every bodily-fluid-carried disease known to medicine, so long as you're still healthy enough to make breastmilk.

I may be overstating my case very slightly, but unsafe water kills so many babies that I don't think there's much of anything that would make breastmilk the worse option by comparison.

If you're dealing with women who are HIV+ and in a place with a safe water supply BUT they're about to be packed off to somewhere without one, these women should be advised to breastfeed. Which is counterintuitive to first-world medical professionals, so I can see this causing problems.

[mjlayman.livejournal.com]

I read Morgan's blog, too. They separated the mother and child, so the child had to go on formula, and they were planning to send both back to Africa where there's dirty water and expensive formula. Morgan was part of the group that exposed Yarl's Wood to the public and there should be changes there soon. People were fired, other people were outraged. I don't know the UK well enough to know if change will actually occur. Here's (http://www.medicaljustice.org.uk/content/view/431/67/) a UK TV clip of what happened.

[almeda.livejournal.com]

One of my friends is a natural immune -- despite a long and risky sex history with very many people who turned out to be infected (in San Francisco, in the 70s, homosexually), he is still completely virus-free.

He actually makes pretty good money giving drug companies periodic blood and tissue samples so they can try to reverse-engineer him. Not that that's really compensation for having had to watch everyone he's ever loved die horribly ...

[naomikritzer]

Did you catch this news story? Christine Maggiore died on December 30th, at the age of 52.