Do relatives need to come to the hospital? Rules for visiting the maternity hospital: what relatives of a newborn need to know
Remember the times when no one was allowed into the hospital? It was the kingdom of mother and child, and happy fathers stood with flowers under the windows and vigorously expressed their joy.
Now visits to women in labor are allowed. And all the "fans" immediately after the birth can visit a new family member. Abroad, this has been accepted for a long time and does not surprise anyone. There, all friends carry gifts directly to the ward to a happy mother. But I often wonder if this is right.
When I gave birth to my daughter, she seemed to me tiny, fragile and defenseless. So it really was. After all, the immunity of the child is formed gradually, in the process of life. It comes with mother's milk. Therefore, it is so important to breastfeed for the first six months, when the baby does not yet have immunity, and you pass yours on to him.
First encounter with microbes
For the first hours of life, the baby is quite enough for acquaintance and mother's microbes. Imagine how stressful it is for a small organism to move from a sterile womb to our imperfect world. The body of the child is immediately populated by a huge number of bacteria.
These are the thoughts that visited me when visitors came to my hospital. These were close and beloved people whom I am always glad to see, but this time their arrival caused me anxiety. At that time, I only cared about my baby and her health.
I gave birth to my daughter in 2007. In my paid ward, visitors were allowed two at a time. And there was a second bed for a visitor staying overnight. Everyone was given clean coats. Purchases of disposable capes and shoe covers were not required then. And very in vain! I have two hands for such security measures.
New trends
But there are maternity hospitals where the visiting regime is even less strict. We have one of these, recently restored and filled with sponsored purchases. They apply new approaches to women in labor, they give birth sitting, standing and in the bath.
But all the relatives who came from the region walk in crowds along the corridors and celebrate in the wards. And some of them are designed for two women in labor. 
For me, this is overkill. I understand that there are women who simply need the help of relatives, I myself was one of them. Don't count on the hospital staff. After all, there are many more young mothers than nurses and doctors. Therefore, visits cannot be prohibited.
But before turning them into a source of income, it is worth creating conditions for everyone to be comfortable. Separate rooms with a toilet and a washbasin, so that the woman in labor does not have to stand in line with other people's coughing aunts.
One of my friends works in a sanitary and epidemiological station, she scared me with a terrible story. They were working on a case where one of the guests infected a toddler. The adult had only a runny nose, and the child developed meningitis (inflammation of the brain). The baby could not be saved.
This, of course, is an isolated case, but no one is immune from such irresponsible relatives.
So it turns out that it is dangerous to let visitors in, and not to let them in is bad. Here every mother chooses herself. What do you think about the guests in the hospital?
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The Ministry of Health approved the Regulations for visiting maternity hospitals and obstetric departments by fathers and close relatives, developed according to WHO recommendations. Medical institutions will still be familiar with the document, it is expected that it should serve well not only for patients and their families, but also for doctors, and help form a system of benevolent perinatal care for mothers and children.
In fact, the news that the rules for visiting maternity hospitals will change, and close relatives will be able to freely visit women after childbirth, sounded at the beginning of the year. It would seem that what the newly-made parents dreamed of for so long has come true. After all, it's one thing to meet and chat live, and quite another - through a window or a mobile phone screen. Of course, today in perinatal centers and maternity hospitals, you can choose partner births. Or stay in a paid ward where visits by relatives are allowed (our mothers and grandmothers never even dreamed of such a thing!). But not everyone has such a desire or opportunity.
Just imagine, more than 100 thousand babies are born in the country every year. Each of them want to visit at least a few relatives. This means that for those who want to meet and spend minutes or hours together, logically, special conditions should also be created. What will they be? Is it possible to come to the general ward or will there be separate places for meetings or joint stay? Will they be allowed to see the mother and the newborn in the first hours after the birth? Do I need any health certificates for this? The regulations say that visiting a woman in labor and a newborn is possible only if they are in a satisfactory condition with the permission of the attending physician. It is assumed that the mother will independently determine those persons who will be able to visit her and the child. But no one will oblige or force her to receive guests in the hospital walls. Access to the mother will be for those who do not have signs of infectious diseases. They will refuse an audience to those who show up drunk. The document also defines the requirements for visiting patients in the neonatal intensive care unit, pathology of newborns and premature babies.
