Saturday, November 9, 2013

7 Easy Substitutes to Get Your Kids Off Sugar

So what's the big deal if my kids are eating sugar? The big deal is that we are predisposing their bodies to suppressed immunity, chronic disease, childhood obesity and potential early diagnosis of Type II Diabetes simply by the kinds of foods/sugars we serve them or give them permission to eat. Individually we now consume as much as 4 pounds of sugar in one week than we would have in the entire year 1700. Sugar shows up in almost all processed foods and is many times masked as High Fructose Corn Syrup. When it's in nearly everything we eat, no wonder our children are born addicted...even infant formula contains sugar. This is a recipe for doom in regards to the health of our children, this next generation being the first who will not outlive their parents. The question now is, are you going to continue to educate yourself on healthier choices for the whole family or continue on the downward spiral toward ill health and costly medical expenses?

Getting our kids off their daily sugar intake may feel like a daunting task, yet I bet you are the one most concerned about this transition. In my experience, kids can experience lethargy, headaches, gut aches, constipation and dehydration due to their sugar intake. What is happening here is a blood sugar crash (lethargy/headaches), a bacterial imbalance (gut ache/constipation), and dehydration (hello soda, "power" and fruit drinks). The quick list of substitutes for sugar laden foods/products below to use for both yourself and your children will help you navigate new or forgotten about options.

These substitutes will just get you started and are based upon basic food habits of someone eating the SAD (Standard American Diet).

Instead of: Fruit Snacks

Try this: Real dried fruit, such as apricots, prunes, dates, and currants. These are all very sweet and can be purchased in bulk for packing into lunches or for individual snacks.

Instead of: Kettle Corn Microwave Popcorn

Try this: Air popped fresh popcorn with sea salt, real butter (NOT margarine) and 2 T. maple syrup.

Instead of: Soda

Try this: 100% real fruit juice (3/4 c) with mineral/seltzer water (1/4 c) for a refreshing homemade spritzer

Instead of: Pop-Tarts

Try this: Whole grain toast spread with cream cheese and 1 T of your favorite jam

Instead of: Chocolate Chips

Try this: Carob chips (use as you would chocolate chips), can be purchased at natural foods store, Whole Foods or a co-op.

Instead of: Cinnamon & sugar on white toast

Try this: Whole wheat toast spread with honey and sprinkled with cinnamon

Instead of: Sugared cereal for breakfast

Try this: Whole grain cheerios with a smoothie made with 1c. whole milk plain yogurt, 6-7 frozen strawberries, 1 banana, 翹 cup orange juice

Instead of: Cookies

Try this: Thinly sliced apples with thinly sliced cheese...a nice blend of sweet and salty.

Instead of: Handi-snacks (those cracker and block of fake cheese combo things)

Try this: a handful of whole grain crackers next to a handful of freshly sliced real cheese.

Caesarean Birth And Post Traumatic Stress

Have you recently found out that your baby will need to be born by caesarean? Did you labour for hours or days only to have a surgical birth in the end? Do you have concerns about the decision? Perhaps you are even angry or depressed? Do you feel as if somehow you failed as a mother and a woman?

A mild form of depression, called the baby blues effects as many as 70% to 80% of new mums. Usually beginning on the third or fourth day after the birth, the baby blues are a reaction to hormonal changes in the body following the birth.

Less common, but still effecting as many as 20% of new mothers is the more serious Post Natal Depression (PND). Unlike the baby blues, PND usually has a gradual onset over several days or weeks. For some women, PND can resolve itself in a few weeks, but for many others it requires months of professional assistance and perhaps even medications. The symptoms of PND are similar to depression. There are no studies which show that caesarean mothers are more likely to suffer from PND.

Birth trauma or Postpartum Post Traumatic Stress Disorder (PTSD) on the other hand does show a dramatic increase following a caesarean birth when compared with a vaginal delivery. One study (PTSD and cesareans, Childbirth Resource Network) reported as many as 28% of the mothers had PTSD following a caesarean birth. According to the Fourth Edition of the Diagnostic and Statistical Manual of Mental Disorders says:

"The essential feature of Posttraumatic Stress Disorder is the development of characteristic symptoms following exposure to an extreme traumatic stressor involving direct personal experience of an event that involves actual or threatened death or serious injury, or other threat to one's physical integrity; or witnessing an event that involves death, injury, or a threat to the physical integrity of another person; or learning about unexpected or violent death, serious harm, or threat of death or injury experienced by a family member or other close associate (Criterion A1). The person's response to the event must involve intense fear, helplessness, or horror (or in children, the response must involve disorganized or agitated behaviour) (Criterion A2). The characteristic symptoms resulting from the exposure to the extreme trauma include persistent reexperiencing of the traumatic event (Criterion B), persistent avoidance of stimuli associated with the trauma and numbing of general responsiveness (Criterion C), and persistent symptoms of increased arousal (Criterion D). The full symptom picture must be present for more than 1 month (Criterion E), and the disturbance must cause clinically significant distress or impairment in social, occupational, or other important areas of functioning (Criterion F).

In other words:

  • There must be a traumatic birth experience that involves intense fear, helplessness or horror.

  • There are flash backs or re-living the birth.

  • There may be avoidance of anything associated with the experience such as hospitals, doctors, the baby or pregnancy.

  • There may be anxiety or panic attacks following the event.

These symptoms must last for more than one month and result in an impairment of function to meet the definition of PTSD.

So what can you do if you are having or have had a caesarean birth to minimise the impact of PTSD?

As a mother who has had three caesarean births, the first of which resulted in PTSD that lasted almost five years, I believe that the most important thing you can do is to prepare for your birth and actively participate in the decision-making process. The defining characteristics are intense fear and helplessness. If you have prepared for the birth by reading about caesarean procedures, talking about them with your doctor and even taking special childbirth education classes that focus upon caesarean births and recovery, then you will minimise fear of the unknown by educating yourself. Likewise if you discuss your concerns with your doctor, research the issues and then compromise on the issues that concern you most then you will be an active participant in your birth and minimise the sense of helplessness.

My oldest son was born in 1986 via emergency caesarean after over nine hours of natural labour. I was hugely disappointed. I felt as if I had failed. And I was angry with my doctor, blaming him somehow. I was frustrated too because every time I tried to talk with someone about my feelings the answer was always...but you have a healthy baby, move on. Eventually I moved on emotionally or so I thought. I realized the truth though when over eighteen months later I found out that I was pregnant once again. All of my old fears and feelings re-surfaced. I sat and cried for hours; not because pregnancy was unplanned or the additional strain that another child would place upon our finances or troubled relationship, but because I would have to endure another caesarean. I began to look for alternatives and eventually found a midwife that would consider a homebirth. Our first pre-natal visit lasted almost three hours and was more about debriefing from the trauma of my first birth than my physical condition.

