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

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.

One solution women could opt for – an independent midwife –has also just been removed

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 of 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 an independent midwife. These self-employed 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 their insurance arrangements are insufficient and has effectively shut them down overnight, 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.

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

Fabrice Muamba was fortunate assist was at hand. It is the exception not the norm

The amount of health-related professionals present at White Hart Lane undoubtedly saved Fabrice Muamba’s lifestyle on 17 March 2012. Photograph: Paul Childs/Action Photos

The unfortunate truth about cardiac arrests sustained by sportsmen and ladies, no matter whether enjoying in the Premier League or down the nearby park, is that they will by no means be fully eradicated. Two years on from Fabrice Muamba’s collapse at White Hart Lane and his remarkable recovery, the truth remains that death in this kind of instances is very unusual. However, the devastating impact of a fatality on the pitch provides lasting scars that are never wiped from memory.

It can appear extraordinary that elite athletes, at the peak of bodily fitness, abruptly drop to the ground without any prior warning because of a severe heart defect. This kind of cardiac arrests are usually caused by genetic abnormal heart rhythms, top to a problem in the organ’s electrical method. A frequent trigger of an arrest is ventricular fibrillation, when the heartbeat becomes shallow and uncoordinated, not contracting and for that reason avoiding blood currently being pumped successfully close to the physique.

There can also be problems with the muscle close to the heart. Hypertrophic obstructive cardiomyopathy, abnormal thickening of the heart muscle, may lead to a fatal rhythm disturbance due to the anxiety of exercising. It is a cruel twist of fate that sportsmen are 3 times a lot more most likely to die from these problems than individuals who do no exercising at all.

Considering that Marc-Vivien Foé collapsed whilst playing for Cameroon in the 2003 Confederations Cup, a variety of specialist players have suffered fatal cardiac arrests, such as Antonio Puerta while enjoying in La Liga for Sevilla and, more just lately, Piermario Morosini in Serie B for Livorno. Because the 19th century a lot more than 80 footballers are identified to have died out of the blue while taking part in.

Employing an automated external defibrillator is the only way to re-set up the heart’s organic rhythm and CPR, cardiopulmonary resuscitation, is also crucial to artificially pump blood round the entire body. The Football Association and British Heart Basis are delivering an improved variety of defibrillators to amateur clubs, crucial products that substantially increases the likelihood of survival after a sudden cardiac arrest. Survival charges drop 10% each and every minute with no defibrillation.

Tragedy can strike even when a defibrillator is present. Jamie Skinner, a 13-12 months-previous from Edinburgh formerly on the books at Hearts, suffered a fatal suspected cardiac arrest on his debut for Tynecastle FC in December. Emergency equipment was present, but the Edinburgh Leisure company, owners of the area exactly where the incident took place, has since suspended two workers and launched an investigation into whether its emergency operation process was appropriately carried out.

Experts argue that more can be completed to increase awareness of heart difficulties, warning indications and procedures, claiming that a lot more cardiac screening would conserve lives. The Professional Footballers’ Associtaion money a screening programme in conjunction with the FA, costing £300,000 every 12 months, for all academy scholars at skilled clubs when they reach sixteen, with youthful gamers provided an ECG (electrocardiogram) test and an echocardiogram.

Nevertheless, these tests rarely filter down to any of the a number of hundred semi-specialist and amateur clubs, even though skilled players can frequently go unchecked again till they sign for yet another club, particularly outside of the Premier League in which testing is undertaken significantly less routinely. In the prime flight thorough screening is frequent, even though all Uefa and Fifa tournaments need pre-tournament screening for gamers and the FA enforces tests for the England men’s, women’s and disability squads.

Professor Sanjay Sharma, chairman of the FA’s specialist cardiac group that was convened after Muamba’s collapse, believes much more screening must be obtainable for gamers at expert degree and below. He said: “Young players not in the Premier League need to be screened each and every two years till the age of 20. I also think that screening ought to be offered to all athletes, not just the greatest players.

“Most deaths take place in non-elite athletes. We need to have a lot more experts in the United kingdom, this is a significant challenge and everyone who workouts need to be provided screening. We require to contain this variety of point in the medical curriculum to train a lot more medical professionals to deal with the difficulty.

“We also require to educate all youthful individuals about the symptoms of heart disease so that they do not falsely attribute difficulties to being unfit.”

In actuality, little has altered because Muamba’s collapse at Tottenham, other than the improved number of defibrillators made obtainable, even though the BHF did raise awareness of CPR via an advert campaign with Vinnie Jones.

Emergency remedy was presently at a large standard and Muamba has admitted that the expert health-related care he obtained, such as from a medical professional in the crowd, is the explanation he is nonetheless alive right now. Pitchside health care care in the Premier League improved drastically after Petr Cech was knocked unconscious playing for Chelsea against Reading in 2006, sustaining a depressed fracture of the skull following a collision with Stephen Hunt.