How do doctors feel about this decision? For example, in the Grodno Regional Clinical Perinatal Center, where more than 4 thousand babies are born a year, mothers come to give birth from all over the region. Doctors have heard about the regulation, but have not yet studied it. Accordingly, a little later, on its basis, a document will be developed here on when and how it will be possible to visit women in labor and babies. Here, by the way, there are already wards for joint stay, in which you can not only visit, but also constantly be near a woman. There is also an office for everyone, where spouses can meet and chat. Even today, fathers are allowed into the intensive care unit or the department for premature babies (of course, if there are no contraindications for health). In general, it is clear that there will be more trouble ... But you are not used to them here. As in other maternity hospitals, the center is always open to communication. For example, if questions arise regarding the health of a child, a mother is invited to medical consultations so that she can directly ask them to specialists. In addition, such openness helps to make sure how much attention and effort doctors devote to patients.
The birth of a child is a colossal physical and emotional stress for a woman. But most of it, even for many husbands, passes as if “behind the scenes”: he took his wife to the maternity hospital, heard the good news, transmitted the program, talked on the phone, a few days later he took a beautiful bundle tied with a pink or blue ribbon. And so you look - thanks to your acquaintance with your daughter or son in the first days, the paternal instinct will wake up earlier ...
A week ago, my close friend gave birth to a boy weighing 4.1 kilos in the maternity hospital at the Central District Hospital. During the day, the young mother came to her senses, the hero also had no reason to feel unwell. Everything was going great until the mother of the woman in labor decided to visit her daughter and grandson. The medical staff at once rose to protect the health of the patient and the baby: "We won't let them in - and that's it." But the girlfriend's mother is not born with a bast. By that time, she had already heard about the new order of the Ministry of Health, which allows relatives to visit women in labor. After long legal disputes and wranglings, the woman was nevertheless let in, however, everyone's mood was pretty spoiled. And how are things going with visiting young mothers in the capital's maternity hospitals? The correspondent of "Respublika" found out the details.
Getting to know the document
The new order of the Ministry of Health, which approved the rules for visiting maternity hospitals and obstetric departments, was signed a few weeks ago - on August 15. The document has already entered into force. The goal that he pursues is, first of all, "the formation of a positive image of the maternal and child health service according to WHO recommendations, as well as openness in the provision of obstetric and neonatal care." This is how the innovation was explained in the Ministry of Health.
According to the new regulation, the procedure for visiting mothers and babies in each maternity healthcare facility is determined by local documents. Relatives can visit a woman in labor and a baby not only in single wards, but also in general ones. The main thing is to comply with all the requirements of doctors. That is, you must come only at the hours established by the internal routine of the maternity hospital, be sure to leave outerwear in the wardrobe, use bathrobes and shoe covers, and treat your hands with an antiseptic. Of course, in no case will a relative with signs of an infectious disease or if he is a little tipsy be allowed to see the mother and child.
Of course, the conditions for visiting newborns in each individual maternity hospital will be different, because everything depends on the technical capabilities of the buildings, the staff of health workers and many other internal factors. However, each institution must ensure 100% sanitary and epidemic well-being of mothers and children.
Relatives are allowed in only upon presentation of an identity document. By the way, the circle of people who can look at the baby will be determined by the mother herself - for one visit there can be no more than two people. And one more important condition - visits are allowed only with the permission of the attending physician or the head of the department with a satisfactory condition of the woman in labor and the baby.
Passage along the "red" corridor
Doctors in maternity hospitals have already noticed: with the signing of a new order, maternity hospitals have become crowded. Newly made fathers are the most active to see their mothers and babies. I decided to find out what really happens behind the closed doors of maternity hospitals and whether it is really so easy to get into the room for a woman in labor now.
I hasten to test the innovation in the maternity hospitals of Minsk. I sit down at the phone and start calling them. First, the first maternity hospital. Without having to wait long, a woman with a loud voice picks up the phone.
- Hello. Tell me, can I visit my sister in the near future, she gave birth to you yesterday ...- I can feel shyness in my voice, that's what it means I don't know how to lie.
- Surname? Floor? the voice asks sternly.
- Ivanova, I don't know the floor, I quickly answer the first thing that comes to mind.