But even the successful VBAC homebirth of my 7 lb. 14 oz. daughter did not lessen my anger at what I thought was an unnecessary intervention. In fact, a casual comment by my midwife that my pelvis was more than adequate caused my anger to intensify. In a classic Post Traumatic Shock Disorder experience, that comment re-ignited all the feelings that I had experienced right after the surgery. I tried to channel my anger in a constructive manner. I became a crusader for natural birth; taking a lay midwifery course. I tried to find an attorney to sue my doctor, but the statute of limitations had expired.

In stark contrast is my second caesarean birth some fifteen years later. I had planned a midwife assisted hospital birth. I was confident that I would have no difficulty with another VBAC. I stayed home during early labour and went to the hospital only once labour was well established the contractions close together and so intense that I was having difficulty managing them. I was sure based upon my earlier labours that the baby's birth was imminent, but when checked I was only 2 cm dilated.

The baby was posterior and my intense back labour was not effectively dilating my cervix. I tried labour upright in the shower. I tried walking. I tried lying on my side. Nothing worked. The pain was more intense than any of my previous labours. I knew that if I choose to have an epidural I would significantly increase my chances of having another c-section, but the pain was so intense that I made the decision to have it anyway. Several hours and several interventions later, I did indeed have another caesarean. This time though rather than anger and resentment, I owned my decision. I was confident that I had done the best I could for me and my baby.

I believe that the two differing perspectives of my caesarean births illustrate the power of educating yourself about your options and actively participating in the decision-making process. After my first birth, I felt powerless and the result was anger, depression and PTSD that lasted five years. With my second caesarean, I had educated myself about labour and birth. I knew with each decision I made what the pro's and con's were and I made the decision with my midwives and doctors. The result was a birth that left me contented and fulfilled as a mother and woman with no regrets.

So if you are facing a caesarean, determine today that you will learn all you can about your condition, the baby's and the procedures involved. If you discover something that concerns you, discuss those concerns with your doctor. Bring research with you. And together make compromise that you can both agree with. Or perhaps change doctors.

But even if you have already had a caesarean birth, you can still apply these principles. Begin by talking openly and honestly with your doctor or hospital. Not in an accusatory way, but just tell him how you are feeling and ask for his side of the situation. Then do more research, realising that rarely is the old adage once a caesarean always a caesarean true anymore. You may be able through education and empowering yourself to have a different type of birth next time, whether that be a Vaginal Birth After Caesarean (VBAC) or a family-centred caesarean.

In either case, by educating ourselves we can reduce the fear of the unknown and by actively participating in decisions we can eliminate the sense of helplessness. Without the fear and helplessness, the catalysts for birth trauma or Postpartum Post Traumatic Stress Disorder are removed, thus minimising or eliminating your chances of developing this functionally impairing mental disorder.

Additional Relief For Your Social Security Disability Clients From an Employment Law Standpoint

Social Security disability attorneys or representatives are often not familiar with some of the civil rights laws and other remedies which may be available to their clients, beyond, or in lieu of, Social Security disability benefits, and which may result in additional or alternative sources of financial proceeds for their clients. Also, as Social Security disability claims have greatly increased due to the lagging economy, client advocates may encounter many persons who will not meet the stringent Social Security disability standards, but may be able to qualify for other relief. This article will explore some of these laws and remedies.

Due to the complexity of some of the remedies and the intricate interaction between them, which often require balancing and negotiation, it will be beneficial to client advocates to establish a relationship with one or more attorneys who practice in the areas of law noted below if they do not, in order to determine if other remedies may exist for their clients. As many of these additional remedies have stringent time deadlines, inquiries should be made as quickly as possible to other counsel as to whether a client has additional remedies and the viability of pursuing them. Indeed, failure of an attorney or a representative to consider these remedies may be the source of a professional liability issue depending on the outcome of a client's case.

An applicant for Social Security disability benefits frequently has a history, such as his medical conditions or work history, which has brought him to the position of applying for this type of benefit, which requires that he is deemed unable to perform substantial gainful work for a minimum of twelve (12) months or he has a condition that will result in death. That history often involves his employment situation and the nature of that situation can serve as the basis for additional remedies. Therefore, a thorough interview with a potential client should determine:

• Whether that person suffered an injury at the workplace;
• Whether his employer terminated him as a result of suffering the injury after the employer was informed that it was a work-related injury;
• Whether the injury, work-related or not, still permitted him to work for his employer with a reasonable accommodation by the employer. The courts' interpretation of "reasonable accommodation" is discussed below;
• Whether the employer refused to make the reasonable accommodation and instead laid off or terminated the employee;
• Whether the employee, who formerly did not have any or few performance problems, suddenly received discipline or write-ups after the injury;
• Whether the employer should have been aware that the employee was suffering from physical or mental problems, and instead of helping him manage those problems, terminated him, laid him off, or eliminated his position;
• Whether the employee had available to him short and/or long-term disability benefits, some type of retirement disability or union benefits for which he could apply.

Significant legislation has been enacted to protect employees who have been injured in and out of the workplace and who are suffering from an illness. The Americans with Disabilities Act of 1990 (hereinafter "ADA") was intended to "provide a clear and comprehensive national mandate for the elimination of discrimination against individuals with disabilities." 42 U.S.C.A. 禮12101 et seq. The Act applies to employers with 15 or more employees and prohibits discrimination against qualified individuals on the basis of a disability in regard to job application procedures, hiring, advancement, termination, compensation or job training. See 42 U.S.C. 禮12112(a).

In the years since the Act's passage into law, the U.S. Supreme Court has handed down specific opinions which have curtailed the reach of the ADA and have greatly limited the definition of a disability under the ADA. Large clusters of people, initially covered by the ADA, have been shut out from the intended far-reaching protections as a result of those court opinions. The result has put a heavy burden of proving a disability on the plaintiff, which was clearly against Congress' intent. See Sutton v. United Airlines, Inc., 527 U.S. 471 (1999) and its companion cases and in Toyota Motor Manufacturing, Kentucky, Inc. v. Williams, 534 U.S. 184 (2002). As a result of these Supreme Court cases, lower courts have found that individuals with a range of substantially limiting impairments are not people with disabilities.

In order to rectify this situation, Congress passed the Americans with Disabilities Act Amendments Act (hereinafter "ADAAA"), which became effective on January 1, 2009. The ADAAA greatly broadens the relevant definitions of the ADA and gives renewed hope to disabled individuals who are ready, willing and able to work with a reasonable accommodation. The Act's new language also enlarged the definition to include a larger array of individuals who are "regarded as" having a disability. Additionally, mitigating factors are no longer assessed in the evaluation of an individual as disabled.

