- About 3 percent of babies born in the United States are affected by genetic disorders.
- Genetic testing is a common tool used by medical professionals and parents to determine if a fetus has a birth defect.
- Experts say abortion restrictions being put into place in the wake of the Supreme Court’s decision to overturn Roe vs. Wade are limiting the options parents have after receiving genetic test results.
Testing for potential genetic defects in a developing fetus has become a common component of prenatal care.
However, the ability to terminate a pregnancy due to a profound or fatal genetic deformity is being limited or even eliminated altogether in states that have imposed new abortion restrictions in the wake of the U.S. Supreme Court decision to overturn Roe vs. Wade’s constitutionally protected right to abortion.
“Since genetic testing is predominantly for information gathering, a change in access to termination will not necessarily change the demand for testing,” said Dr. Anjali Kaimal, the chair of the American College of Obstetricians and Gynecologists (ACOG) Committee on Clinical Practice Guidelines – Obstetrics and chief of the Division of Maternal-Fetal Medicine at Massachusetts General Hospital. “It will change the options and resources available to patients who desire pregnancy termination for any reason, including abnormal test results.”
“Depending on the laws, [testing providers] may not be able to deliver results in a timeframe that would allow for patients to consider termination,” added Lauren Doyle, a certified genetic counselor and the director of the University of North Carolina at Greensboro’s Genetic Counseling program.
Prenatal tests can detect genetic disorders linked to missing or extra chromosomes in fetal DNA as well as inherited genetic mutations.
Down syndrome is a condition related to having an extra chromosome. Others include Patau syndrome and Edwards syndrome.
Sickle cell disease, cystic fibrosis, and Tay-Sachs Disease are examples of conditions caused by inherited genetic mutations.
Kaimal told Healthline that while data on how frequently pregnancies are terminated due to genetic test results is limited, some small studies have shown that with diagnoses of Patau Syndrome and Edwards Syndrome, “which are severely life-limiting and associated with a high risk of death during pregnancy or in the first weeks of life, the rate of pregnancy termination may be 75 percent or higher.”
She added, however, that “this may not be the case with genetic changes that have less impact on life expectancy and risk of complications.”
“When a parent finds out that a fetus has significant developmental problems early on, like congential diagphragmatic hernia resulting in no lung tissue, anencephaly resulting in the brain being unprotected, hydrops that will result in heart failure, and others, the parent can wait for the fetus to pass naturally and risk complications for the mother that could have consequences during the pregnancy or in a future pregnancy, or terminate the pregnancy at a time and in a manner that is safest for the parent,” Doyle told Healthline.
“It is emotionally and psychologically devastating for someone to be told that their baby has significant developmental defects or a condition that will not allow the baby to survive. Termination provides parents with an opportunity to have some control in a situation in which they are otherwise completely powerless, and can provide an opportunity to have a safer delivery for the mother,” she added.
Prenatal screening tests can alert pregnant women to the risk that they are carrying a child with a genetic defect. Diagnostic tests are used to confirm whether a defect exists.
“It is standard of care and the current guidelines to offer genetic testing to all pregnant persons in every pregnancy,” Doyle said.
Screening tests, which include drawing samples of the mother’s blood and an ultrasound exam, typically take place between weeks 10 and 13 of pregnancy, according to ACOG.
Confirmatory testing for conditions such as Down syndrome, Edwards syndrome, and neural tube defects of the brain and spine aren’t conducted until the second trimester of pregnancy, between weeks 15 and 22.
“The nature of testing within pregnancy is such that aspects of fetal development are not knowable at the moment of conception,” Doyle said. “While screening and testing have advanced significantly in the past several years, we remain limited by the nature of the process. Conditions that are lethal to a fetus are not known or knowable until different time periods in pregnancy. Some structural conditions can be identified in the first trimester if a pregnant person has access to quality prenatal care in the first trimester. Others are not known until 20 weeks or even in the third trimester.”
