Hospitals around the country are now banning vaginal birth after cesarean delivery and insisting women undergo repeat cesarean delivery. Hospitals say they cannot comply with the guidelines issued in 1999 by the American College of Obstetricians and Gynecologists. The guidelines call for a doctor to be available “immediately” throughout active labor when a woman is attempting a vaginal birth after cesarean delivery, in order to perform an emergency cesarean section if needed. Previous guidelines had called for a physician to be “readily” available. In order for a hospital to comply with the new recommended guidelines, a whole operating crew, an anesthesiologist and obstetrician would have to be in the hospital around the clock. Only major medical centers, with in house physicians, will be able to continue to offer vaginal birth after cesarean delivery. Smaller hospitals may now have to abandon the practice.

Why the controversy? Women attempting vaginal birth after cesarean delivery are at a greater risk for uterine rupture than what was once believed. Uterine rupture can be life threatening for both the mother and her baby. Some patients with uterine rupture may require a hysterectomy and some infants may die. The controversy that arises with the risks associated with vaginal birth after cesarean delivery is that many women are willing to take the risk, but their freedom of choice over who controls childbirth is being steamrolled by physicians and hospitals. Women are not being allowed to have a choice in their mode of delivery. Doctors say their position is based on concern for the patient’s safety.

Doctors now have a new worry that women trying to avoid repeat cesarean delivery may give birth at home or in birthing centers that are not equipped to perform emergency cesarean surgeries if necessary. Also of concern is the possibility that laboring patients may wait to the last moment to go to the hospital to avoid repeat cesarean section.

The controversy surrounding vaginal birth after cesarean delivery is not only a health care issue, it is becoming a women’s civil rights issue. A woman should have the right to choose her mode of delivery. Currently the right of a woman to be involved in her birth plan is being crushed under the weight of new laws and strict healthcare limitations that should be a cause for concern for all women across the nation.

If you are considering a vaginal birth after cesarean, be certain to discuss your options completely with your healthcare provider.

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If the parents have lived in the same city for most of their lives, getting the out early might not be as urgent. Usually, in this circumstance, the close family and friends live near by and will be able to hear about the birth of the new baby by word of mouth as opposed to a birth announcement in the mail.

However, it is still important to get the announcements out in a reasonable time frame, usually within the first month after delivery. Often, friends who might not be as close to the parents might not want to bother the new parents with a visit. A great solution is to send photo birth announcements, which will allow them to see the baby early in its life.

For parents who are away from most family members and friends, a general guide is to send the baby announcements as soon as possible after the baby is born, ideally within two weeks. While word of mouth might still carry the news of the baby, friends and relatives still want to hear personally from the parents. If parents get organized before the baby is born, the can be fairly easy to get out promptly.

Make a baby announcement address list and figure out how many birth announcement you will likely need. At the very least, you might want to select the store or website in which you will buy the baby announcements. Many websites allow you to order you birth announcements before the birth of your child and will send you your envelopes early so you can start addressing them. This is typically called, ?Envelopes Early? and is offered by many websites online.

During the hectic times surrounding the birth of a baby, and especially after the birth, parents usually lack the time to send birth cards to their friends and family even if they have prepared ahead of time. If parents do not send the birth announcements within the first couple of weeks, it is still acceptable to send them later. Current etiquette indicates most recipients are happy to receive a baby announcement, even if it is after the first two weeks of the baby?s birth. You can include.

If the new parents are strapped for time (and what parent isn?t?), photo birth announcements can be a very easy option since most of the legwork can be done without leaving home. Using photo birth announcement sites and digital camera technology, pare0

In my childcare book The Portable Pediatrician, I talk about the emotional meaning of hospitalization for children of each age group from Birth to Five. (It?s in the ?What If? section of each age-based chapter, along with such challenges as parental divorce, death of a pet, arrival of a new sibling, and so on.) While I still stand by that advice, there have been three big changes since then when it comes to keeping children as safe and as comfortable as possible:

1. A national shortage of nurses, including pediatric nurses, may require parents to step up their own role as caretaker to a greater degree one would ever have expected.

2. Physician care in the hospital is more likely to be directed by a ?Hospitalist,? a doctor employed specifically to care for hospitalized children. Primary care physicians are fading from the picture, and sometimes parents need to be the link among three physician groups: primary care doctor, hospitalists, and specialists (in such fields as infectious disease, neurology, cardiology.) This is especially crucial if physicians disagree, and also at the time of discharge, when follow-up instructions can be crucial.

