The sad truth about having a baby: ‘cattle’ care is now the norm

It’s the most IMPORTANT, meaningful and – for many – anxiety-provoking day of your life. You’re going to experience the rare privilege of being at the centre of the action as a new life begins. Added to this, you may well be naked and somewhat indisposed. Who would you choose to be with you? Someone you know and trust? Or a total stranger? It’s a no-brainer, isn’t it?

And yet a report published today by the National Federation of Women’s Institutes (NFWI) and childbirth charity the NCT has shown, yet again, that this most obvious of human needs is simply not being met for women. Rather than being accompanied by a familiar and trusted figure, most women (88%) surveyed did not know their midwife when they went into labour or gave birth. Of these women, 12% said this made them feel alone and vulnerable, and 6% said they felt unsafe. Comments were made comparing treatment to that of cattle, and like being on a conveyor belt.

The report also highlights that as many as 50% of women are experiencing so-called “red flag events” in their labour – situations which are seen as warning signs of understaffing, such as women having to wait more than 30 minutes for pain relief, or more than an hour to receive the stitches they need.

Midwife shortages have long been highlighted; the last estimate by the Royal College of Midwives in 2016 suggested that 3,500 more were needed to meet the rising birth rate. And the impact of shortages reaches far beyond red flag events. The effect of not being able to establish a relationship with your midwife begins long before you are in stirrups waiting for stitches: research has shown, for example, that women who know their midwife are 24% less likely to experience pre-term birth, and are 16% less likely to lose their baby during the pregnancy.

Knowing your midwife also means you are more likely to have a vaginal birth, and less likely to experience interventions such as forceps or episiotomy. And women who experience continuity of care repeatedly report higher levels oaf satisfaction, an increased sense of agency and control, and more positive birth experiences. After the birth, as the NFWI/NCT report highlights, almost one in five women are not seeing a midwife as often as they need to, let alone one with whom they have a relationship. This is a vital yet neglected time for maternal mental health.

We know this – all of this – and have done for some time. We know that relationship-based care is better for women, and we know that we need many more midwives to raise services up to this standard. We also know that this is what midwives themselves want, with many feeling burnt out by a system that – as one person who had left after 30 years in the NHS anonymously told me – demands that they are “with COMPUTER”, rather than, “with women”.

Indeed, the recent Maternity Review highlighted “continuity of carer” as one of the key priorities in improving birth. And yet, in the current system, it seems to be harder and harder to come by. Women who I meet via my organisation, the Positive Birth Movement, often report fragmented care experiences in which they have to repeat their histories to each new midwife, a situation which is at best frustrating, and at worst dangerous. Getting the birth you want in the setting you wish for can also be a tough battle: home births can be denied due to lack of staff, midwife-led units closed or full, and higher-risk women such as those with twins or breech babies left feeling they have limited options in a system that is over-stretched and depersonalised.

One solution women could opt for, and which I chose for my own second and third births, has also just been removed: the option of a self-employed independent midwife. These midwives, with huge expertise in normal birth, can – for a fee – attend you personally at every step of your pregnancy, birth and postnatally, in your own home. However, this week the Nursing and Midwifery Council has ruled that the insurance arrangements of these midwives – the 82 members of Independent Midwives UK – are insufficient, in effect shutting them down, with many of their clients being left without a midwife. The charity Birthrights has said that the decision “directly jeopardises the health and safety of the women it (the NMC) is supposed to safeguard”.

NHS England has today offered assurance that the Better Births initiative, now being rolled out in pilot schemes following the recommendations of the Maternity Review, will provide women with “access to a small team of midwives for continuity throughout pregnancy, birth and postnatally”. We can live in hope, but right now, this level of care – which both women and midwives want and deserve – seems a long way off, and conveyor-belt care, or worse still, being treated like cattle, is more likely.

• This article was amended on 18 and 20 January 2017 to clarify that the NMC’s ruling related only to the insurance arrangements of the self-employed independent midwives who are members of Independent Midwives UK. An earlier version also said the decision meant the NMC had “effectively shut them down overnight”. The NMC disputes that; its statement about the ruling points out that it wrote to IMUK and its midwives in August 2016 to say it did not consider that their indemnity provision provided appropriate cover.

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Melania Trump's style evokes Jackie Kennedy and Nancy Reagan

If Melania Trump had former first ladies on her mood board while shopping for the inauguration, then it was dominated by Jackie Kennedy’s ceremonial formalities on the West Lawn and Nancy Reagan’s evening celebrations.

