This is a really complicated subject but I'll try and pass on what I've worked out...
1. You do not have to have the injection if you don't want to.
2. It is given as a precaution to women who are rh negative who may have a rh positive baby.
3. The reason it is given is because an rh positive baby is incompatible with mum. Mum MAY develop antibodies which attack baby's blood cells, causing it to be anaemic.
4. Antibodies will only be triggered if mum has been exposed to a previously sensitising experience. Potentially sensitising events include the following:
- Abortion
- Miscarriage
- Bleeding during delivery
5. So if this is your first ever pregnancy you are less in need of anti-d during pregnancy. Baby's blood will be tested after birth and if baby is rh positive then it's recommended that you have anti-d to protect any future babies you choose to have.
6. The blood tests you have early on in pregnancy (when you find out your blood group etc) also includes a test to check for the presence of antibodies in your blood.
7. If you are sensitised during one of the above events and you do not receive anti-d, there is no retrospective treatment that will stop antibodies developing in future pregnancies where your baby is rh positive. All medical professionals can do is monitor the pregnancy closely and in extreme cases, give blood transfusions to the baby while in utero. Please note that it is very rare for a woman to be left unprotected after a potentially sensitising event (though studies I've read suggest that in some cases of missed miscarriages there's a small chance your blood group is not taken into account and therefore the anti-d may not be administered.)
I think the long and the short of it is that it's a complicated issue, but ultimately down to you. I believe health professionals give anti-d because they feel there's good reason. However, it is perhaps more important in subsequent pregnancies rather than your first.
I'm not a doctor or midwife and can only give you advice based on what I've researched. I am rh neg and a chronic worrier.
Good luck! xxxxxx