By overturning the Roe vs. Wade decision, the Supreme Court returned the ability to limit or ban abortion to the states. Some responded with so-called “trigger laws” that immediately constrained abortion rights.
Right now, 13 states have laws on the books mandating near-total bans on abortion. Some took effect immediately while others take effect 30 days after the ruling.
All these laws have exceptions for procedures that save the life of the mother, but only five allow exceptions for pregnancies arising out of rape or incest.
Another 11 states have laws with early gestational bans that restrict abortions to the earliest stages of pregnancy.
None of the laws in states banning abortions make explicit exceptions for terminating a pregnancy due to known fetal defects.
Practically speaking, any of these state abortion laws will make it more difficult or even impossible for women to get genetic test results in a timely enough fashion to decide whether to terminate a pregnancy that will yield a dead or profoundly disabled baby.
“For people who are having initial prenatal visits in the first trimester, testing is usually done at that time,” said Kaimal. “Results usually take 1 to 2 weeks to come back. If a screening test shows an increased risk, diagnostic testing is recommended for definitive information. Results from a CVS also take about 2 weeks. So, from the time a test is sent until the time that the diagnosis can be made may be about 4 weeks.”
Genetic testing in pregnancy is not and never has been simply about choosing to terminate a pregnancy or continue, said Doyle.
“It is a tool for expanding information, for helping families to prepare for a birth experience or child that may not be what they originally envisioned,” she said.
“Many times, including for those who thought they would never choose abortion, having the option to terminate a pregnancy is a critical component to shifting lives in response to an unexpected event,” said Doyle. “Heartbeat laws limit autonomy, options and choice in many ways. People who are unable to act on results of genetic testing are likely to experience additional emotional, psychological and physical burdens. Stress has an epigenetic influence on developing babies and the generations who come after them, if they survive.”
“Being forced to birth a fetus that will die puts an incredible burden and risk on the mother and family,” said Doyle.
Read the full article here
Examples of the Effects of Mental Health Stigma
Over the past few decades, we’ve come a long way in how we view and talk about mental health.
And that should come as no surprise, because 1 in 5 adults in the United States lives with a mental health condition. Many people are also becoming more open to the idea of sharing their personal experiences.
But there’s still a stigma surrounding mental health. It’s a stigma, in fact, that affects millions of people around the world who live with mental health conditions. It affects everything from their social relationships and professional opportunities to the way they view themselves.
We’ll explore more about what mental health stigma is, and how we can all work to address this and improve the lives of people living with mental health conditions.
Mental health is often stigmatized because of a lack of understanding about what mental health conditions are and what it’s like to live with a mental health condition. Stigma can also arise from personal thoughts or religious beliefs about people who have mental health conditions.
Generally, the lack of understanding about mental health — as well as the harmful assumptions about people living with mental health conditions — is at the heart of a bias or stigma. This can result in avoidance, rejection, infantilization, and other discriminations against people who are neurodivergent or have a mental health condition.
We often use the word “stigma” to describe the overarching experience that people have. However, there are actually three types of stigma: public stigma, self-stigma, and institutional stigma.
- Public stigma: This refers to the negative attitudes around mental health from people in society.
- Self-stigma: This describes the internalized stigma that people with mental health conditions feel about themselves.
- Institutional stigma: This is a type of systemic stigma that arises from corporations, governments, and other institutions.
While there are many examples of mental health stigma in society, here are some of the more common instances you might notice:
- When people are viewed as attention-seeking or weak when they try to reach out and get professional help.
- When others use harmful language, such as “crazy” or “insane”, to judge or trivialize people who have mental health conditions.
- When people make jokes about mental health or certain conditions.
- When people avoid others with certain mental health conditions, like schizophrenia, because of fear or misunderstanding.
- When family or friends tell someone with depression that they can get better if they just “work out and get more sun,” or make other unhelpful judgments.
- When someone living with a mental health condition views themselves as worthless or talks down to themselves because of their condition.
- When companies refuse to hire someone or provide them with adequate accommodations because of their mental health.