If one has a client who lost his job due to a negative job action and who is covered by the newly expanded ADAAA, but had no recourse but to initiate a Social Security disability claim, either because his condition worsened or because he could not locate another job with his disabilities, he will be required to file a claim with a government agency at the local, state or federal level in order to protect his rights and preserve his right to bring later litigation, if necessary. That government agency may hold a fact-finding conference or a mediation, depending on the agency's practice, and while the matter is at the agency level it may be settled without resorting to litigation. Bear in mind that the ADA claim can proceed independently and concurrent to the Social Security disability claim.

Employers are required by the ADAAA to reasonably accommodate those employees known to have a disability to allow for the fulfillment of essential job functions. However, these employers will not be required to make accommodations which will cause an undue hardship. Under U.S.C. 禮12111(9), those reasonable accommodations include, but are not limited to, (1) making existing facilities used by employees readily accessible to and usable by individuals with disabilities, (2) job restructuring, (3) modification of equipment or devices, (4) appropriate adjustment or modifications of examinations, training materials or policies, and (5) the provision of qualified readers or interpreters.

It is the employee's responsibility to inform his employer that an accommodation is necessary in order for that employee to fulfill his essential job functions. It is also important to know that the new amendments make it clear that employees who are simply "regarded as" having a disability are not eligible for the aforementioned accommodations. Once the eligible employee requests an accommodation, an interactive process with the employer regarding the appropriate accommodations will begin. U.S.C. 禮12111(10) enumerates factors that would cause an undue hardship on the employer when accommodating an employee and are thus not mandated under the law. That list includes: (1) the nature and cost of the accommodation, (2) the overall financial resources of the facility or facilities, (3) the overall size of the business and (4) the type of operation.

It is also significant to note that simply because an employee's doctor sends a note to the employer limiting the employee's ability to work, requesting time off for the employee, requesting reduced hours, or asking that the employee be assigned to light duty, the employer is not necessarily governed by the doctor's request. Legions of employees have been terminated because an employer either did not feel the need to honor a doctor's request or seized upon the doctor's request to terminate an employee because, according to the doctor, the employee cannot do the job as required. An employee would be wise to seek legal help, if possible, in negotiating a disability accommodation from an employer.

It is not uncommon for employers to begin plotting for an employee's termination shortly after they are informed, formally or informally, of the employee's illness. Red herrings often used by employers to terminate or alternatively force an employee to resign include giving an employee a series of baseless poor performance evaluations, job restructuring rendering the affected employee's position nonessential, suddenly changing absence policies, or engaging in poor treatment of an employee which encourages his resignation.


The Rehabilitation Act Title V entitled "Nondiscrimination under Federal Grants and Programs" 29 U.S.C.A. 禮 720 et seq. protects those with disabilities from discrimination on the basis of those disabilities in programs organized by or receiving money from the federal government. The standards for determining employment discrimination under the Rehabilitation Act are the same as those used in Title I of the Americans with Disabilities Act described above.

The two primary laws that protect women during pregnancy are the Pregnancy Discrimination Act and the Family Medical Leave Act ("FMLA"). An amendment to Title VII of the Civil Rights Act of 1964, the Pregnancy Discrimination Act was established in 1978. The Act requires employers with 15 or more employees to treat employees with pregnancy-related conditions in the same manner required by law as those with other health conditions. For example, if an employee with a serious medical condition is permitted to take leave or work a modified schedule under FMLA, the pregnant woman will be afforded the same options. The Act also prevents an employer from firing or refusing to hire a woman based on her pregnancy or ability to take maternity leave. In that same light, an employee cannot lose credit accrued for seniority or retirement benefits during her leave. Lastly, an employer is required to keep the job open and maintain health care benefits as though the woman was on sick or disability leave.

Pregnant women also rely heavily on FMLA. As previously discussed, expecting and new mothers can take up to 12 weeks off within a 12 month period to care for the birth of their child. One key distinction between FMLA and the Pregnancy Discrimination Act is that FMLA only applies to employers of 50 employees or more. Moreover, the employee must have worked either one full year or 1250 hours to request FMLA leave.


The Age Discrimination in Employment Act of 1967 ("ADEA") protects those employees over the age of 40 from workplace discrimination based on age. 29 U.S.C. 禮 621 et seq. It applies to employers with 20 or more employees, state, local and federal governments, and employment agencies and labor organization. Under this Act, it is unlawful for employers to discriminate against employees or job applicants with respect to any term, condition, or privilege of employment, including hiring, firing, promotion, layoff, compensation, job assignments and training. As with the ADAAA, this Act also makes retaliation relating to the aforementioned unlawful.

Although an employee can be asked to waive their rights under the ADEA when signing a severance agreement, a clearly established protocol must be followed. The agreement must be (1) in writing and understandable; (2) specifically refer to ADEA rights; (3) not waive rights or claims that may arise in the future; (4) offer valuable consideration; (5) advise the employee in writing to consult with an attorney prior to execution of the waiver; (6) allow for 21 days in which the employee can consider the agreement; and (7) allow for 7 days within which the employee can revoke the agreement after signing it. Consider this protocol if a severance agreement concludes one's client's disability matter.


The Family Medical Leave Act, (P.L. 103-3, 107 Stat. 6) ("FMLA") was enacted on February 5, 2003 for the purpose of helping people who were stressed about trying to balance the competing demands of work and family life. The FMLA allows an employee to take up to 12 weeks of unpaid leave in a 12 month period for the birth or adoption of a child, to care for a family member, or to tend to his own serious health problems. The employee has three options from which to choose when deciding how to take time off. He can take the entire 12 weeks at once, take leave as needed following proper procedures, or he can simply work a reduced schedule. Note that FMLA time off may be combined with paid time off and employers generally have an option of requiring that employees use up their sick/vacation/personal time prior to using FMLA time. Employers have the burden of providing employees with information, notice and guidance about FMLA requirements.

It is important that any FMLA documents completed by the client and their doctors be reviewed by an attorney if possible. Moreover, an attorney or representative should ensure that the FMLA documents conform or are at least considered when applying for other types of disability. Often these documents will have different or contradicting onset dates, diagnoses, prognoses, or levels of severity of condition which will complicate the Social Security disability application procedure. The FMLA leave documents can be of assistance and provide documentary support in a Social Security disability claim.

The Department of Labor's Wage and Hour Division published a Final Rule under the FMLA in January 2008 which became effective on January 16, 2009, and an updated set of regulations by the Department of Labor were published. The FMLA benefits provided to military families (referred to as military caregiver leave and covered service-member leave) greatly expand the usual 12 weeks of FMLA leave up to 26 workweeks of leave in a single 12 month period to care for a covered service member with a serious illness or injury incurred in the line of duty on active duty. Also, the time spent performing light-duty work doesn't count against the 12 week FMLA leave. The regulations provide added guidance of what a "serious health condition" is.