- You can visit us only in paid single and double rooms from 17 to 19 hours, and the woman in labor must indicate you in the list,- gives voice of interest.
- And what about those who lie in common?
There is only silence in response...
In the help desk of the second maternity hospital, they answer the question with a question: “Do you want to visit or give the package?” As a result, the situation is exactly the same as in the first case - a visit is possible only in paid individual wards. True, the time frame is slightly wider: from 12 to 15 and from 17 to 20 hours.
Finally, in the third maternity hospital, I was pleased: a visit is possible not only in individual, but also in general wards from 17 to 19 hours.
- Just call your sister in advance, agree that she is not opposed. Well, don't forget the bathrobe with shoe covers,- warned there.
In the fifth city maternity hospital, the relatives also did not interfere with the visit. The time is the same - from 17 to 19 hours. True, here I would have to meet with "sister" and "nephew" right in the hall. If the neighbors in the ward did not mind, they would let me inside.
As it turned out, the sixth maternity hospital was also already occupied with might and main by relatives of women in labor. Visiting rules are about the same as in other maternity hospitals. True, the time of the visit is limited - no more than a quarter of an hour. Here, the entrance to the general ward is prohibited, a special room is equipped for meetings with relatives.
- She gave birth to a boy three days ago. I already feel more or less normal, but the child is so-so. Upon admission, she signed a paper in the emergency room, which allowed close relatives to visit me and the baby after childbirth. Before giving birth, I even prepared a dressing gown with shoe covers for my husband,- smiles Alena Ivanova, a woman in labor from the "six". - True, you can visit us only with the written permission of the pediatrician, so for now you can’t visit us. I gave birth free of charge, on general terms, I am in a general ward. None of the relatives of my neighbors in the ward bothers us, a separate room is equipped for all meetings. 
Newly made fathers are the most active to see their mothers and babies. Roman and Anastasia VOLODKO with their daughter Anna, doctor Elena BOLBATOVSKAYA.
Questions internal
- Now the document has been received by all obstetric institutions of the city, and our main task for the near future is to thoroughly work it out, adapt it to each individual institution. Of course, here much depends on the material and technical base of each maternity hospital. Despite all the difficulties, the new order will help make obstetric and neonatal care more open and accessible to the population- this is the opinion of the head of the department of medical care for mothers and children of the health committee of the Minsk City Executive Committee Svetlana Manysheva. - It's good that the last word in the matter of visiting women in labor and children by relatives remains with the doctor, the mother's opinion takes second place. In general, such a novelty is a normal practice in many countries of the world. How earlier child meets healthy flora, the better for him.
The specialists of the Clinical Maternity Hospital of the Minsk Region also thoroughly familiarized themselves with the order of the Ministry of Health. Now the institution is creating conditions for visiting women in childbirth.
- The document provides for the arrangement of separate rooms for visiting women in childbirth, wardrobes for outerwear visitors. But most importantly, women themselves should be ready for such a novelty,- Tatyana Basalai, Deputy Chief Physician for the Medical Department of the Clinical Maternity Hospital of the Minsk Region, expresses her opinion. - Imagine the state of mothers who have just given birth. Often they do not want to see anyone at all, depression occurs. Therefore, we need to start from the question - is it necessary for a particular mother to have crowds of relatives go to her? And, of course, if so, then for this we, healthcare institutions, must comply with all safe conditions.
But in the Republican Scientific and Practical Center "Mother and Child" they are developing their own internal document that determines the rules of visits.
- Women in labor come to us from all over the country, only 10-15 percent of Minskers are here, so the number of women who want to visit women is not very large compared to other institutions in the capital. We are by no means against such an initiative, but everything should be within reasonable limits. Not every dad or relative should rush to his wife. We think we should start with partner births, where the father passed the appropriate examination, was trained in everything,- Svetlana Nagibovich, Deputy Director for Obstetrics and Gynecology, talks about the internal "kitchen" of her institution. - We are preparing an internal document that will allow visits only for dads who have completed partner birth courses. We intend to allow visits only in single rooms. But if necessary, we will allow you to enter the intensive care unit and the intensive care unit.
As you can see, the issue of visiting women in labor with babies is still controversial and not fully worked out. In fact, only three out of seven maternity hospitals located in Minsk have arranged visits of relatives to general wards. And even then, provided that it does not interfere with the neighbors. Whether this is right or not is not for us to decide, we can only follow the further development of events ...