The debate close to screening, although, is a contentious 1. There can be small doubt that increased exams on gamers will help conserve lives, but even then factors can slip underneath the radar. The extensively accessible tests only choose up 80% of cardiac issues and the circumstances that lead to death are really existing in one athlete out of every single 300. The vast majority of people circumstances by no means manifest themselves in critical incidents.

Dr Ian Beasley, head of health-related providers at the FA, stated: “It is an region that requirements consistent evaluation and, together with the pertinent bodies in English and international football, we carry on to assess the ideal approaches and strategies for early detection and care.”

Sudden death is rare, at a rate of one particular in every 50,000 for elite athletes. Even so, outside of professional sport 12 individuals below the age of 35 die every week from cardiac arrests. “Far too often there is a death in a particular person where screening had in no way been regarded as,” stated Prof Sharma. “What a waste of a daily life.”

Fabrice Muamba was fortunate assist was at hand. It is the exception not the norm

Obese kids could turn into new norm in Europe, says WHO

Boys working. In 23 out of 36 European countries, much more than 30% of boys and ladies aged 15 or above are not receiving adequate physical exercise, Photograph: Mike Egerton/PA

Being obese is in danger of turning out to be the new norm for kids as properly as grownups in Europe, the Globe Well being Organisation warns, issuing figures displaying that up to a third of eleven-12 months-olds across the area are as well heavy.

In accordance to the EU figures, Greece has the highest proportion of obese eleven-yr-olds (33%), followed by Portugal (32%), Ireland and Spain (the two thirty%).

Whilst the UK’s figures are not directly comparable, information from the childhood measurement programme in 2011/12 suggests England has as significant a issue as any country, with 35.4% of ten- to eleven-yr-old boys and 32.four% of girls overweight. Amongst people, twenty.7% of boys and 17.seven% of girls had been obese.

The school-based mostly measurements also display that 23.5% of 4- to 5-year-outdated boys and 21.six% of ladies are overweight.

The WHO mentioned the figures for young children have been alarming. “Our perception of what is regular has shifted being overweight is now far more common than unusual. We must not let one more generation expand up with weight problems as the new norm,” mentioned the WHO regional director for Europe, Zsuzsanna Jakab. “Bodily inactivity – coupled with a culture that promotes inexpensive, practical foods large in fats, salt and sugars – is deadly.”

The WHO’s European regional workplace issued a series of country profiles at the opening event in Athens of the Greek presidency of the EU. The United kingdom profile based on WHO information shows that 64.two% of the grownup population have been obese in 2008, between whom 26.9% had been obese.

By 2030, it is forecast that much more than a third of the population – 36% of men and 33% of women – will be obese. Only the Czech Republic and Malta currently have a increased proportion of obese adults, according to the WHO information.

Young children in Europe are not physically energetic ample, the WHO says. In 23 out of 36 countries, a lot more than thirty% of boys and girls aged 15 or over are not acquiring ample exercising and eating the wrong kinds of meals.

“We need to have to produce environments exactly where physical exercise is encouraged and the healthier food choice is the default decision, regardless of social group,” mentioned João Breda, programme manager for nutrition, bodily action and weight problems at the European regional workplace. “Physical activity and healthful meals alternatives must be taken extremely critically in all environments – schools, hospitals, cities, towns and workplaces. As nicely as the meals market, the urban organizing sector can make a difference.”

Uk information demonstrates that saturated body fat can make up twelve.seven% of the calories in an regular adult diet plan, which is greater than the WHO suggested limit of ten%. The fruit and vegetable intake was only just under the recommended 600 grams per day, at 588g.

The United kingdom does extremely poorly by comparison with the rest of Europe on breastfeeding. Only 1% of babies have been breastfed by the age of 6 months as the WHO recommends, in 2010.

WHO Europe condemned the marketing of junk food to kids final 12 months in a difficult-hitting report. It mentioned youngsters had been currently being surrounded by adverts for food items higher in salt, sugar and saturated body fat, even in schools and sports activities centres. The report expressed concern about the use by foods marketers of personal computer games and smartphone apps that kids readily entry.

Some nations have managed to contain the epidemic, says the WHO, though they have not succeeded in turning it close to. In France and some Scandinavian nations, the figures seem to display a plateau impact. The WHO says they have implemented the policies it advises, such as promoting the eating of fruit and veggies in colleges, improving the nutritional good quality of college lunches, controlling advertising and imposing taxes on some foods, alongside initiatives to inspire more physical exercise in kids.

Obese kids could turn into new norm in Europe, says WHO