- When people view examples of neurodivergence as illnesses or something to be cured.
According to the study results, from roughly 1996 to 2006, people became more knowledgeable about mental health — including acknowledging differences between daily experiences and symptoms of diagnosable conditions.
And from around 2006 to 2018, there was a significant decrease in social stigma against depression — specifically, less desire to be socially distanced from people with depression. However, when it came to schizophrenia and alcohol dependence, not only did social stigma increase but so did negative perceptions of these conditions.
Another earlier study from 2018 took a slightly different approach in analyzing the social perception of mental and physical health conditions. In this study, researchers used automated software to track over a million tweets related to mental health and physical health over a 50-day period.
According to the results of the study, mental health conditions were more likely to be stigmatized and trivialized than physical health conditions. And the results varied by condition — with schizophrenia being the most stigmatized, and obsessive-compulsive disorder (OCD) being the most trivialized.
Intersectionality refers to how someone’s intersecting identities — such as race, gender, sexuality, or class — contribute to their own unique experience with discrimination and oppression.
When it comes to mental health, intersectionality can play a huge role not only in someone’s overall mental health, but also in how mental health stigma affects them.
According to the researchers, less than 20% of the men who were referred to mental healthcare from the clinic continued to receive the recommended care — often as a result of increased social and professional stigma for men to go without mental healthcare of any kind.
Mental health stigma can have a hugely negative impact on the lives of people living with mental health conditions. In fact, stigma can often lead to mental, social, or even professional consequences for the people who are stigmatized.
People living with mental health conditions are more likely to experience low self-esteem and lower self-confidence if they’re stigmatized.
Stigma may lead to difficulty seeking treatment or even following through with treatment. And some people may experience increased symptoms of their condition, or even develop new ones — like anxiety or depression — because of experiencing stigma.
Self-stigma may even hinder someone’s ability to recover from a mental health condition. In one smaller
Social mental health stigma may lead to isolation from friends or family. People with mental health conditions may experience bullying or harassment from others — or possibly even physical violence.
And when others have a judgmental view of mental health, it can be difficult for people living with these conditions to build relationships with them.
Stigma in the professional world can lead to fewer opportunities to excel at school and fewer opportunities to advance at work. People living with mental health conditions may have difficulty fulfilling school or work obligations — especially if they have trouble with classmates, teachers, coworkers, or bosses.
It’s not just classmates or colleagues who contribute to mental health stigma in a professional setting, either.
Stigma comes from everywhere — institutions, society, and even ourselves. But we can all take steps to address and reduce the stigma of mental health:
- Learn about mental health: One of the most important steps toward reducing mental health stigma is to learn more about it. Learning what mental health conditions look like and who they can affect can help reduce some of the fear, misunderstanding, and judgment around them.
- Use words carefully: When we use words with negative associations, like “insane” or “crazy”, we contribute to the judgment and stigmatization of others. It may take some effort to change the way we speak, but it can help reduce the stigma that people with mental health conditions face.
- Take part in campaigns: Many mental health organizations, like NAMI, create fundraising campaigns to help bring awareness and provide funding for mental healthcare. Even if you can’t get directly involved, these campaigns are a great way to learn more about people living with mental health conditions.
- Share your story: If you’re someone living with a mental health condition, one of the most powerful tools for reducing stigma is to share your story. By educating people on what it’s like to live with a mental health condition, we can help reduce the misunderstanding and judgment that people feel.
Mental health stigma plays a significant role in the lives of people with mental health conditions — from the way that they’re treated to the way they feel about themselves. But we can take steps to reduce this stigma.
By being more mindful about how we speak to others, learning more about what it’s like to live with a mental health condition, and sharing our stories when we’re living with these conditions, we can help reduce the stigma surrounding mental health.
Read the full article here
Can People with Diabetes Eat Candy?
Eating candy can be a controversial topic for people with diabetes.
Misconceptions about sugar and candy being off-limits for people with diabetes can be found in the public mindset, in media and entertainment, and within the medical community itself.