Implementation of the ADA and the FMLA sometimes cause friction between an employer's right to know about an employee's condition and an employee's right to keep his medical conditions private. Relying on a medical treatment source for this information is not suggested, as doctors have been known to tell patients they are not required to reveal any information about their medical conditions, when that is not always the case, which can result in an employee's termination for refusal to divulge information an employer has a right to know.

Generally, the information that must be revealed by an employee or his medical treatment sources under the FMLA must be enough to permit the employer to know how to best accommodate an employee, or to provide the information on Department of Labor Form WH-380E, which is a certificate of health care provider for an employee's serious health condition. This information, requested from a doctor, includes, among other things, the beginning date of the condition, dates treated for the condition, probable duration of condition, medication prescribed, treatments, referrals made to other health care providers, and whether an employee can perform certain job functions.

Employees on FMLA must follow an employer's usual and customary procedures for reporting an absence, barring an usual circumstance. Further, an employer's direct supervisor cannot contact health care providers and cannot ask for additional information beyond that required on the certification form, as the Health Insurance Portability and Accountability Act ("HIPPA") is invoked to limit this information. There are also provisions for certification of ongoing conditions and fitness for duty certifications.


The Federal Employees Compensation Act ("FECA"), 5 U.S.C.A. 禮 8101 et seq., provides federal employees with compensation benefits for work-related injuries or illnesses. Administered by the Department of Labor's Office of Workers' Compensation Programs, all claims generally must be brought within three years of the date of injury. The federal employee will continue to receive compensation benefits as long as they remain totally or partially disabled. The federal employee will receive two-thirds or three-fourths of their salary at the time of the injury depending on whether the employee has dependents.

Another piece of federal legislation that attorneys who handle disability matters should be familiar with is Federal Employers' Liability Act ("FELA"). 45 U.S.C.A. 禮 51 et seq. This Act was initially meant to protect the rights of railway workers who were injured while at work in this country. Since its enactment, FELA has been greatly expanded. There is a three year statute of limitations from the date of the injury. Generally the statute begins running when the employee knew or should have known of the existence of the injury and that the FELA statute of limitations is triggered in an occupational injury case when the injured worker knew or should have known: 1) of the existence of the injury; and 2) that workplace exposure was a cause


Clients frequently are not aware that they are entitled to make a claim which entitles them to receive some form of some short and/or long-term disability payments as a general benefit of their employment, membership in a union or because they have opted to receive additional benefits paid for through payroll deductions. Employees may also have disability coverage they have purchased privately.

However, simply because this type of benefit exists does not mean that it is easily procured. Disability insurance carriers may be reluctant to approve clients for benefits, particularly long-term disability benefits, and if they are approved, carriers often attempt to terminate the employee prematurely. Employees are sometimes lulled into thinking that because they have received short-term disability benefits easily that receiving long-term disability benefits will also be an easy process. Moreover, if an employee is receiving long-term disability benefits, this normally indicates that the injury is not work-related, because a worker's compensation claim would ensue instead.

Insurance disability carriers tend to have little respect for the fact that a claimant has been awarded Social Security disability benefits prior to or even after an ALJ's decision, and this type of award does not have significant impact on a carrier's decision to award long-term disability benefits. However, a detailed decision by an ALJ judge, the Appeal's Council or a court, will usually be helpful in a long-term disability claim. In the event that a client suffers from physical and mental impairments, because many policies limit the number of years of benefits for mental impairments, carriers may seize on a decision and allege that the mental impairments take priority over the physical impairments, so one should use care in emphasizing the nature of the disability claimed.

Most insurance carriers require that a successful applicant for long-term disability benefits apply for Social Security disability benefits, and if that claim is successful, those benefits will be offset against any amount paid to the applicant under long-term disability coverage, after the deduction of any attorney's fees. If that claim is not successful, it should not impact on private disability insurance benefits.

There are several levels of administrative appeal in the long-term disability denial process and insurance carriers frequently extend the administrative process as long as possible, hoping to wear out the applicant. It is important that each stage of the administrative process be followed, and that any and all medical evidence is submitted to the insurance carrier during the administrative process. This is because there is case law which states that evidence submitted after the administrative process cannot be introduced if a denial is later litigated under The Employee Retirement Income Security Act of 1974 ("ERISA"), found in the U.S. Code beginning at 29 U.S.C. 禮1001.

ERISA is a federal law which mandates minimum standards for most voluntarily established pension and health plans in private industry. The result is additional protection for individuals with covered plans. Long-term disability appeals are included in the health care plans covered by ERISA. Being familiar with ERISA is particularly important when dealing with denials of long-term disability benefits in that this federal law preempts the vast majority of state and local laws pertaining to similar subject matter.

ERISA dictates an administrative process which must be fulfilled in its entirety before the employee obtains the right to sue. The administrative processes differ from policy to policy but the common thread running through every policy is that stringent timelines must be followed in order to safeguard the claim. ERISA also provides for an internal appeal process. Once this process is complete, a lawsuit can be brought.


Although there may be risks if a claimant applies for both unemployment insurance ("UI") benefits and Social Security disability benefits contemporaneously, for those who don't have a financial choice, one is not precluded from filing for both benefits contemporaneously. In order to receive UI benefits, one must assert that he is ready, willing and able to work but cannot find employment. Conversely, to file for Social Security disability benefits one must show that his medical condition prevents him from working in his previous position or any other field and he is not currently seeking employment.

Although there appears to be an inherent conflict in these positions, in Cleveland v. Policy Management Systems Corp, 526 U.S. 795 (1999) the U.S. Supreme Court held that: (1) claims for Social Security Disability Insurance (SSDI) benefits and for ADA damages did not inherently conflict, and (2) an employee was entitled to an opportunity to explain any discrepancy between her statement in pursuing SSDI benefits that she was totally disabled and her ADA claim that she could perform essential functions of her job. A similar analysis can be applied to the receipt of UI benefits where one alleges an ability to do some type of work.

Administrative law judges may not look favorably upon Social Security disability claims where the employee is receiving UI benefits, but they should consider a claimant's application for and/or receipt of UI benefits as only one of the statutory factors adversely impacting the claimant's credibility in assessing the ability to work, and it should be considered as part of the five step sequential evaluation process and the totality of circumstances.

Holding oneself out as being able to work is not the same as being able to work and perform substantial gainful activity. Also, a mere desire to work is not proof of the ability to work, because many employers will not hire someone with a myriad of medical problems, despite that person being willing to make a work attempt.

A November 15, 2006 Memorandum from Chief Judge Frank A. Cristaudo to Regional Chief Judges and Regional Office Management Teams, states that "[t]his is a reminder that the receipt of unemployment insurance benefits does not preclude the receipt of Social Security disability benefits. The receipt of unemployment benefits is only one of many factors that must be considered in determining whether the claimant is disabled. See 20 CFR 404.1512(b) and 416.912(b)." The Memorandum states that Social Security Ruling 00-1c incorporates Cleveland. A long line of Appeal's Council and ALJ Decisions prior to Cleveland support this analysis, which requires consideration of all of the evidence and the totality of circumstances, making the ability to receive both types of benefits possible.