3. Over the last few years, the study called MRI has become much more available and more casually used. At the same time, there are no governmental regulations or oversight to make sure that safety is maintained. An ordinary thoughtless action, such as bringing an IV pole into the MRI suite, can cause disaster, even death; parents need to be present and watchful to help prevent such accidents.

My book What You Don?t Know Can Kill You, discusses in detail the implications of all of these changes, but primarily for adults. Parents of hospitalized children need a different take on these matters. I hope that reading these, even casually, before a planned or unplanned hospitalization, will tell you what to prepare for.

So here is my advice for parents on each of these topics, starting with the Nursing Shortage.

Nurses: Missing in Action

We are in the midst of a critical nursing shortage. Nurses are ?aging out? — half are 45 and older. So there are fewer and fewer of them, which means that they have to work longer and harder, making it tough to recruit new nurses. And even if there were lots of candidates, there is a corresponding shortage of nurses qualified to teach them.

This shortage, with its avalanche of increased demands, is particularly hard on Pediatric Nurses, who went into the profession in the first place because they really like children, and who now rarely may get a chance to interact with anything that isn?t sounding an alarm.

The bottom line here is that when you assume a nurse is going to be there, for whatever situation, there just may not be a nurse available. You, the parent/grandparent/other loving adult, must step in. To do so, you need to be familiar with the contents of the child?s room, the ward the room is in, and solutions to common and to crisis situations.

Most especially, you need to bond with the nursing and helping staff, making yourself useful without being intrusive. If something needs to be cleaned up, or fetched, or changed, see if it is possible to do it yourself — ask a staff member if you?re not sure. If you think there is a problem, present it as your concern, not as a foregone conclusion that the staff person has erred. Once you have a reputation for being positive, helpful, and reliable, the staff will be even more responsive to your requests.

The Constant Grown Up

Someone competent, loving, and familiar should be with the child 24/7, both at the bedside and accompanying the child on any within-hospital trips.

When you stay overnight in the hospital, you need to be both self-sufficient and vigilant.

Self-Sufficient: Try not to ask the staff for help with your own needs. You must be responsible for your own food, drink, and hygiene products. A hospital overnight kit for the adult should include all your personal needs, a flashlight, and a sleep mask and ear plugs. I also recommend a shrill loud whistle to wear round your neck tucked into your shirt, to use ONLY if there is a true emergency and nobody comes to help.

Protect against hospital-acquired infections: Hospital-acquired germs can be very dangerous. Hand-washing is crucial, and nurses tend to be more fastidious than doctors about this. Nonetheless, keep a rub-in hand cleanser at bedside: use it yourself, and offer it to any professional or staff member before they touch your child.

Since both children and hospitals tend to be sticky, bring along a container of disposable antibacterial/antiviral wipes, and frequently clean off the surfaces that need it most — TV remotes, telephones (including your own cell), door knobs, bed control buttons, toys and dolls.

Vigilant:

Massive corporations often provide their products for free to customers as a as a way to generate good will in an attempt to get you as a regular customer. They anticipate that once buyers try out the free product , it’ll increase brand loyalty and result in additional future purchases.

Pampers, Huggies, and other brand name diaper manufacturers are no exception. It is easy to get no cost diapers from these firms. All you have to do to get no cost diapers is to enter your e-mail and your baby’s date of birth or due date. Some companies give out no cost diapers to people to entice them make a decision about their future diaper purchases. While it doesn’t cost the firms much to send out no cost diapers, as new parents, you benefit by getting no cost diapers that would otherwise cost a fortune if you were to buy them from stores.

Few couples buy diapers beforehand. Most parents go to the hospital and return home with few infant diapers that they get from diaper manufacturers as free samples. Once the baby is at home, parents realize they need lots of diapers and other baby stuff for their babies and start shopping for those essentials. While lot of people prepare beforehand in terms of baby outfits, wash cloths, furniture, etc; very few of them prepare up front by stocking up on diapers.

Once they start shopping for diapers and other stuff, they realize how costly these necessities can be. And because costs are consistently rising and family budgets are being stretched to the limit, it is a much needed break for parents to get no cost diapers, coupons, and other free baby products in the mail. Luckily, there are ways to get no cost diapers and other free baby products. You just have to find out where to get them.

To get no cost diapers as well as other baby stuff for free, visit No Cost Diapers ! You will find quite a few programs that supply tons of free baby stuff and all you have to do is enter an e-mail address!