With the Halloween season upon us, both kids and adults with diabetes as well as their loved ones and friends may face this issue even more often than at other times of the year.
This article will explore if people with diabetes can actually eat (and enjoy) candy, how much may be allowed, and whether sugar-free candy is worth considering.
Short answer: Yes, people with diabetes can eat candy.
Adults and children with diabetes (no matter the type) are just as entitled to a sweet treat occasionally as anyone else. Like everything else, details and context matter most, and moderation is key for anyone living with diabetes when it comes to food choices. High sugar foods and drinks can impact glucose levels more quickly and dramatically, so understanding how those influence your diabetes management is important.
People with diabetes must consider extra planning if they want to eat candy. They need to be cognizant about counting carbohydrates and dosing insulin correctly if they happen to use that hormone to help manage their condition.
It’s important to remember, too, that people with diabetes are typically watching the total carbohydrate count of food and drink, and not necessarily honing in on the sugar content.
While candy can make blood sugars rise more quickly, it’s that carb count that needs to be watched when consuming a piece of candy. The same applies to sugar-free candy, which also contains a certain amount of carbohydrates and that needs to be considered when factoring that food choice into your diabetes management.
Certain candies, such as those containing peanut butter or nuts, can take longer to impact blood sugars and won’t lead to as dramatic spikes immediately after eating them. However, other regular candies with sugar can cause quick spikes in blood sugar, and some medical professionals suggest eating a piece of candy closer to mealtime in order to “soften the blow” of a sudden spike in blood sugar.
Of course, you’ll still need to account for the calories and carbs contained within the candy.
While sugar-free candy certainly doesn’t get an award for being “healthy” per se, many people with diabetes (especially children) turn to it as an alternative to regular candy. The thought is that sugar-free candy may be healthier for blood sugar levels.
Sugar-free candy is made with artificial sweeteners, meaning that it can have a lighter impact on blood sugar levels.
However, a common misconception is that sugar-free candy does not impact blood sugar. It does, in fact, contain carbohydrates and calories. That means you still need to dose insulin or take glucose-lowering diabetes medications for those sugar-free candies.
If someone with non-insulin dependent diabetes is being mindful of their weight, eating sugar-free candy is not a free pass for sweets. These sugar-free options may sabotage weight loss efforts due to their high calorie content.
A non-diabetes-related benefit of sugar-free candy is that it’s kinder to teeth. Absent of the higher sugar contents, these sugar-free treats don’t lead to as much tooth decay or cavities often linked to frequent sugar consumption.
Additionally, there’s usually not a very big difference in terms of total fat or protein content in sugar-free versus regular candy.
The big issue with sugar-free candy comes down to sugar alcohols in those treats, which can have some negative effects depending on how much you eat.
Side effects included:
- nausea and upset stomach
- excess gas
The study participants who were given sugar experienced no such side effects.
Sugar alcohols are considered fermentable oligosaccharides, disaccharides, monosaccharides, and polyols, or a type of FODMAP. These are food molecules that some people cannot digest easily, especially when eaten in large quantities.
Sugar alcohols can also cause a laxative effect, especially if you’re prone to stomach issues.
While they contain fewer calories than sugar, they’re not calorie-free. Eating any treat in excess can inhibit weight loss or cause weight gain.
Eating sugar-free candy made with artificial sweeteners can also cause side effects, including interrupting the gut microbiome that is important to your health.
While it may not be the healthiest low snack, treating any low blood sugar with fast-acting sugar can be helpful.
Some candies that contain sugar are very fast-acting. However, some others (including those with chocolate or peanut butter) have higher fat content and are slower to digest and take longer to impact blood sugars, so they may not be appropriate to treat severe hypoglycemia quickly enough.
Another con of eating candy to treat low blood sugars is that it can react quickly and if you eat too much, it may cause higher blood sugars (rebound highs).
Make sure to consult your diabetes care team about any concerns or questions relating to candy and treating low blood sugars.