Some advocates delay the date of onset of the condition in a Social Security disability claim paving the way for a client to receive UI benefits for a period of time. However, the Social Security disability process can be quite lengthy, and may not always be successful for claimants, so it may be desirable for them to have a stream of income pending the Social Security disability process. UI benefits are not offset by Social Security disability and therefore can serve as additional funds for claimants during the Social Security disability application process.


Since 1891, Pennsylvania common law held that in the absence of a specific statutory or contractual restriction, an at-will employment relationship could be terminated by either the employer or the employee at any time, for a good reason, a bad reason or no reason at all. Henry v. Pittsburgh & Lake Erie Railroad Co., 139 Pa. 289, 21 A. 157 (1891). It was not until almost 100 years later that this holding was reevaluated in Geary v. United States Steel Corporation, 456 Pa. 171, 319 A.2d 174 (1974). In Geary, an employee was terminated for warning his fellow coworkers of the valid dangers posed by the new product the company was manufacturing. Interpreting Geary, Yaindl v. Ingersoll-Rand Co. held "when the discharge of an employee at will threaten public policy, the employee may have a cause of action against the employer for wrongful discharge." 281 Pa.Super. 560, 422 A.2d 611, 617 (1980).
Some states may have statutory or common law making it a violation to terminate an employee who has been injured during the course of employment. In Pennsylvania, for example, the courts have established a narrow exception to the standard employment at will doctrine which permits employers to terminate their employees for minimal reasons, stating that it is a violation of public policy to terminate an employee who initiates a claim of worker's compensation. Rothrock v. Rothrock Motor Sales, Inc., 810 A.2d 114 (Pa.Super. 2002). However, this is often a difficult standard to meet and employers often ignore this exception, taking the risk that an injured employee will not have the substantial resources necessary to sue the employer for violation of the policy.

In September 2009, a record setting consent degree was entered into between Sears, Roebuck and Co. and former employees who were allegedly discriminated against when Sears maintained an inflexible workers' compensation leave exhaustion policy and terminated employees rather than providing them with reasonable accommodations for their disabilities in violation of the ADA. The case was docketed as EEOC v. Sears Roebuck & Co., N.D. Ill. No. 04 C 7282. The Chicago based U.S. Equal Employment Opportunity Commission declared that the class action lawsuit it had initiated would be settled for $6.2 million with additional remedial relief. Many attorneys in the workers compensation field believe that this settlement will lead to important changes in how companies structure their leave policies.

However, the Pennsylvania public policy exception to the employment at-will doctrine will not apply where a statutory remedy is available. For example, an employee who was terminated based on race, color, religion, national origin, or sex is entitled to file under Title VII and similar state statutes, although he may be permitted to raise the exception as an ancillary state claim.


Another helpful tactic which should be considered if Social Security disability standards cannot be met but an employee must leave his position because he can't perform his job duties due to some disability and/or his employer can't reasonably accommodate his disability, is negotiating a severance agreement to include additional funds for a client and/or lengthen his entitlement to health insurance benefits. The agreement will be enforceable so long as the scope is reasonable, no laws are violated, consideration is present and the agreement is knowingly and voluntarily entered into.

Employers are oftentimes willing to enter into a severance agreement to avoid the lengthy discrimination agency or litigation process. It may be far more cost effective for an employer to give these concessions early in the negotiation process. It is important to exhaust all other remedies discussed earlier if a severance agreement is to be signed because standard severance agreements terminate the employee's right to sue the employer for any actions that took place during a certain time frame, with the possible exception of worker's compensation claims, depending on state law.


It is not unusual to have a client suffering from a job-related injury or illness who would have been able to continue to work given a reasonable accommodation under the ADAAA or following a FMLA leave. Instead, many employers terminate, lay off, or force these employees to resign in violation of the law and the public policy exception to the employee-at-will doctrine and the aforementioned statutes, depending on state law. That client, in addition to the receipt of Social Security disability benefits, could potentially receive worker's compensation benefits, short and/or long term disability benefits, retirement disability and/or a settlement from an employer due to alleged violations of one of the civil rights acts or policies. Note that there may be financial offsets from receipt of more than one of these types of benefits. Also, a negotiated severance agreement or settlement may include severance pay, extension of insurance benefits and attorney's fees and costs for a client.

In conclusion, there is no doubt, as outlined by the various remedies above, that the disability field of law is often confusing as it requires interaction with various laws and policies which often have not only varying, but conflicting, burdens of proof. However, a practitioner who is at a minimum familiar with other possible remedies can be of great help to his client. Also, this help may result in additional sources of income to the client and to the practitioner who undertakes these additional claims or refers them to other attorneys and is able to collect referral fees depending on state guidelines.

Make Your Pregnancy A Great Time By Following These Great Tips

Most people will have some questions about what to expect during pregnancy. Many of the questions and worries concern the health and safe arrival of the new baby. However, information is power in a time like this and through these tips, you can gather a wealth of information that will give you the power to take proper care of yourself, your child and your future as a family.

While pregnant, your body should be supported, while you sleep. There are pillows available that are made to cradle the pregnant belly for comfort and support when sleeping. If you do not have one, you can use a regular pillow for support. Sleeping with a soft pillow between your knees and another under your stomach is usually the most preferred way to sleep while pregnant.

Be sure to get your name on the list right away for prenatal classes, since these groups tend to fill up quickly. Once you know you are pregnant, get signed up. Your doctor and your hospital are great resources for finding information about classes that are available to you. If a tour of your birthing hospital isn't included, book one separately.

It is important that a pregnant woman stays away from stress, as much as she can. Not only can stress cause a variety of different problems in a woman, but it can also cause the baby to become stressed. Studies clearly show that stress can contribute to pre-term labor and birth.

Your doctor should be alerted to any symptoms you are experiencing, including exceptionally swollen feet. While this may just be a normal side effect of pregnancy, it's a possible symptom of preeclampsia, a condition that causes high blood pressure in pregnant women. In order to have a healthy, normal birth, you should have this condition treated immediately.

Use a doula to assist you during your delivery. "Doula" is the name given a support specialist who helps a mother through her pregnancy. She may help the mother as she creates a birthing plan, work with her to facilitate a natural birth, or simply offer emotional support.

When you become pregnant and go see the OBGYN, you will be given a prenatal vitamin. Take your vitamin at the same time each day, usual with a meal to prevent nausea. The prenatal vitamin supplements your diet with a variety of vitamins and minerals that are essential for the healthy development of your baby.

Protein is extremely important during pregnancy. This is essential to having your baby grow healthy, and it's good for you too. To keep this protein in your diet eat foods like sunflower seeds, peanuts, beans, eggs, chicken, tofu and even hamburger meat.

