Processes Of Post Partum Care Nursing Essay

Processes Of Post Partum Care Nursing Essay Postpartum care presents a special challenge, as it concerns two i.e. mother and her baby people with very distinct needs. However it is believed that contribution to good quality care ensure to balance the challenge. The major maternal and neonatal health challenges include nutrition and breastfeeding, birth spacing, immunization and HIV/AIDS, therefore Post partum care is pre-eminently about the provision of a supportive environment in which a woman, her baby and the wider family can begin their new life together. Therefore this guideline aims to identify the essential core (routine) care that every woman and her baby should receive in the first 6-8 weeks after birth, based on the best evidence available. This guideline has been written within a conceptual framework which places the woman and her baby at the centre of care, appreciating that all post partum care should be delivered in partnership with the woman and should be individualized to meet the needs of each mother-infant dyad. Thus this clinical guideline of post partum is to offer information to support midwives to increase the knowledge and skills that enable them to handle mothers and their neonates and management of postpartum complication, and referral. Objectives: Perform postpartum examination on mother and baby and provide care to ensure safe post partum. Provide first line EmONC or referral for the complication occurring during postpartum period Facilitate the process of lactation and infant bounding. Support of the mother and her family in the transition to a new family constellation, and response to their needs prevention, early diagnosis and treatment of complications of mother and infant, including the prevention of vertical transmission of diseases from mother to infant Counsel the couple for: resumption of sexual activity and birth spacing regular contraception service, emergency contraceptive methods, dispelling myths and birth spacing in special situation. maternal nutrition, and supplementation if necessary baby care support of breastfeeding Immunization of the infant and mother. Referral of mother and infant for specialist care when necessary CLINICAL PLACEMENT Out Patient Department Postnatal wards Well baby room Community Primary Health Care centers POST PARTUM VISIT SCHEDULE AFTER 3rd STAGE OF LABOUR TILL 2 HOURS AFTER 2 HOURS TILL 24 Hours First visit (within the first week, preferably within 2-3 days) Second visit (4-6 weeks) More frequent visits or different schedules may be required according to client need and or hospital policy. Encourage the woman to bring her partner or family member to at least 1 visit. KEY ELEMENTS OF POSTPARTUM CARE: 6-12 hours 3- 6 days 6 weeks blood loss pain BP advice/ warning signs breast care temperature/infection lochia mood recovery anaemia contraception IMMEDIATE POST PARTUM CARE (After 3rd stage of labor till 2 hrs) Initial Postpartum Recovery Assessment: special attention to: Monitoring and assessment of maternal well being, prevention and detection of complications (e.g. bleeding, hypertension, and infections) Determine; Assess amount and the character of BLEEDING , Measure and document vital sign (BLOOD PRESSURE, pulse rate and temperature Other warning sign like fever, uterine involution, pain etc Status of the perineum, (tears laceration) Status of the fundus; position and firmness Document urine void within 6 hours. Ensure emptiness of urinary bladder Monitor for signs of bladder distension. After delivery IV fluids infusing type and amount Response of the woman and her partner to the newborn Give woman time with baby and family to facilitate bonding and celebrate the occasion. Status of the breasts once immediately after delivery and then again just before transfer to postpartum Allow women to rest Pain assessment; if the woman is experiencing any pain; Determine the characteristics, quality, timing, and relief after comfort measures, Investigate the source (e.g., after pains, episiotomy, painful urination, pain in the calves). If the woman had a cesarean delivery; check the incision dressing for intactness and determine incision bleeding if any complain for pain type, and success of analgesics and comfort measures to control the pain; toleration of ambulation status of the bladder; Provide hygiene care. Help woman to re dress Establishments of breastfeeding/ ROUTINE PROGRESSIVE POST PARTUM CARE (After 2hrs till 24 hrs) Take medical and pregnancy histories and perform physical examination that are important to alert for postpartum risk such as postpartum Hemorrhage, infection, and lead to normal healing First Visit HISTORY (should include significant pregnancy, labor and birth newborn history Review of Ante Partum chart and labs, problems which may need follow up Review of Intra Partum course and labs Check records: any complications during delivery Receiving any