Yes, children and adults with diabetes can and do eat candy. The key is moderation and making sure to track the number of carbohydrates and calories eaten. Sugar-free candies can be better for blood sugar levels, but they still contain carbs and calories. The sugar-alcohols in these treats can also cause upset stomach, nausea, diarrhea, and excess gas.
Candy can be used to treat hypoglycemia, but it may not always be appropriate for urgent low blood sugars requiring glucagon or emergency medical assistance.
Read the full article here
Where Can I Go for Medical Care Without Insurance?
Finding affordable healthcare without insurance may seem daunting, but there are more options than you may think. Here are more than 18 resources that can provide assistance.
It’s no secret that accessing healthcare can be very expensive. If you don’t have insurance, those costs are even higher. In fact, 85% of uninsured people in the United States reported that paying for healthcare was difficult in 2022.
Fortunately, there are resources that can help you find and pay for medical care without insurance. You can find care at low or no cost with a variety of programs designed to help people without health insurance get the care they need.
Yes, you can get medical care if you don’t have health insurance.
In the United States, hospital emergency rooms are required to provide treatment regardless of insurance or ability to pay.
Additionally, there are many medical facilities that provide routine care to people who don’t have insurance. You will be asked to pay for any care you receive, but there are ways to find healthcare at a lower cost.
There are a variety of options for seeking care if you don’t have insurance. Many of these options are designed to be affordable. In some cases, you might be able to get certain healthcare services for free.
You can find low cost or free care in several locations:
Community health centers
Community health centers are nonprofit health clinics that offer low cost or free care. Often, fees are set on an income-based sliding scale, and staff will work with you to determine your costs.
The exact services offered by a community health center depend on the location but generally include:
- preventive healthcare
- basic healthcare
- family planning services
- chronic condition management
Some community health centers also offer prescription medications and dental care. You can search for community health centers near you by checking here.
State or county departments of health
Your state or county department of health might cover certain healthcare services for eligible residents. Often, this includes access to preventive care, such as vaccines or screenings.
You might need to register in advance and prove that you reside in the county or state to receive free care.
You can search for your local department of health here.
Urgent care and walk-in clinics
Urgent care centers and walk-in clinics offer care without an appointment. Often, these facilities offer reduced cost care for people who don’t have insurance. Some urgent care centers list costs for standard services on their websites.
You can also call ahead to talk with a representative about fees and possible cost reductions for people without insurance.
Pharmacy care clinics
Pharmacies, including the pharmacies inside major national chains such as Walmart, often provide preventive care services for free. These services are normally provided during health clinics held on specific days.
Services offered can vary but typically include:
You can check with your local pharmacy about any upcoming clinics, or search online for pharmacy clinics in your area.
If you have a teaching hospital in your area, you might be able to receive care at a reduced rate. The exact care you can access at a reduced rate depends on the hospital and the needs of the medical students.
You can call the teaching hospital and ask whether they offer any reduced cost care.
Employer-sponsored wellness programs
Some employers offer wellness programs to their employees. In many cases, this includes preventive healthcare, such as annual vaccines and healthcare screenings.
You can check in with your human resources department if you’re not sure what healthcare benefits are part of your employer’s wellness program.
The National Association of Free & Charitable Clinics
You can use the National Association of Free & Charitable Clinics website to search for health clinics and pharmacies in your area that offer free or low cost services.
The association is dedicated to caring for people who are uninsured or underinsured. There are more than 1,400 clinics and pharmacies in the association.
If you need assistance paying for care, you have a handful of options:
Some states offer charity care that reduces the cost of medical care for people who meet income requirements. If you qualify, you can receive low cost or free medical care.
In certain states, people are screened automatically. In other states, you will need to apply for the program.
Medicaid is a federal program that provides healthcare for people who meet income requirements. Each state oversees its own Medicaid program. Income limits and exact coverage vary by state.
You can find your state’s Medicaid website here.