The skirt suit and matching gloves in retro powder blue the new first lady wore for the swearing in was followed by a vanilla, off-the-shoulder evening gown. TheDRESS, a collaboration between Mrs Trump and the designer Hervé Pierre, featured a full-length ruffle in six layers of crepe, a narrow red ribbon bow belt and a deep side slit. Bold and dynamic rather than romantic or ladylike, it was closer to the vigorous, red-blooded style that Nancy Reagan brought to the White House in the 1980s than to Jackie Kennedy’s demure elegance or to Michelle Obama’s take on modern romance.

Ivanka Trump, the first daughter, also appeared to have taken a leaf out of Nancy Reagan’s book. The full SKIRT of her sequinned Carolina Herrera gown was reminiscent of the early 1980s White House, while the deep V-neck nodded to the red lace gown Mrs Reagan wore in 1988 for her husband’s endorsement dinner of George HW Bush.

There was a striking contrast between the soft silhouette of Ivanka’s champagne-coloured gown and the staccato details of Melania’s DRESS. The new first lady’s decision to take authorship of her own gown, creating a dress in partnership with a designer whose name is less well known than hers, seems to speak of confidence and self-belief. The White House bio of the new first lady mentions her design prowess, including her short-lived jewellery label, in its list of her accomplishments. The president is perhaps not the only one in the White House humming My Way.

But while Hervé Pierre has little public profile, he has huge experience. He worked at Carolina Herrera, a house that has DRESSED a succession of first ladies, for 14 years. He rose to creative Director before leaving last year. Pierre told Womenswear Daily that the design process was “organic … [Mrs Trump] has a very strong personal style and doesn’t plan to change it because of her new function. So it was fun to respect her very tailored sense of fashion … she knows what she likes.”

According to a report on vogue.com, the French-born Pierre, who headed the house of Balmain before working at Carolina Herrera, is poised to become a sartorial adviser to the first lady, and helped her to style the blue Ralph Lauren SUIT worn earlier in the day.

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5 KILLED AFTER GUNFIRE ERUPTS AT MUSIC FESTIVAL

The shooting broke out at an electronic music festival that had drawn visitors from around the world to the beach resort city.

Video of the aftermath posted on social media showed frantic club-goers rushing into the street as rescuers arrived.

Two Canadians, an Italian and a Colombian were among the dead, state prosecutor Miguel Angel Pech Cen told reporters.

“I heard what sounded like firecrackers. Everyone started screaming and running for cover,” said Andrew Badecker, who was outside the Blue Parrot club when the shooting began.

People climbed over a fence behind the club to escape, the professional poker player said.

“I was trying to help people over,” he said. “I was worried someone would get trampled.”

In fact, a woman died in a stampede of people rushing out of the club, the state prosecutor said.

Several victims were found dead on the beach outside, he said.

Playa del Carmen, about 40 miles (64 km) south of Cancun, is a popular destination for tourists from Mexico and around the world.

It’s located in Mexico’s Quintana Roo state, which has maintained a reputation as a safe travel destination even as other parts of the country have struggled to deal with drug-related violence.

‘We are overcome with grief’

Of the 15 people injured, seven remained hospitalized Monday morning, Pech Cen said.Authorities haven’t released the nationalities of all the victims. Five Mexicans, four Americans, two Canadians and a Colombian were listed among the wounded.

On a Facebook page for The BPM Festival, a 10-day electronic music event that was closing Monday, organizers said a lone shooter had opened fire in front of the Blue Parrot. Three members of the event’s security team were killed trying to protect patrons inside, the festival said.

The festival’s statement said four people had been killed in the shooting. Officials could not be immediately reached to explain the discrepancy in the death toll.

“We are overcome with grief over this senseless act of violence and we are cooperating fully with local law enforcement and government officials as they continue their investigation,” the festival statement reads.

Authorities interrogating three people

Authorities in Quintana Roo say they’re still trying to determine who was behind the shooting — and why it occurred.

A preliminary investigation indicates that the shootout began when members of event security tried to stop a person who entered the club with a firearm, Pech Cen said.

Investigators found 20 shell casings at the scene.

Authorities are interrogating three people, the state prosecutor said, but it’s unclear whether they were involved in the shooting.

CNN’s Ana Melgar, Leyla Santiago, Alison Daye, Elwyn Lopez, Daniela Patiño and Julia Jones contributed to this report.

Ever Wondered What The Half Moon Shape On Your Nails Mean?

Our nails aren't just a bunch of dead cells meant to decorate and flaunt nail art with matching clothes. They are a very important part of our body since nails carry symptoms of many diseases, including cancer. Don't worry, we're not here to scare you this time!