treatments Review of status since birth to postpartum period Review if patient is Tdap immunization status Obtains information about cultural factors influencing clients health and compliance Assesses clients and significant others feelings and level of understanding of sexuality, post partum. Observe the gravid woman for verbal and non-verbal clues to exclude post partum bluesdepression HIV status CONTINOUS POST PARTUM ASSESSMENT (ONCE PER SHIFT) Take the vital signs including of Respiratory characteristic s and Rule out labour breathing shortness of breath and chest pain. Regular Heart rate Height, And Weight Performs review of systems appropriate to POSTPARTUM Body parts Assessment and Probable findings Breasts Inspect the: Colostrum excretion breasts for signs of engorgement, nipples aversion/ redness, or cracks, then Palpate the breasts gently to determine if they are soft, filling, or engorged with milk Note if there is pain/ oedema/ swelling Abdomen Inspect the abdomen and note: striae, scars, shape and size of the abdomen Any organs enlargement and any masses. Palpate the abdomen to assess uterus involution (by height of fundas) determine consistency, tone, position, size/height in relation to the umbilicus Genitalia Inspect Vulva and perineum for: tear, swelling, pus. Observe external genitalia for color of skin, varicosities, and laceration, episiotomy stitches healing. vaginal opening for cystocele or rectocele. Vaginal discharge (lochia); special attention to color, amount and odor Bladder and bowel; Assess voiding amounts (more than 100 mL per each voiding) frequency If amounts smaller than 100 mL check for urinary retention, i.e. suprapubic distention Auscultate for bowel sounds in each quaderant. Ask the woman if she has had a bowel movement after delivery. Peripheral vascular Inspect the extremities for edema equality of pulses, and capillary refill. Check for Homans sign when the feet are dorsiflexed or woman is walking. Hemoglobin and hematocrit (hh). Compare the HH before delivery. Note the blood type and Rh. If the woman is Rh-negative, arrange for RhoGAM MEDICATION For pain relief advise: Topical cold therapy Paracetamol NSAIDs if not contraindicated In areas of high prevalence of iron deficiency anaemia, 400 mg ferrous sulphate (2 tablets) per day or once a week, with 250 ÃŽÂ ¼g folate for 4 months is recommended for pregnant and lactating women. In areas of low prevalence 1 tablet of ferrous sulphate daily may be sufficient. IMMUNIZATION Offer Anti-D immunoglobulin within 72 hours to every non-sensitized Rh-D-negative woman following the delivery of an RhD-positive baby. Complete TT vaccination for woman according to given schedule if required Offered an MMR (measles, mumps, rubella) vaccination following birth and before discharge from the maternity unit if they are in hospital if on antenatal screening women found to be sero-negative for rubella following the safety protocol Health Education for mother All women should be given information about the physiological process of recovery after birth, and that some health problems are common, with advice to report any health concerns to healthcare professional, in particular: Signs and symptoms of PPH: sudden and profuse blood loss or persistent increased blood loss; faintness; dizziness; palpitations/tachycardia. Signs and symptoms of infection: fever; shaking; abdominal pain and/or offensive vaginal loss. Signs and symptoms of thromboembolism: unilateral calf pain; redness or swelling of calves; shortness of breath or chest pain. Signs and symptoms of pre-eclampsia: headaches accompanied by one or more of the symptoms of visual disturbances, nausea, vomiting, feeling faint. Women who have had an epidural or spinal anesthesia should be advised to report any severe headache, particularly when sitting or standing Diet during post partum Caring breast while breast feeding Fundal Massage Perineum and Vaginal Care Pain Management: explain the non- medicinal ways of easing pain, such as applying warmth to the abdomen to help soothe after pains. Activities contribute to or prevent constipation. If non immune for rubella educate for rubella immunization SECOND VISIT (4-6 weeks) HISTORY Follow the guideline of ROUTINE POST PARTUM CARE (After 2hrs till 6hrs) CONTINOUS POST PARTUM ASSESSMENT follow the guideline of (After 2hrs till 6hrs) MEDICATION Follow the guideline of ROUTINE POST PARTUM CARE (After 2hrs till 6hrs) VACCINATION Follow the guideline of ROUTINE POST PARTUM CARE (After 2hrs till 6hrs) HEALTH EDUCATION Follow the guideline of ROUTINE POST PARTUM CARE (After 2hrs till 6 hrs) Postpartum Discharge Plan and complete all necessary assessment and care as per hospital policy by consider maternal and infant health and financial status. HISTORY Review of the womans physical, emotional and social well-being at taking in account the routine examinations Counsel mother family on baby care. ASSESSMENT OR EXAMINATION