Children’s Health Insurance Program (CHIP)
The Children’s Health Insurance Program (CHIP) is a federal program that provides healthcare for children. Just like Medicaid, qualifying for the program depends on income level. Each state sets its own income limits and coverage varies.
You can read about CHIP in your state here.
The Hill-Burton program
The Hill-Burton program provides funds to participating hospitals and healthcare facilities in exchange for offering a set amount of free or low cost care to people who meet income requirements.
You will need to apply for the Hill-Burton program with the admissions or business department of the healthcare facility. You can find a directory of Hill-Burton facilities here.
Aunt Bertha is a social and human services database you can search to find programs in your area. This includes programs that can help you pay for healthcare.
You can enter your ZIP code and a category to find programs that will meet your needs.
Keeping prescription costs low is a great way to lower your overall healthcare costs. Here are some options:
Prescription drug manufacturer programs
The makers of many prescription drugs offer programs to help people afford their medications. You can often join these programs to get your medication at low or no cost. You might need to meet certain income requirements to qualify.
You can use RXAssist to search a database of manufacturer programs.
GoodRx is a website that will show you the prices of your medication at stores in your local area. It can also show prices at online and mail-order pharmacies. By comparing pharmacies, you can find the lowest price.
Plus, GoodRx will even help you find coupons and manufacturer discounts.
Walmart, CVS, and other pharmacies have membership programs that can save you money. By signing up for these programs, you can get access to discounts on your medication. You can also earn discounts to use on other pharmacy purchases.
Grants for charitable organizations can cover your medical costs. Some examples include:
The PAN Foundation
The PAN Foundation helps uninsured people who have received a diagnosis of a life threatening, chronic, or rare disease pay for their medical care. You can see a list of conditions the foundation currently provides assistance for on its website.
If you have a condition listed on the site, you can instantly check your eligibility and can then apply online for a grant.
The HealthWell Foundation
The HealthWell Foundation helps uninsured people with certain medical conditions pay for their medical expenses. You can see their list of covered conditions on its website.
If you have a condition covered on the site, you can apply for a grant that will cover your medical expenses.
Good Days is an organization that can help people with chronic and acute conditions pay for their medical treatments. You can check out the list of covered conditions here.
Applications for assistance are available in both English and Spanish.
There are a few additional options you can explore to get access to lower cost or free healthcare. If you haven’t already, consider doing the following:
- Ask the hospital or doctor’s office about installment payment programs.
- Search for programs specific to a health condition you have.
- Apply for low cost health insurance on the Health Insurance Marketplace.
- If you’re a veteran, apply for VA benefits.
- Sign up for clinical trials in your area to help researchers study new treatments.
- Consider telehealth for conditions that don’t need in-person care.
You can learn more about accessing medical care without insurance by reading answers to common questions.
When can I enroll in Medicaid?
If you qualify for Medicaid, you can enroll at any time. Check out your state’s Medicaid website for income limits and other details.
What if I can’t pay an emergency room bill?
In an emergency, getting care is your No. 1 priority. But this can leave you with a bill that is outside of your budget, especially if you don’t have insurance.
However, medical bills are often negotiable. In many cases, you can call the hospital’s billing department to work out a plan.
If you’re unable to work out a plan with the hospital, there are nonprofit organizations that can help you apply for debt forgiveness.
Will healthcare professionals treat me if I don’t have insurance?
It’s illegal for healthcare professionals to refuse care in an emergency.
This isn’t the case for nonemergency care. Most healthcare professionals will list payments they accept on their websites.
If private pay is listed, you can get treatment without insurance. If it’s not, it’s best to call in advance to make sure the healthcare professional accepts patients who don’t have insurance.
You have options for receiving medical care even when you don’t have health insurance. There are several sources you can turn to for care, prescriptions, payment help, and more. Some programs are limited to certain states or certain health conditions.
Additionally, you will need to meet income requirements to qualify for some of these programs. If you don’t, options like telehealth and urgent care can help you cut costs.
You can also look into getting affordable insurance through the Health Insurance Marketplace.
Read the full article here
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