Pregnant women are advised to wear sports bras. They offer the breasts extra support and may relieve some of the pregnancy aches and pains. On addition, you will want to wear looser undergarments in the stomach and waist areas. This could keep the blood from circulating and bringing oxygen to the baby.

It is a wise idea to be tested for any potential sexually transmitted diseases when you are pregnant. STD's can be detrimental to the health of you and your unborn baby if they are left untreated. Most tests for STDs are done with a blood, urine or pap smear sample. If you do have a sexually transmitted disease, you may need to have a C-section to protect your child.

You must notify your doctor if you notice extensive vaginal discharge during pregnancy. You could have a vaginal infection, which is common during pregnancy. However, if it isn't treated, it can become a serious problem.

When you are pregnant, you must avoid all alcohol. When a woman drinks during her pregnancy, the alcohol will pass through her placenta directly to her unborn fetus. Therefore, when pregnant or when trying to get pregnant, it is advisable you refrain from alcohol. Drinking while pregnant can cause physical or mental problems to the developing baby and also increases the risk of miscarriage or premature birth.

You should begin to massage your stomach near the end of the second trimester. You can use your bed or the couch as a massage table; use whichever one feels more comfortable. Support your back with a couple of pillows. Instead of lotion, apply oil onto your belly, and massage lightly. Breathe deeply to the sounds of some soothing music as you gently massage. Doing these things maintains your calm and soothes your baby.

Take some time out for yourself. Once your baby arrives you entire focus will be on caring for him or her, and any time to pamper yourself will be very limited. You should take care of yourself by doing things you enjoy. Whether you'd prefer to do solitary activities, like engaging in a favorite hobby or do things with friends, participate in your favorite activities as much as possible while you still can. It will help you feel better, and the baby will too.

If you are pregnant and you get an illness or eat a food that causes diarrhea, be sure that you drink plenty of fluids. While diarrhea can lead to dehydration, this is especially dangerous for women who are pregnant and may require hospitalization.

Reduce the amount of caffeine your drink during pregnancy. Caffeine can cause many problems during pregnancy. For the best health during your pregnancy for you and your baby, avoid caffeinated drinks and foods.

Women in the third trimester of pregnancy should always sleep on their left side. By sleeping on the left side the fetus gets the greatest blood supply, and you also get a good blood flow to the kidneys and uterus. Do not sleep your back, as it's not a good way to get blood flowing.

Many moms-to-be aren't fully sure of the best way to take care of themselves during pregnancy. As society gains more knowledge on the subject, what's best practice tends to change. However, if you bring to bear the sensible advice in this article, you will have made a major contribution to your health, your baby's health, and the enjoyment of your pregnancy.

Importance of Using Compression Stockings and Other Foot Care Products

The present working conditions include long working hours which is one of the main causes of stress and other issues. Most of us sit for long hours which create several feet problems due to lack of leg movements and blood circulation. It is recommended to exercise on a daily basis but not all of us have enough time for exercising. This is one of the main reasons why foot care products are introduced these days.

Here are some details about few foot care products:

Compression stockings and support hosiery

Compression stockings and compression support hosiery are known to be one of the best remedies for foot problems. They help in regulating blood circulation in the lower part of the body. Nowadays, you will find that these stockings are available in different styles, colours and shapes. Thus, you can buy the one which suits your needs.

Compression stockings and compression support hosiery are designed in such a way that they apply appropriate pressure on the legs. This pressure helps the blood to circulate in your legs properly.

Diabetic socks for men and women

Nowadays, many people suffer from diabetes. And one of the common problems faced by diabetic patients is diabetic foot. To solve these conditions,diabetic socks have been introduced in the market. These socks are designed in such a way that they control the moisture in the foot area which decreases the risk of infection in the feet.

Maternity support hose

Wearing a maternity support hose is necessary to take care of your body during pregnancy. A maternity support hose helps in resolving blood circulation problems in your legs. In addition to this, it helps in reducing swellings and also prevents several future varicose veins.

Thus, the above mentioned foot products help in keeping you fit in several situations.

You Can Still Look Sexy While Pregnant!

Big, Bold, and Beautiful: How to Look Hot During Pregnancy

If you think "looking hot during pregnancy" is slightly oxymoronic--save those insufferable summer months when you can't seem to cool down for the life of you--you're not alone.

Many a pregnant woman has felt awkward, unattractive, and, well, large. However, simply by learning a few tricks, and with just a little effort, you can look and feel like that hot mama-to-be that you are.

Looking hot during pregnancy starts with learning to take care of yourself. Although some women treat it as such, pregnancy should not be a license to "let yourself go," eat whatever you want, and stop caring what you look like. "But I'm taking my prenatal vitamins and avoiding my daily shot of vodka," you may protest. And while that's all well and good, there is so much more involved with self-care during pregnancy.

A few tips in this department include drinking lots of water, eating healthy as much as possible (with the odd treat here and there, of course), exercising moderately (walking, swimming, prenatal yoga), and maintaining your hair and makeup regimen. As your skin stretches during pregnancy, take good care of it with a good prenatal moisturizing lotion like cocoa butter.

Next, in order to claim that "big, bold, and beautiful" label as yours, you need to take advantage of what the pregnancy hormone gods have given you. Your fingernails will likely grow faster around month four--splurge on a manicure! You will also be the proud owner of a full and fabulous head of hair (since pregnancy hormones slow down hair loss), so work this to your advantage. And don't forget that wonderful, where-did-you-come-from cleavage that you now have to show off.

Finally, you must learn to dress the part. Stop dreading that inevitable maternity clothes shopping trip. By knowing what to look for--and, of course, what to avoid--you'll be on your way to looking pregnant and sexy. First, look at your assets, and what you (or your man) find most attractive--breasts? Belly? Arms? Legs? Back?--and find cute and trendy apparel that flaunts them accordingly.

It's best to avoid buying plus-size clothing. They won't fit or look right. Wear your regular clothes as long as possible and then head straight to the maternity department. If everything looks plain, out-of-style, frumpy, or huge, consider shopping online, where you'll find a ton of hot, attractive, and sexy clothes for the mom-to-be.

Should Pregnant Women Undergo Chiropractic Care?

This is an important question that all pregnant women should know the answer to. During pregnancy, a woman's body undergoes many physiological and endocrinological changes as the baby inside the womb begins to grow and develop. Due to these changes, the pregnant mother experiences various forms of misalignments in her joints and/or spine, that could result in one or a combination of, the following:

- A growing, prominent curve of the back
- Enlargement of the abdomen
- Pelvic changes
- Postural changes

These changes in the pregnant woman's body could result in them experiencing difficulty attaining proper balance and alignment. Hence, chiropractic care helps correct these conditions and enables the development for better posture that puts less stress on the pregnant body. Importantly, the misalignment of a pregnant woman's pelvis could limit the baby's development inside the womb.