Follow the guideline of ROUTINE POST PARTUM CARE (After 2hrs till 6hrs) HEALTH EDUCATION Explain all take home medication with their effects and side effects. Allow them to resolve their queries. Educate mother about danger signs, personal hygiene, perineal care, postpartum exercises, follow-up visit baby care, baby mother immunization, breast feeding, Postpartum COMPLICATION MANAGEMENT essentc Hypertension during postnatal period Continue to assess patients for signs and symptoms or worsening of preeclampsia in the postpartum period. For postpartum patients on magnesium sulfate: In general the magnesium sulfate is continued for 24 hours postpartum Strict IO in the initial 24 hours postpartum Evaluation between 4 and 8 hours postpartum for vital signs especially BP, IO, signs of magnesium toxicity, evaluation for further information Refer: World Health Organization, International Confederation of Midwifery (ICM) (2008). Midwifery education modules second edition Managing Eclampsia Available: http://whqlibdoc.who.int/publications/2008 Baby Blues/ Post Partum Depression Definition: A transient period of depression that occurs during the first week or two after birth Causes: hormonal changes, fatigue Sign and symptoms: mood swings, anger, weepiness, anorexia, insomnia Intervention Usually will resolve naturally Should receive social support Needs plenty of rest Anemia (Refer PHRplus/Albania (2005) Toolkits for Strengthening Primary Health Care Clinical Practice Guideline for Family Doctors; Quick References Partners for Health Reforms, USAID) Available: http://www.who.int/management/ToolkitsforStrengtheningPHCAlbaniaPHC.pdf Postpartum Hemorrhage Refer: World Health Organization, International Confederation of Midwifery (ICM) (2008). Midwifery education modules second edition Managing postpartum hemorrhage Available: http://whqlibdoc.who.int/publications/2008 Puerperal Sepsis Refer: World Health Organization, International Confederation of Midwifery (ICM) (2008). Midwifery education modules second edition Managing Puerperal Sepsis Available: http://whqlibdoc.who.int/publications/2008 Diabetes in postpartum period Refer: World Health Organization Reproductive Health AND Research (2005). A pocket guide for essential practice Sexually Transmitted and Other Reproductive Tract Infections integrating STI/RTI, HIV Care for Reproductive Health

Ethical problems Essay

What is ethics?The most common way of defining â€Å"ethics†: they are norms for conduct that distinguish between or acceptable or unacceptable behavior. (http://www.apa.org/ethics/)Most people learn ethical norms at home, in school, in church, or in other social settings. Human rights: The basic rights and freedoms, to which all humans are entitled, often held to include the right to life and liberty, freedom of thought and expression, and equality before the law. I would like to talk to you about privacy and confidentiality. Privacy: the quality or condition of being secluded from the presence or view of others. (http://www.answers.com/topic ) Confidentiality: Containing information whose unauthorized disclosure could be injurious to either or both parties. Not all the ethical issues have clear answers; some hinge on researcher’s judgment and scruples. Need for respect. Privacy and confidentiality should be fairly self explanatory. We need to be sensible as medical practitioners and respect the need for the protection of personal privacy in data, and need to facilitate access to data for research purposes. Respect: The state of being regarded with honor or esteem. Respect has great importance in everyday life, as children we are taught (one hopes) to respect our parents, other people’s feelings and rights. Dramatic events of World War II. Respect for patients as individuals prior to, during and after the research is one of the key issues of dramatic and horrifying events of World War II and the Nuremberg military tribunals highlight the degrading and inhuman consequences of research without respect for the individual. History: When dignity was taken away from people. History has played a large factor in the way people are treated and respected in present day. One particular incident is the Nuremberg military tribunals which played a major part in how human research is viewed concerning peoples rights. This code was formed in 1947 and still plays a big roll in research today. (Genocide. First relating to the Holocaust. It was not listed as a crime in the Nuremberg court’s charter, but after pressure from Raphael Lempkin the scholar who had actually coined the term â€Å"genocide† prosecutors included it in indictments against some of the major Nazis on trial, and their closing remarks. http://iwpr.net/pdf/reporting_justice_p1_w.pdf ). This was one scenario that took away, the rights and dignity of human beings. Another example of history that has disrespected human kind, was UNIT 731, this was biological warfare research