Have you noticed a crescent-shaped whitish area at the bed of a fingernail while trying to stop biting nails for the 1000th time? It isn't just an area of pigment change under the nails; in fact, it is a highly sensitive area and you should make sure it doesn't get damaged.

The lunula is known to indicate health conditions of a person as well

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According to Chinese alternative medicine, a lack of lunula indicates anemia and malnutrition while a bluish/pale lunula indicates possible diabetes

This whitish half-moon on the nails is quite sensitive and must be taken care of.

This crescent-shaped whitish area is called 'lunula' which means small moon in Latin.

It is the visible part of the nail's root and if the lunula gets damaged, the entire nail gets permanently deformed.

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Though it's safe if the rest of the nail gets damaged or gets surgically removed since the lunula stays intact and safe.

Lunula:

The lunula is most visible on thumbs and might be faintly visible due to eponychium, the thickened layer of skin surrounding fingernails and toenails that cover the lunula.

Reddish smudges on the lunula might be an indication of cardiovascular diseases.

A lack of lunula (or a very small one) indicates indigestion and toxin overload in the body.

And guess what! You can paint your nails in half-moon style as well!

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11 Important Facts About Abdomen Your Doctor Never Told You, #9 Is Surprising

Abdomen is present between thorax and pelvis of the human body. As major part of the alimentary canal is present inside the abdomen, absorption and digestion of food occurs inside it. There are several little known facts about abdomen. Let's check out few important facts about abdomen that your doctor never told you


1) Abdomen provides support and posture to the body. 

Thus, it is important to exercise abdominal muscles regularly to strengthen your body. 

2) Yoga and jogging help in strengthening and balancing your abdominal muscles. 

Healthy abdominal muscles help in combating back aches, spasms and injuries due to stress or strain. 

3) Transverse abdominal muscle is responsible for body posture.

It is the deepest muscle,  thus can't be touched from outside the body. 

4) Breakdown of food occurs in the abdomen. 

However, only the first part of digestion takes place in the abdomen. The tiny food particles called chyme leaves the abdomen and move to the intestines for the further digestion process. 

5) Sugary foods are digested quickly by the abdomen

When you consume your meal, a small amount of air also enters your abdomen along with the food particles. However, you can get rid of this excess air by burping after your meal. 

6) Besides digestion, abdomen also has an important role in immune system.

It serves as the first line of defense for the immune system. The presence of hydrochloric acid in abdomen provides immunity from bacteria and viruses that might enter your body during ingestion. 

7) Drinking soda or carbonated beverages cause a lot of air in your abdomen.

It serves as the first line of defense for the immune system. The presence of hydrochloric acid in abdomen provides immunity from bacteria and viruses that might enter your body during ingestion. 

7) Drinking soda or carbonated beverages cause a lot of air in your abdomen.

When you consume your meal, a small amount of air also enters your abdomen along with the food particles. However, you can get rid of this excess air by burping after your meal. 

8) Ever pondered about the capacity of your abdomen? 

One of the amazing facts about abdomen is its tendency to carry large amount of food. An adult abdomen can hold around 1.5 liters of food/drink. 

9) The size of abdomen is similar in both thin and fat people. 

However, the change in size of abdomen might be caused due to surgery.

10) People suffering from abdominal obesity can fall prey to many chronic diseases.

Some of these diseases include type 2 diabetes, heart disease, asthma and hypertension. 

11) The abdomen inside injury can cause damage to the organs present inside it. 

If you know more interesting facts about abdomen, then please share in the comments section below.

Share this little-known information with your friends and family

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After The ACA: Where Healthcare Coverage Goes From Here

Or: Why Health Insurance Is Like Auto Insurance And Unlike Almond Butter

In the shadow of ACA repeal and something vaguely resembling “replace eventually, maybe, if we figure out how," the media coverage of healthcare coverage has come fast and furious. It seems to leave us asking: Where, exactly, does healthcare coverage go from here?

In this period of sound and fury and abstruse intentions, I very much doubt anyone can say--perhaps least of all those leading the assault. What we can say, however, is that some very fundamental attributes of healthcare and its coverage account for the relative necessity of the ACA or something like it, and the widely cited and rather grave consequences of repeal-whether-or-not-ready-to-replace.

Let us start, then, with healthcare coverage 101, which we may reasonably distill down to three key principles:

1) Healthcare is not like almond butter.

2) Care only when sick is fine; coverage only when sick is ruinous.

3) All for one, and one from all.

1) Health care is not like almond butter.