Not all future mothers know when it is necessary and how to choose the right maternity hospital.
In Soviet times, our parents went to the nearest medical facility from home. Modern medicine gives pregnant women the right to choose any maternity hospital, depending on their requirements and taste preferences. A woman is not limited in choice, it is only necessary to fulfill several conditions.
Can I choose my own home?
In the last months of pregnancy, a woman is puzzled by the question of whether the ambulance will take her to the chosen maternity hospital.
Many future parents agree with the doctor in advance while the pregnant woman is registered. Normal practice is considered to be a preliminary acquaintance with your doctor and obstetrician 1-2 months before the due date (estimated date of birth).
During such a period of time, you can have time to meet with the doctor several times, he will be able to carefully look at the medical (exchange) card and find out about possible complications. In this case, it will be possible to establish contact with a professional doctor.
At the first visit to the maternity hospital, the expectant mother is often offered to conclude a contract on a paid basis, they begin to acquaint her with the list of additional services. They require comfortable living conditions, the necessary medicines and the attentive attitude of employees. So, it will be possible to choose a separate ward and be in it with her husband, mother and other close relatives.
In the process of getting to know the doctor, it is strongly recommended to take his phone number from him, as well as to clarify the possibility of calling at any time of the day if necessary. Such an agreement implies a monetary reward.
It is important to understand that even paid childbirth does not guarantee their easy resolution. Often, on a paid basis, the conditions for a future mother in the maternity hospital are improved.
In the absence of the ability to pay for childbirth, you can use a birth certificate, which allows a mentally vulnerable woman to be confident in the future and not worry about the upcoming event.
In 2006, a state program was adopted that allows pregnant women to choose a consultation and a maternity hospital. Its action significantly improved the medical care of the population.
At the same time, young mothers and their children are provided with high-quality medicines completely free of charge. The presence of a birth certificate greatly simplifies financially the management of pregnancy, childbirth and further observation of children by pediatricians in the first year of their life. It allows a woman to choose in which maternity hospital she wishes to give birth to her baby. The expectant mother has the right to come to any medical institution and declare her desire to become its patient.
When is it impossible to choose a maternity hospital on your own?
Today, there are a number of cases that do not allow a woman in labor to choose a maternity hospital of her choice.
- The first reason is the lack of a birth certificate when the contractions began. In this case, the ambulance will take the woman to the nearest facility. The occurrence of such a situation sometimes leads to the most adverse consequences in the form of a lack of urgent qualified assistance from health workers and the necessary equipment.
- Secondly, all maternity hospitals are forced to close once or several times a year for sanitation. Therefore, when the day of birth coincides with this procedure, the expectant mother will not be able to get to the chosen clinic.
- Many maternity hospitals specialize in providing certain types of care. In the event of complications during pregnancy, it would be advisable to contact an institution that meets the necessary requirements. Not all clinics are equipped with everything necessary for delivering women with diabetes, problems with the cardiovascular system, and so on.
The essence and purpose of the birth certificate
The state program "Health" organizes competition between medical institutions that seek to provide comprehensive assistance to a large number of pregnant women. At the same time, it is possible to improve the quality of the medical services provided in all clinics.
Registration of a birth certificate helps to stimulate the desire of all healthcare institutions to provide assistance in gynecology, obstetrics and pediatrics. Hospitals are becoming interested in being equipped with certified drugs, as well as modern equipment.
To issue a certificate, you must perform the following steps:
- register (in the 1st trimester) in the antenatal clinic;
- regular visits to the clinic (for at least 12 weeks);
- monthly visit to the pediatrician with an infant.
Who can issue a birth certificate:
- All citizens of the Russian Federation, regardless of age, the fact of official employment and registration.
- Women with any condition of the fetus, with or without a legal spouse.
- Citizens of other states with a temporary residence permit or a residence permit also have the right to issue a certificate.
The need to obtain a birth certificate
A birth certificate is a kind of material incentive for modern clinics, maternity hospitals and antenatal clinics, which provide the population with high-quality medical care on favorable terms. They receive cash payments of a fixed amount from a special fund (FSS), ensuring interest in each expectant mother, as well as her baby.