on humans by the Japanese army. It is events like these that have shaped how ethics have come about in today’s society. Making decisions that wouldn’t be damaging. How’s people’s respect and dignity protected today? What if during the course of research, an investigator notices that a person seems to have a learning disability or some other treatable condition? The decision to share this information with guardians or other services that could help shouldn’t be made lightly, since sharing information of uncertain validity may create damaging misconceptions about that person. On the other hand researchers need to know and inform participants of their legal responsibility to report abuse or neglect or any other illegal activity of which they become aware (Papalia, Olds, Feldman; Human Development p.56). Privacy questions are also raised when employers expand the depth of their searches, sometimes including psychological, polygraph and even medical record checks. The privacy of medical records is of growing concern. Our medical history contains extremely sensitive information, and access to it should therefore be limited. However insurance providers, researchers, have an interest in obtaining and using our information. Example from national nine news. There was a story on the news about how private our personal details can be? (http:/aca.ninemsn.com.au/article, Fri 07/07/06). Victorian MP Anna Bourke says there are numerous ways in which our personal information is traded. â€Å"There are cases of doctors giving out patient information to drug companies, private schools selling off old student lists, it goes on and on. Even Centerlink has been caught out passing on personal information. You don’t realize how often you give away your details†, she says. We all value our individual personal privacy, trouble is many other people put a price on it to making your personal affairs their business, information that you think is confidential now been bought and sold without your knowledge and without your consent. In one case, being investigated by the Privacy Commission, data was outsourced to and Indian Phone Company called Bricks and Click. Somehow that information ended up on the black market- the names, addresses, driver’s license numbers and even Medicare numbers of 1000 Australians. The challenge is to create policy or legislation that can balance the legitimate needs of health care and insurance providers with individual rights to privacy. The idea of privacy is ancient. The idea that medical records should be kept private is ancient, going back to Hippocratic Oath. The oath stated, â€Å"whatever, in connection with my professional practice or not in connection with it, I see or hear, in the life of men, which ought not to be spoken of abroad, I will not divulge, as reckoning that all such should be kept secret†. http://www.srcd.org/ethicalstandards.htmlThis idea has become one of the keystones of medical ethics; doctors should not reveal confidential information about their patients. However, there are certain times when it appropriate to share medical information. In today’s medical world, it is common for a person to have  multiple doctors, and to seek treatment from specialists. If medical records are not readily available to doctors, than the patient’s care ultimately suffers, as information about past treatments and conditions could be unavailable. Some questions remain though, how much information should an insurer be privy to? Should they be allowed to check and individual’s genetic record? Should they know if an individual has ever taken an HIV/AIDS test? How really available should our medical information be, and what steps should be taken to protect it? These important questions are currently unanswered. Questions:Why are there so many ethical disputes and issues in our society?How would you feel if your privacy was invaded and information spread around to people who we didn’t want to have that info?References:Australian Institute of Health and Welfare (2002). Australia’s health 2002. Canberra: AIHW. Barnsteiner, J., & Prevost, S. (2002). How to implement evidence based practice. Reflections in Nursing Leadership, 28 (2), 18-21. Draper G, Turrell G, & Oldenburg B (2004). Health inequalities in Australia: Mortality. Health Inequalities Monitoring Series No 1. Canberra: Queensland University of Technology and the Australian Institute of Health and Welfare. Hamric, A. B., Spross, J.A., Hanson, C.M., (2005) Advanced Practice Nursing. An Interactive Approach (3d ed.). Elsevier Saunders. Lynch, J. W. & Kaplan, G. (2000). Socioeconomic position. In Berkman, L.F. & Kawachi, I (Eds) Social epidemiology, (pp13-35) New York: Oxford University Press. Papalia, D.E., Wenkos Olds, S., Feldman, R., (2004) Human Development (9th ed.). Boston: McGraw Hill. Polit, D. F., Beck, C.T., & Hungler, B.P. (2001) Essentials of Nursing Research (5th ed.). Philadelphia: Lippincott Williams & Wilkins.