For those of us who like almonds, almond butter is very tasty stuff. Which means we might want to buy it. But though we might want almond butter, and perhaps even love almond butter, the simple fact is we could never conceivably need almond butter. (Perhaps the same may be said of meatloaf, but I wouldn’t know.)

No one ever truly needs almond butter, and thus some who might want it would simply forego it if they couldn’t find it or afford it.

Healthcare, alas, is a case quite apart from this “two out of three ain’t bad” scenario. When run over by a bus, dismembered by a shark or more mundanely undone by the prevailing heart attacks, strokes, complications of diabetes and related scourges of modern epidemiology--we need healthcare. We are out of options.

Not only are we all prone to need healthcare in situations of blood and guts and hemodynamic mayhem, but we are often unconscious of it at the time. We don’t make any choices at all. We wake up--if we are fortunate--to find out what decisions were made on our behalf.

To the best of my knowledge, no one ever decides while you are unconscious that you must have almond butter, so that you wake to confront the bill for jars filling your pantry. Healthcare at the acute end of the spectrum is just so. You get it when you need it whether or not you want it, or can afford it.

2) Care only when sick is fine; coverage only when sick is ruinous.

While the travails of the ACA have been exploited to propagate many falsehoods (e.g., death panels), at least one valid lesson has run that same gauntlet all but universally: the importance of allowance for preexisting conditions. Even ardent ACA detractors seem inclined to acknowledge, however begrudgingly, that requirements for coverage despite preexisting conditions are essential. In their absence, the combination of a chronic, costly condition and employer-based health insurance would preclude any employee ever leaving that job. No insurer not required to do so would rationally want to take on your costs without charging you enough to make you a source of profit, which you couldn’t possibly afford. The logical choice is to reject you.

That has led to a great deal of vague and vapid rhetoric about protecting this part of the ACA, while dismembering the whole. Here’s the problem with that: if you can get coverage despite a preexisting condition, why get it until you have one?

In other words, if private insurance companies are obligated to take us on no matter what costly conditions we may have, it makes good sense for us to avoid the direct costs or payroll deductions for health insurance until we get sick. But that means the only clients health insurance providers will have are all sick and costly. When every one of your clients is a source of loss rather than profit, you are in a very dubious business.

One option, then, is to mandate coverage, but allow the charges to vary. This, of course, can’t work--because for an insurance company to profit, it would have to charge us more for coverage than the costs of our care. And the only reason we need coverage in the first place is because we can’t afford the costs of our care, let alone those plus the extra.

This, then, leads to a need to mandate not just coverage, but coverage at comparable cost, which brings us back to insurance companies losing money, going bankrupt and exiting the market. The only way obligatory coverage of preexisting conditions can work is if everyone is obligated to pay into the system when healthy, providing the revenue, and profits, that make universal “sick care” coverage possible. This, then, leads to the third principle.

3) All for one, and one from all.

Health insurance markets work as private enterprise like any other insurance market: clients pay more into them than the companies pay out. Consider, for instance, an auto insurance market that required coverage of a preexisting condition, but allowed for people to drive without insurance at all.

Presumably, all reasonable people would take advantage of the opportunity to drive without insurance, until we had a crash. That crash, and the attendant damage, would be our “preexisting condition,” despite which auto insurers would be obligated to cover us. We would then logically sign up for coverage only in the aftermath of a crash, and only when the costs of coverage were substantially less than the costs of repairing or replacing our car, and any related liabilities. Which of course means the auto insurer would lose money on every client, and this industry would collapse.

How, then, does auto insurance actually work? All for one, and one from all. In the complete absence of fuming and fussing attached to requirements for health insurance, all of us who drive are required to have auto insurance. Perhaps that bears repeating, since this seems so contentious when applied to obligatory insurance for humans: We are all required to insure our cars. And everybody seems OK with it.

This works, because most of us are not crashing most of the time. Those of us not crashing pay into the system without withdrawing. Those funds from us all cover the costs of any one client who does crash, leaving a profitable margin behind.

Auto insurance makes sense as a for-profit enterprise because there is revenue from all to cover costs of the one. Health insurance as a for-profit enterprise makes sense exactly, and only, under the same circumstances.

Implications

In the absence of health insurance at all, people who can’t afford routine healthcare simply don’t get any. They wait for a calamity, at which point they will get what they can’t afford, often while unconscious. They wake, if ever, to discover they have been bankrupted by bills they can’t pay. Who does pay? Taxpayers, of course; we all do. The same is true when health insurance exists, but is unaffordable for millions.

If coverage can be denied for preexisting conditions, it’s a variant on the same theme, particularly since in modern epidemiology, chronic conditions spanning years and decades are by far the greatest cost center.