According to the birth certificate, a woman chooses a maternity hospital for herself, taking into account the peculiarities of the course of pregnancy. At the same time, the presumptive nature of childbirth (complicated or uncomplicated) is taken into account. When choosing a maternity hospital, it is strongly recommended to take into account the territorial sign (in the nearest place where the contractions began).
You can get a birth certificate absolutely free of charge at the 28-30th week of pregnancy in a consultation or obstetric center, which is registered future mom. The document allows you to choose the best medical institution.
It will be necessary to obtain a birth certificate to select:
- consultations for monitoring pregnancy;
- maternity hospital;
- children's polyclinic for patronage observation of your child up to 1 year.
Having a certificate in her hands, a woman has the right to contact any maternity hospital she likes (with an exchange card) and agree on the upcoming birth. The manager is required to sign the card, so on the expected day of delivery, the expectant mother can come to the selected hospital. When contractions come at home, ambulance doctors will take the woman in labor there.
It is impossible to sell or cash out the certificate, it is not financial assistance. The main purpose of the document is to pay for medical services in public institutions. The certificate will not be accepted by commercial private clinics.
Is an ambulance obliged to take to the hospital and admission without a certificate
A birth certificate protects a pregnant woman from the provision of poor-quality and hazardous medical services. She has the right to choose any antenatal clinic (maternity hospital), even if the medical institution is located in another city or region of our country. The issuance of a document helps women receive comprehensive support during pregnancy and in the early stages after childbirth.
Even in the absence of a certificate, a pregnant woman will not be denied medical care. She will be able to apply to the maternity hospital only at the place of residence. The document gives the right to choose any maternity hospital, regardless of registration. Moreover, in the hospital itself, if a woman has all the necessary documents, she will be helped to issue a certificate on the spot. If a document is lost, it can be easily restored. Women's consultation will be interested in the efficiency of this process, since on the basis of it, funds for the services provided are transferred to the settlement account of the institution.
Modern maternity hospitals are divided into 3 types:
- the predominance of uncomplicated childbirth (up to 500 babies are born a year), they do not provide for a round-the-clock stay of an obstetrician;
- the birth of up to 1500 children per year (the department has an intensive care unit and intensive care units);
- regional and federal institutions with assistance during pregnancy and the postpartum period (often there is a pathology department).
Depending on the characteristics of bearing a child, the gynecologist issues a referral to the maternity hospital of one of the above categories. With such documents, you can go to the selected hospital during contractions. With a post-term pregnancy (from 40 weeks), you can enter a hospital in such an institution up to the expectation of the onset of labor.
How to choose a maternity hospital?
Which is better to choose a maternity hospital - many women in labor are puzzled by this question starting from the first trimester of pregnancy. Future parents often visit several institutions, learn about the conditions offered, communicate with doctors and choose the best option. It is important that an agreement be concluded between the pregnant woman and the maternity hospital. The attending physician makes appropriate notes in the pregnancy chart. Only in this case, when the waters break or the onset of contractions, can an ambulance be required to take the woman to the maternity hospital of her choice.
To understand how to choose the right maternity hospital, you need to study its following criteria:
- the proximity of the institution to the house;
- living conditions (presence of a separate shower, cleanliness, sterility, etc.);
- availability of good medical equipment;
- qualifications and experience of personnel;
- the possibility of partner (joint) childbirth;
- 24/7 stay with a baby.
When choosing a maternity hospital, it is necessary to study the attitude of all staff towards natural childbirth.
Domestic medical institutions are guided mainly by natural delivery. In this case, a planned caesarean section is used exclusively according to indications.
Sometimes there are emergency situations when, when the waters break, weak labor activity occurs. In this case, additional stimulation is indispensable, and the life of a newly born person will depend on the high qualification of the staff and the availability of modern medical equipment. After a successful birth, it is desirable that experienced gynecologists, neonatologists and polite medical staff take care of the mother and newborn.
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Republican congress "Mom Pro", which was held in Brest over the weekend, became a sensation.
- The Ministry of Health has made a decision in all maternity hospitals, maternity wards, obstetric and gynecological departments to allow visiting women after childbirth. So that they would not go downstairs, as before, but dad or other family members could visit mom and child in the ward. In our opinion, this will contribute to a positive atmosphere in the family, increase trust between parents and the doctor, - said the chief obstetrician-gynecologist of the Ministry of Health of Belarus Yulia Savochkina, BelTA quotes her.