Midterm Learning Reflection Essay

Introduction. You should print this out, although you may also use it as a template to type over. You will be writing two reflections this term: a midterm reflection and a final reflection. The final reflection is the one you want to have ultimately on your portfolio. Both your midterm and final learning reflections must be 700 to 1000 words, which is approximately two to three MLA-formatted pages. You can check your word count by going to Tools/Word Count on the menu bar. Style and Format. The writing style of the learning reflection is primarily expressive, but will also contain narrative elements. You do not need a Works Cited page unless you cite something. So, if, for example, you cite song lyrics, one of our texts, a poem, or even a work of art, then you need a Works Cited page. I’ve included one here to serve you for formatting purposes. File formats. We are going to be learning how to convert Word documents to pdf format so that they load more easily in a browser window. If you can, please practice with one or both of the following two methods, which are what I use (they are free). 1. Install a free pdf converter. These are not truly â€Å"free† in that they either force you to look at some advertising or they add a line on each page advertising the manufacturer of the software. I don’t have a problem with either of these and gladly suffer through the free advertising every time I convert a file to pdf, which I do all the time. The one I use to create all the pdf files for my classes is at http://www.pdf995.com/download.html. Download both the Pdf995 Printer Driver and the Free Converter (they are both free; they are required to work together, but for some reason, they are two separate downloads). After you go through the download and installation process, every time you want to create a pdf file from Word, all you need to do is select File/Print and then chose PDF995, which will show up as a â€Å"printer.† When you initiate this process of creating a pdf file, you will be prompted for a place to save the file, as well as a file name. Be careful to save the file to your H: drive or, if to your C: drive, to ftp (transfer) it over to your H: drive later. You will notice that some advertisements come up as the conversion process occurs. That’s the â€Å"price† you pay for the free conversion software. 2. The other pdf-conversion method I like is to use the free OpenOffice word processing software. This software should be in our labs. You can also download it for free on your own computer, from http://www.openoffice.org/. This is basically an open-source version of Microsoft Office. Once you’ve installed it (it’s large and takes a while to install), you can open any Word document with the OpenOffice word processing program (Open Document). Some of the original Word formatting may be lost – especially the header information with your last name and page number. You will need to add that back in; be sure you do it correctly. When you’re satisfied with the format, there is a little pdf icon on the toolbar that you can click, and that will automatically convert the document to pdf format. Learning Reflection Content. What should you discuss in your reflection? In general, you discuss what you’ve learned, what you’ve done especially well, what you’ve enjoyed – and the challenges you’ve encountered and how you might make changes in the future. Here are some suggestions for what to write about: †¢ Your experience transitioning from high school (or wherever you were previously) to a freshman in college, focusing on how you have grown as an individual and an independent student. †¢ Your experience in this particular course – your year-long freshman inquiry. In this regard, you should probably focus on the University Studies goals and the ways in which you have grown and developed with respect to those goals. I would expect that other courses have also contributed to the goal areas, so you might want to highlight any that have been particularly useful in that regard. †¢ Other experiences as a student here at Portland State. Portland State University’s mission is â€Å"Let Knowledge Serve the City,† which reflects the fact that we are an urban university. What have you learned with respect to community, diversity, and the connection between a learning community (the university) and the city in which it is located? Keep in mind that you may have acquired valuable experiences outside of the classroom, but still connected to your identity as a student. o Perhaps you have learned important lessons about discipline and time management as a student athlete, which may serve you well when you enter the workforce. o Maybe your involvement in activities with other students – such as taking dance classes or playing in the band or spending hours in an art studio or toughing out chemistry and physics labs – has improved your personal skills and brought to light new areas of interest, which you’ve pursued in your free time. o Or perhaps you’ve found out that you are a loner, that you haven’t connected very well with a lot of the people in your classes. As you reflect on this (or any other conclusions that some – maybe you – might consider, well, depressing), think of this is an opportunity to think of ways to make some changes in the future. †¢ A reflection, in other words, should include a self-assessment element as well as thinking along the lines of â€Å"What could I do better or differently in the future?