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Alicorn comments on Efficient Charity: Do Unto Others... - Less Wrong
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I've donated blood a few times and I'm type A+. Why is it that B's are less likely to donate, or is that unknown? Are my donations likely to be marginally useless?
I have mostly donated blood in the past for signaling reasons, conversational high ground, and a vague desire to match the 15-gallon mark that my grandfather got his name in the paper for. There's a plaque of the newspaper mention in my grandma's house and I've been looking at it my whole life. Also I figure the Red Cross will let me know if I come down with one of the diseases they screen for, and it's a free way to get my iron levels checked (attempting to donate blood was how I found out I was anemic in the first place). These reasons aren't likely to evaporate if I find that I have been saving only tiny fractions of expected lives, but I would probably endure less inconvenience in order to donate for only these reasons as opposed to these reasons on top of lifesaving.
Your donations are not marginally useless! (unless you've been pregnant a couple times - in that case, consider stopping).
The reason for the discrepancies in donation rates between types A and B is both simple and complex: ethnicity. In the interests of safety (avoidance of Hepatitis C, HIV, etc) we've set up a system that subtly encourages certain types of donors and discourages others. The system is not racist per se, but it is most effective in obtaining donations from white, middle-aged, middle-class males.
Regarding signaling reasons: we are obviously very afraid of blood donated for signaling purposes. Accordingly, we do not allow people to donate to their relatives except under very unusual circumstances. Additionally, we give people an "out" by checking a box which tells the center to draw and discard their blood. That way people who fear they may be high-risk donors can get the social approval of donating without harming any patients.
I've never been pregnant, but what is it about multiple pregnancies that renders the blood non-preferred?
Obvious guess: Your blood then contains antibodies to the blood type of your babies.
Essentially this. The A/B/O blood groups represent the most relevant antigens in human blood. There are a host of others (Rh, Duffy, Kell, etc.) which typically create only minor problems in a transfusion and which can be ignored in an emergency. But a person who has been exposed to allogeneic blood via multiple transfusions or pregnancies becomes more likely to develop antibodies to some of these antigens. The donor's antibodies or white cells can react to the person being transfused, causing lung damage.
In the case of the Rhesus factor it should be noted that it is minor once and then only minor for males. Being thereafter unable to safely give birth to healthy Rh+ children is definitely not a minor consequence even if it is better than 'probably going to die today'. (Unless, I suppose, you happen to some Rh+ antiserum lying around but no Rh- blood, which will usually avoid the future difficulties.)
I use "minor" differently than you do, to mean "unlikely to cause death". Obviously cross-matched blood is always preferable for a variety of reasons (including possible infertility, in the case of young females).
I would avoid RhoGam in the case of a patient who needs a RBC transfusion, incidentally. It would be unlikely to be safe or effective.
I would like to express that my approval of this phrase extends beyond the capacity of upvoting and into the capacity of a comment expressing approval.
And having both your arms removed is "Just a flesh wound!".