Is Chiropractic Care During Pregnancy Safe?

All licensed chiropractors are trained about using chiropractic procedures on pregnant women. There are chiropractic professionals who specialize in treatments for prenatal and postnatal care individually. Hence, these professionals are trained and are required to direct their specialization to ensure the safety of both baby and mother.

Chiropractors who treat pregnant women must adjust the intensity of their treatment procedures depending on the condition and in what stage of their gestation period the woman is in. Many times, chiropractors will recommend a regimen of stretching and exercise in order to ensure optimum health for the pregnant woman.

Chiropractic Benefits for The Pregnant Woman

Before women undergo labor, it is highly recommended that she undergo chiropractic care as it assists in many ways throughout her pregnancy and delivery.

It assists in the following:

- It helps to achieve a healthier pregnancy.

- It enables the patient to achieve good control over their symptoms and/or conditions associated with pregnancy.

- It enables the patient to have an expeditious and effective delivery.

- It enables relief from pain on the neck, back, or joints which get tremendous strain during pregnancy.

- It enables women to avoid the possibility of undergoing cesarean section.

Chiropractic Effects During Labor

In addition to the benefits for prenatal conditions mentioned above, chiropractic care offers great benefits during the actual labor and delivery of the baby, especially in terms of pain management. A more successful delivery is possible upon receiving chiropractic care.

Duration of Labor

When the human body undergoes extremely stressful situations, such as in the delivery of a baby, the balance level and adaptability of the pregnant body is crucial. Most women who have to undergo Cesarean section during delivery are due to the body's inability to cope with the normal stress of delivery. Most of the time, when a woman is not strong enough to deliver a baby normally, it is the result of a misalignment of the pelvis. This slows down the descent of the fetus towards the birth canal. A limited range of motion is also a culprit that affects a woman's ability to labor efficiently. Hence, getting chiropractic adjustments during pregnancy enables a woman to address the above problems and significantly reduce her time in labor.

The Fetal Position

Another component that impacts labor time is the positioning of the fetus. Chiropractic treatments will help to adjust and place the fetus for proper movement through the birth canal. Many health experts also believe that chiropractic treatments help avoid the acquisition of any form of back conditions.

Friday, November 8, 2013

Pregnancy And Depression - How To Guard Mothers Against Depression During Pregnancy

Pregnancy and depression are closely linked to one another. Depression during pregnancy is difficult to avoid due to various hormonal and other changes taking place in a woman's body. Depression can be dangerous to the health of both the fetus and the mother. Pregnancy marks a time when women tend to undergo extreme highs and lows of emotion. The emotions of pregnant women tend to be highly varying, moving from the feelings of extreme elation to that of depression. Keeping the negative effects of the depression during pregnancy in mind, medical professionals alert expecting mothers from being gripped by depression.

What Causes Depression During Pregnancy?

The medical experts have been closely studying the relation between pregnancy and depression and how to keep pregnant women at safe distance from worries, anxieties, negative feelings etc. Becoming pregnant gives rise to a variety of feelings, but there are also those hormonal changes, which are inevitable during pregnancy. These hormonal changes result in drastic mood swings from happiness to the extreme grief to anger. Medications and several birth control pills taken prior to pregnancy interfere with ovulation and tend to generate bio-chemic alterations in a women's body, thereby contributing to increased levels of depression during pregnancy. Most women find strive to find ways in which depression can be eradicated during pregnancy.

Depression in pregnancy results from the hormonal secretion in the mother's body which is required to support the development of baby. There are several external factors which lead pregnant women to feel depressed. other These factors can be the levels of stress arising from health matters, finances required to support the pregnancy treatment and the baby after delivery, other kids, relationship with the spouse and other family members, previous experience of infertility etc. The symptoms of depression during pregnancy is marked by an frequently feeling low, helpless, neglected and insecure about how her loved ones feel about her. Women tend to be tearful, short tempered and feel irritated. Expecting mothers are found to travel between highs and lows of moods and their energy levels are directed in response to the changes in mood. Women in pregnancy and depression can also feel extremely restless and feel like hurting their babies, even themselves. Risks of suicides also happen to increase among women during this phase.

Medications Helpful To Reduce Depression During Pregnancy

There are several drugs are available to reduce the chances of being caught by depression during pregnancy. There are anti-depressant drugs such as Valium, Xanax, Prozac, and similar drugs of the Selective Serotonin Reuptake Inhibitors (SSRI) family of drugs that can be taken before pregnancy to avoid depression. These medications are known to influence the neurotransmitters of the brain and change some particular signals.

These drugs have been shown to lead patient's brain to function in different manner to oppose depression and affect mood changes. There are negative side effects of these drugs that are perceived through adverse effect on the growth of fetus in terms of breathing problems, malformation of cardiac organs and many more. Therefore, look for natural remedies through proper nutrition and meditation, and take adequate rests to weaken the connection between your pregnancy and depression.

Ladies, Top 3 Signs That Your Hormones Are Out of Whack!

As women, it is important for us to be in touch with our own bodies. The way we feel and the way our body reacts to things and situations actually reveal something about the state of our hormones. Hormonal imbalance is the cause of many women's health problems. Being able to spot the changes in our body, therefore, is of the utmost importance so that we can seek the necessary treatment or medical help.

Hence, these are the top 3 signs that indicate something is wrong with your hormone system:

You're Always Under the Weather

Depression is one of the most common symptoms of a woman's hormone imbalance. If you are always feeling tired and lethargic even after getting the required hours of sleep, or feeling particularly anxious or down for no particular reason, you may be suffering from depression.

Sleep Does Not Come Easy

A sudden onslaught of insomnia is a sure sign that something is wrong with your hormone system. If you have never had problems with sleeping and then all of sudden you are staying awake till the wee hours of the morning, it's time to seek your doctor's advice.

You're Losing Hair

Combing your hair and noticing strands and strands stuck between the teeth of the comb, or clumps that have fallen onto the floor is not a good sign. The two female hormones, i.e. estrogen and progesterone may be out of sync with each other, thereby causing this hair loss condition.

Ignorance is bliss, but it's going to cause you a lot of unnecessary discomfort and anxiety if you do not recognize these top three symptoms of hormone imbalance and find the appropriate help and treatment for the problem.

There are actually many more signs and symptoms that indicate this pervasive health problem in women. And thanks to the efforts of women's health care professionals, these type of information have been compiled and made easily accessible to every discerning woman.

So, in conclusion, these three signs indicating a possible hormone imbalance should be what all women ought to be on the lookout for: depression; sleeping difficulty; and hair loss.