† Consider the challenges you’ve faced, how you’ve overcome them, or how you’d like to overcome them in the future. Conclusion. Your reflection should end in a way that gives the reader the sense that you are closing up a chapter in your life and ready to move on, with some ideas in mind of what you might do differently. My suggestion is that you do not spend a lot of time critiquing the world around you; after all, you can’t change that very much. Confine your reflection to you and what you have learned and experienced. Dwelling on what you don’t like about a given course or program is not a reflection about you, but about something else. Works Cited Eakin, Paul John. How Our Lives Become Stories: Making Selves. Ithaca and London: Cornell UP, 1999. Fiske, John. â€Å"Popular Culture.† Critical Terms for Literary Study. Ed. Frank Lentricchia and Thomas McLaughlin. Chicago: University of Chicago Press, 1995. 321 – 335. Harrison, Claire. â€Å"Hypertext Links: Whither Thou Goest, and Why.† First Monday. 7 Oct. 2002. 10 Feb. 2004 .

Significant Role Of Vaccinations - Free Essay Example

Sample details Pages: 7 Words: 2001 Downloads: 8 Date added: 2019/07/31 Category Medicine Essay Level High school Tags: Vaccines Essay Did you like this example?   Vaccinations are deemed as one of the most essential and practical achievements in epidemiology to date by nearly eradicating and counteracting several diseases that were once prevalent and killed hundreds of thousands in the past centuries. Despite its efficacy in substantially reducing certain diseases, the only vaccine discontinued because the disease was permanently eliminated from the public was smallpox. That is it, just one out of the dozens available. Don’t waste time! Our writers will create an original "Significant Role Of Vaccinations" essay for you Create order All other vaccine-preventable diseases still cause suffering and death in the United States and the rest of the world as a result of the growing amount of exemptions from vaccines due to parental ignorance and anxiety from fears of unsafe use. As a subsequent consequence, herd immunitya form of indirect protection from infectious disease in a populace is narrowing. As a result, it is essential for vaccinations to be mandated as a culmination of its success in nearly eradicating several contagions and improving the human quality of life exponentially.   Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   Vaccines have been essential in preventing diseases that had otherwise a high mortality rate. In an effort to reduce childhood morbidity, the Centers for Disease Control and Prevention Advisory Committee on Immunization Practices issues annual recommendations and guidelines for childhood and adolescent immunizations (Ventola). They serve to provide immunity that is a byproduct of natural infection without the consequences of being afflicted. The creation of the first adaptive vaccine begun in England and paved the road for vast advancements in modern medicine. In the late 1700s, Edward Jenner, a physician in Southern England observed that milkmaids were immune to smallpox- a fatal disease that repeatedly devastated the English countryside. In testing his theory that blisters on the hands of milkmaids were similar to the blisters on the udders of a cow, Jenner extracted fluid from the blister and inoculated a young boy with the pus of both a maid and a sma llpox victim. In turn, the boy was immune to the malady (Offit). Unknowingly, Jenner took advantage of a phenomenon that is known as a species barrier. Viruses and bacteria that have adapted to infecting one particular species have less of an effect on others (Offit). Although Jenners speculations and the outcome was not necessarily correct, his legacy remains pertinent for pioneering immunology and the first known vaccine. Jenner laid the foundations for germ theory [the theory that specific germs cause certain diseases] (Heller) and the advancement of the medical field by erasing a pandemic that has caused millions of casualities for centuries. The immune system has immense power in protecting individuals from the ravages of infection through expunging disease-causing microbes from the body. However, while it can eliminate infectious agents, if some function in the body goes wrong, it can yield disastrous effects for the host, leading to life-threatening diseases (Paul). When the immune system is functioning properly, it protects individuals from infectious diseases; however, one-way