The news literally blew up the Internet, causing a flurry of reactions "for" and "against".
Of course, the women immediately imagined the perfect picture, almost like in American films: “She gave birth to a child, he, on the wings of love, immediately ended up in her ward, and now they are both kissing a beautiful baby on fluffy ruddy cheeks.”
What do doctors think about this?
“Not all maternity hospitals are ready for such a decision”
“At the moment, there has been no order from the Ministry of Health on this matter,” says Natalya Odintsova, deputy head physician for obstetric and gynecological care at the 6th City Clinical Hospital of Minsk. The chief obstetrician-gynecologist of the country made an oral statement. I think that not all maternity hospitals in our country are ready for such a decision. After all, most often a woman with a baby is in the ward with several more of the same puerperas. Each has its own emotional and physical state. Now imagine a situation when relatives of one of the women enter the ward. Firstly, it will interfere with the rest of the puerperas. And if relatives of several women come at the same time? Do not leave the same the rest of the corridor. But that's not all. It must be understood that such visits will disrupt the work of the medical institution, and, what is there to hide, there may be problems associated with the theft of personal property. After all, as far as I understand, we are talking about the free access of strangers to the wards, in which several women lie at once.
We understand perfectly well that a maternity hospital is not a prison. All women go out for a while to their husbands, communicate. If one of the relatives certainly wants to get into the ward to the puerperal, we let them into the ward, accompanied by our health worker.
- There is an opinion that thanks to such visits, paternal instinct wakes up faster in dads.
“We already have the conditions for the awakening of the paternal instinct. If desired, men can attend partner births, because no one forbids. Dad can cut the umbilical cord and stay with mom and baby after giving birth for several hours.
Yes, but it's a nice idea.
- Of course, but in our realities, in order to implement such a decision, it is necessary to resolve technical issues, including logistics issues, and without fail coordinate the decision with the sanitary supervision authorities.
- In what conditions, in your opinion, can this idea be promoted without prejudice to all parties?
— Ideally, these should be chambers family type. Such wards for providing a complex of obstetric services were opened in our maternity hospital in September 2016. The chambers are located in a separate block, have a separate entrance from the street. In this department, the logistics are built perfectly, - says Natalya Aleksandrovna. “Visitors that a woman wants to see change clothes and shoes in special lockers and can spend as much time in the ward as they want. Perhaps something similar is real in other maternity hospitals, including maternity hospitals in regional centers, where there are few births and women in labor.
AND AT THIS TIME
We got through to one of the maternity hospitals in the capital to find out if the newly-made fathers were already trying to visit their mothers and babies in the ward?
“There haven’t been such people yet, and we imagine this picture with horror: crowds of strangers in the maternity hospital ... Perhaps drunk, possibly unhealthy,” admitted the staff of one metropolitan maternity hospital. But if there is a decree, it will have to be carried out.
PSYCHOLOGIST'S OPINION
“The sooner dad sees the baby, the sooner the necessary connections will arise”
“I support the initiative of the Ministry of Health,” says family psychologist Natalya Olifirovich. - But the words "maternal and paternal instincts" I would not use. The word "instinct" to people in general is very weakly applicable. We have neither maternal nor paternal instincts. Psychologists tend to use the word attachment. It is formed during the interaction of the child and the one who cares for him. It doesn't matter if it's mom, grandma or dad. Healthy quality attachment does not occur overnight, but over time. Often a woman, having given birth to a child, feels horror, confusion and falls into depression. So is the man. The sooner dad sees the baby and can contact him, the sooner the necessary connections will arise between them.
There are other benefits to this solution as well. When a man sees his woman in bed - vulnerable, to some extent helpless, he feels how she needs him - strong, responsible, able to support. Previously, people gave birth right at home, the newborn was swaddled and taken out to the father. The proud father almost immediately felt involved in the process. Even if during childbirth he was kicked out of the house, he could hear the moans of the woman in labor, see the fuss, feel anxiety ... In our country, men are practically alienated from childbirth. And after giving birth, a woman needs to restore the spent resources, she needs emotional support. The presence of a husband who will regret, kiss and say: “What a fine fellow you are,” “What a beautiful baby” is an ideal option for this moment.