The superficial remedy is to require coverage despite those conditions, but this can only work when coverage costs less than treatment. That, in turn, can only work for private companies if there is a way to derive profit; and that can only work if healthy people pay into the system, in a model exactly analogous to auto insurance. That, obviously, means that coverage for all must be mandated.

Absent that, private companies will exit the market, leaving only the government to cover costs no one else does. This leads to the public, single-payer option favored by many of our peer countries.

That model is certainly better than ours. In our model, taxpayers still get the bill, but for calamity care and bad outcomes. In sensible approaches to public insurance, taxpayers have bills to pay, but for routine and preventive care producing better outcomes at lower costs.

If the American approach to health insurance favors free-market competition, that can work--and perhaps even make the system better. But it requires treating health insurance more like auto insurance and less like almond butter. Everyone must be obligated to participate so the revenue from those not needing care covers the costs of those who do. Under these terms, companies can compete to lower costs and raise profits with creative approaches to disease prevention and health promotion. When costs go down, profits rise, and overall vitality increases--everybody wins.

The traditional antipathy to universal healthcare coverage in the U.S. is a benighted boondoggle for both public health and the economy. The burden of covering care for all does not go away; it just gets shifted to calamity-based care. We all still get the bill, but in the most irrational manner possible. This explains why the U.S. spends more on disease care than any other country, with worse outcomes than many.

The ACA was intended as a remedy to much of this, and has proven to be just that. It is, however, a very imperfect remedy not because it went too far, but rather because it did not go far enough. Its limitations were no accident. They were imposed on it by those opposed to it, so they could be invoked to justify the repeal that now looms. But even despite this willful sabotage, healthcare coverage in the U.S. is better and more rational with the ACA than it was before.

Where American healthcare coverage goes from here is uncertain. What is certain is that back to the future is a very bad choice. A system in which free-market ideology ignores the realities of modern epidemiology and pretends that healthcare coverage can be sold like almond butter–is, in a word, nuts.

David L. Katz, MD, MPH - President, American College of Lifestyle Medicine; Founder, True Health Initiative

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Inside the Cryotherapy Craze: Why Celebrities and Athletes Take the Deep Freeze

My fascination with Cryotherapy all started in the south of France a few months ago, while at the spectacular Thermes Marins Spa in Monte Carlo. Wealthy guests were lining up for a chance at freezing themselves at a cost of $100 for two minutes. The treatment was touted as a way to procure relaxation, reduce stress, improve sleep disorders and dramatically improve jet lag. But cryotherapy was first developed in physical medicine for three main conditions; to help athletes recover and improve their performance, to prevent relapses for different illnesses and in the treatment of muscular and inflammatory pathologies. The anti-aging virtues of extreme cold have been known for a long time in Nordic and Eastern countries for rejuvenation and as an apparent fountain of youth.

It wasn’t until at the recommendation of several celebrities, I started a diet treatment in Los Angeles with well-known Lifestyle Medicine Specialist Dr. Joe Raphael. Dr. Joe started me on a simple routine of losing weight utilizing low calorie protein shakes while maintaining a restricted but sensible diet. I quickly discovered how celebrities like Christine Aguilera were able to lose weight so quickly and safely, and have been a devoted disciple of Dr. Raphael ever since.

While working out was part of the follow up to the diet, I found that my joints were not recovering well and I was often in pain going up and down stairs. Dr. Joe referred me to the Cryohealthcare Clinic in Beverly Hills to basically freeze my pain away. I had read for some time how popular the clinic was with numerous famous celebrities and major athletes including Floyd Mayweather and the professional dancers from the ABC-TV series “Dancing with the Stars.”

I decided to give it a try and scheduled a visit. When I arrived I was met with three supermodels, (well in my mind they appeared to be supermodels), in fact they were the owners; Medical Director and Co-Founder Jonas Kuehne, M.D, his wife Emilia Kuehne and brother Robin Kuehne, both Co-Founders and Managing Partners. Tan, fit, incredibly vital and energetic, this was the dream team that I wanted to treat my worn out and aching body.

Cryohealthcare is the only company in the U.S. to feature a single-person Cryosauna, a Walk-In Cryochamber, and local cryotherapy devices in their office. Cryohealthcare was among the first companies to bring Cryotherapy to the United States in 2009.  Dr. Kuehne graduated from UCLA School of Medicine ('03) and was the first physician to introduce this alternative non-medical treatment in Northern America with the company's headquarter in Los Angeles.  Dr. Kuehne also developed and trademarked the Cryofacial^TM treatment and set standards in positive results and safety since their introduction.

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