vaccines offer protection is by causing antibodies to form and by neutralizing the disease-causing microbe (Paul). The substance in the vaccine that causes an immune response is known as the antigen. Vaccinations also prepare the individual to make a secondary antibody response on infections with the organism bearing the antigen. This secondary antibody response is much higher in amount and more rapid than the response would have been had the individual not been vaccinated (Paul). Although the immune system is the bodys primary defense against infectious organisms and other invaders, vaccinations offer a secondary powerful shield of defense from any possible invaders. According to a study conducted by the CDC in examining the efficacy of vaccines reducing the incidence disease, [s]ince the introduction of vaccines for rubella, diphtheria, Haemophilus influenza type b, measles, mumps, pertussis, polio, and tetanus, we have seen a drop of between 97.8 percent and 100 percent in each of the diseases (Largent). Moreover, the chickenpox vaccine was introduced in 1995. At the time, 4 million cases of chickenpox occurred every year. Within a few years, the number of cases declined to about 400,000, a 90 percent drop (Largent). This is a substantial decrease given these diseases prevalence in the past. Vaccines, successfully paired with the immune system,   nearly eliminate several contagions. As compared to other demographics, such as impoverished countries in Africa where the occurrence of disease is high from a lack of prope r healthcare, Western countries have a low incidence rate of transmittable viruses. If an unvaccinated child is exposed to an illness at a young age and survives, it can yield severe repercussions such as paralysis or brain damage. There have been recent trends of parents in Western countries refusing to vaccinate their children due to numerous perceived fears. Over the last decade especially, questions have been raised regarding a relationship between autism and vaccines. Subsequently, this has led to a large number of parents exempting their children from receiving several mandated vaccines (Halpbern). While there has always been objection since its creation, there has been a recent surge in the opposition to vaccines in general, specifically against the MMR [measles, mumps, and rubella] vaccine (Hussain, Azhar, et al). This trend has been primarily due to Wakefields fraudulent correlation between the MMR vaccine and the occurrence of autism. An adverse effect of the increasing number of exemptions can be noted from a case in Washington wherein 2008, public health officials singled out Washington State for its high number of unvaccinated children and identified the source of one of the largest outbreaks in re cent history of measles as an unvaccinated child who spread the disease to seven other unvaccinated children in her household (Largent). Although all states have vaccination mandates for schoolchildren, in recent years they have granted a growing number of nonmedical exemptions, such as religious or philosophical. As a result, the risk of infectious disease outbreaks, especially among children whose immune systems are not fully developed, has increased. In an analysis of parents who opposed compulsory vaccination, researchers from the CDC asserted, [b]ecause many parents lack firsthand knowledge of vaccine-preventable diseases such as measles or polio, they are not likely to perceive such illnesses to be an immediate threat to the health of their children (Largent). This assertion was validated, researchers say, by a 1999 telephone survey that found parents were more likely to refuse a vaccine when they perceived the severity of the disease to be low (Largent). Vaccines are useful n ot only because they protect individuals who have been vaccinated but also because they enable a broader protection for communities by establishing herd immunity. When a sufficiently high proportion of a population is vaccinated against communicable diseases, the entire community can obtain protection. As the number of vaccinated people in a given population increases, the likelihood that a susceptible person will come into contact with an infected person decreases; making difficult for a disease to infect a host. Although the vaccination rate required to achieve herd immunity varies by the vaccine, it typically ranges from 80 percent to 95 percent of a given population (Stratton), as the number of exemptions grows within a population, those that were previously protected by herd immunity are now vulnerable to contracting an ailment. A large proponent and facilitator for the anti-vaccination movement was Andrew Wakefield, an ex-physician in England. In 1998, Wakefield published a paper in the journal Lancet. Wakefield hypothesized that the MMR vaccine caused a series of events that include intestinal inflammation, entrance into the bloodstream of proteins harmful to the brain, leading to the consequent development of autism (Hussain, Azhar, et al). In support of his hypothesis, Dr. Wakefield described 12 children with developmental delay, with eight having autism. All of these children had intestinal complaints and developed autism within one month of receiving MMR (Childrens Hospital of Philadelphia). Despite the small sample size, the uncontrolled design, and the speculative nature of the conclusions, the paper received wide publicity (Rao and Andrade). However, a concern with this publication is that there have not been nearly enough longitudinal studies to determine the long-term consequences of a vaccine, or the effects of giving multiple vaccines to young children at one time. Wakefields studies were controversial for several reasons. For one, multiple sources have debunked any correlation between MMR and the development of autism. About 90 percent of children in England received MMR at the time this paper was written. Since MMR is administered at a time when many children are diagnosed with autism, it would be expected that most children with autism would have received an MMR vaccine recently. The observation that some children with autism recently received MMR is, therefore, expected (Childrens Hospital of Philadelphia). However, it is imperative that when studying the incidence of autism from the MMR vaccine, both vaccinated and unvaccinated children are utilized as proper control and experimental designs. This was neglected in the study. Further, Wakefield has been since discredited as a doctor. His studies were ultimately retracted; his papers are no longer part of the scientific record because it was found to be based on scientific misconduct. In this case, the studies were deemed fraudulent as data was misrepresented and falsified. However, the effect of his papers was monumental in spiking anxiety in families globally. The damage was done and parents across the world did not vaccinate their children out of fear of the risk of autism and MMR vaccination rates especially began to drop, thereby exposing their children to the risks of disease. In the UK, for example, [t]he MMR vaccination rate dropped from 92% in 1996 to 84% in 2002. In 2003, the rate was as low as 61% in some parts of London, far below the rate needed to avoid an epidemic of measles (Hussain, Azhar, et al.). Given the highly contagious nature of airborne illnesses such as measles, entire communities can be exposed to the pathogen. Another primary concern for vaccines is that it contains harmful ingredients that are damaging to the body. Thimerosal, an organic mercury compound that is metabolized to ethylmercury and thiosalicylate, has been used since the 1930s as a preservative in some vaccines and pharmaceutical products (Stratton). Recently, fears that mercury at very low levels may be toxic to the brain have raised additional concern among many in the public. Parents have begun questioning its safety and concluded that the compound is further correlated with autism. However, what families do not realize is that there are two varieties of the organic molecule.   There are good reasons to believe that the ethylmercury used in vaccines is very different from the damaging and toxic methylmercury studied in environmental science and fish (Baker). For one, the body readily breaks down ethylmercury and eliminates it, causing no bodily or cognitive harm (Baker). Second, there are such minute amounts of mercury pr esent in thimerosal that there is no definitive evidence to conclude its linkage to autism (Ventola). It is all merely speculative. Moreover, these preservatives are essential in killing or preventing the growth of microbes in the body. In a tragic case from Columbia, South Carolina, in 1916, a tainted batch of typhoid vaccine stored at room temperature caused 68 severe reactions and 4 deaths. A similar incident took place in 1928 in Queensland, Australia, where 12 of 21 children inoculated with contaminated diphtheria vaccine died of multiple staphylococcal abscesses and toxemia (Baker). Without mercury-containing preservatives like thimerosal in vaccines to counteract microbial growth in the rare case that the vaccine is accidentally contaminated with multi-dosages, it can produce lethal effects. Vaccinations are vital in boosting the immune system against viral and bacterial pathogens. With the general increase in the number of parents seeking exemptions for children to receive all of the recommended schedules of inoculations, there has been a massive influx in the number of nearly eradicated diseases making a comeback. In turn, children and those that have a weakened immune system from factors such as cancer are more susceptible to being contaminated by an unvaccinated individual. The rationale that vaccines are unsafe and cause bodily or cognitive harm is severely flawed. Parents seemingly would rather risk the chance of their child contracting an illness and dying over having autism, yet being otherwise healthy. It is a selfish mentality to bear.