Depression During Pregnancy - Mood Swings

Depression during pregnancy refers to the stress or strain which is caused due to the increase of hormone level in a woman's body resulting in mood swings , in particular the two main female hormones-estrogen and progesterone causemood swings during pregnancy. This is not a disease but a normal problem which can be treated through extra love, care and protection.

Is depression more common in women than in men?
Yes. Women are twice as likely as men to experience depression. The reason for this is unknown, but changes in a woman's hormone levels may be related to depression.

What are the symptoms of depression in women during pregnancy ?

If you're depressed, you may have some of these symptoms nearly every day, all day, for 2 weeks or longer:
- Feeling sad, hopeless and having frequent crying spells
- Feeling guilty, helpless or worthless
- Thinking about death or suicide
- Sleeping too much, or having problems sleeping
- Loss of appetite and unintended weight loss or gain
- Feeling very tired all the time
- Having trouble paying attention and making decisions
- Having aches and pains that don't get better with treatment
- Feeling restless, irritated and easily annoyed
What causes depression in women during pregnancy ?
Depression seems to be related to a chemical imbalance in the brain that makes it hard for the cells to communicate with one another for example the improper level of serotonin in the brain can cause mood swings. Depression can also be hereditary, which means it runs in families.

In the days following the birth of a baby, it is common for some mothers to have mood swings. They may feel a little depressed, have a hard time concentrating, lose their appetite or find that they can't sleep well even when the baby is asleep.

How is depression during pregnancy is treated?
Depression can be treated with counseling, medicine or both. It's also important to take good care of yourself, to exercise regularly and to eat healthy foods. See the health tips below. Counseling alone may help if the depression isn't severe.

Some do's and don'ts when you're depressed
- Always ensure to talk with your loved ones, friends and family to avoid the feeling of isolation. Always seek the advice from your family doctor.
- Exercise balances the hormone and avoid mood swings. Example the level of serotonin in the brain can cause mood swings and can be balanced by doing yoga, aerobics etc.,
- Remember not to blame yourself for your depression. You didn't cause it.
- Suppress the discouraged feeling by keeping positive sign boards and try to do meditation to clear your depression.
- Do eat balanced meals and healthy food.
- Do get enough sleep. Some women sleep more during depression.
- Do take your medicine and/or go to counseling as often as your doctor tells you to. Avoid self medication.

Does depression affect my unborn baby?

Yes. It has been proved by many research that depression can affect the growth of the fetus. Mothers-to-be who are depressed during pregnancy are more likely to have babies sleep problem during their 18th month says O'Connor a research expert.

In his recent research, O'Connor says, follow others' research showing that mothers who report being stressed during pregnancy have children with higher rates of behavioral problems, as well as hyperactivity and anxiety.

How To Prepare Your Body For Pregnancy - A Mother's Guide

In getting pregnant, you just don't think about which sex positions will help you conceive effectively and successfully. More than body positions, you also need to pay attention to the physical condition of your body. You need to know how to prepare it in order to become pregnant.

First, you need to be attentive with what you eat. What you need are foods that can increase levels of fertility. Nutritious and balanced meals will not only be good in slimming down your waistline. These meals will also influence your menstrual cycle, ovulation and eggs. Foods that can help enhance fertility are unsaturated fats like olive oil, avocados and nuts. Eating such foods can help prepare the body for an imminent pregnancy.

Pay attention to your health problems that might be an obstacle or issue in pregnancy. Thyroid diseases, diabetes, ovarian syndrome, etc. can greatly affect the chances of conceiving. Natural treatments for these conditions must be considered. You should discuss with your doctor how the prescribed medications will affect your chances of getting pregnant healthily. Diseases that are sexually transmitted may also hinder pregnancy chances. STDs can make the fallopian tube blocked due to probable scarring.

You must also be able to lessen the amount of stress your body experiences. Stress can greatly interfere with the brain, which also controls and directs the ovaries to produce eggs on a monthly basis. Chronic stress can affect the menstruation cycle, ovulation phases and the egg hatching. There are lots of techniques that will help you reduce stress and increase your fertility levels.

Avoid unhealthy habits like smoking. Smoking per se does not only affect the mother and her baby during pregnancy. This cigarette habit can also have an immense impact prior to pregnancy. The blood vessels, including those leading to the ovaries, become constricted. This then results to quick loss of eggs. Early infertility can be caused by smoking.

Take folate or folic acid to prepare you for pregnancy. Folate can be difficult to obtain from your diet alone so taking folate supplements will be necessary. Taking folic acid will also help prevent defects in the neural tube such as Spina Bifda that is known to be among the common birth defects. Folate must be taken three months before conception. About 400ug of folate is recommended until the 12th week of being pregnant. Folate can be obtained from foods such as broccoli, spinach, asparagus, berries, beef and bran flakes.

Staying fit is also another great preparation for getting pregnant. Exercising will do much in improving fertility, but only if done appropriately. The body needs to be healthy in order to be prepared for conception. Exercise will promote proper blood circulation to all parts of the body, including your reproductive system. Exercise can also help reduce stress from every day events. It will help you to achieve better sleep, giving your body sufficient time to recover and recharge. Nevertheless, exercising more than how much you should can also degrade fertility. Running over 20 miles within a week can cause irregular menstrual cycles. If your present fitness workout is interfering with your menstruation, you need to lessen it and promote regular menstruation and higher level of fertility.

Vitamins To Get Pregnant - How The Sun Can Help You Get Pregnant

Vitamins to take when trying to get pregnant are important. Are there any vitamins to help one increase the probability of fertility and get pregnant? The American Pregnancy Association suggest that those who are trying to get pregnant should, at least three months prior, change the diet and also boost their vitamins consumption to ensure their bodies are as healthy as possible which in turn might have a positive affect on infertility.

Despite of the pros and cons reports of the dangers of skin upon over exposure to the sun causing skin cancer have made many people wary of spending too much time in the sun. However, it is the fact of the matter that human beings need the sun's rays for health and wellness and, believe it or not, play a part in lowering cholesterol levels and blood pressure.

It is important therefore that we shouldn't all get a sun phobia as the sun does plays a vital part in both our physical and mental welfare and a certain amount of time spent in the sun will do us a lot more good than harm.

Naturally, when the skin is exposed to ample sunlight, stimulated by UV radiation, the body makes vitamin D3, the biologically active form of vitamin D. 90 per cent of vitamin D in the body is produced by the skin.

However, the use of sunscreen blocks the ultraviolet radiation necessary needed to manufacture Vitamin D.

How much sunlight one's need? Well, by no means are you advised to sunbathe to the point of burning. It is best to sunbathe in the morning because there is much more beneficial ultraviolet rays in the morning, and by the time day hits, avoid the exposure of the sun as it has changed to be primarily infrared rays which is very hot and fierce to the skin.

If you're fair skinned, experts say going outside for 10-15 minutes in the midday sun-in shorts and a tank top with no sunscreen-will give you enough radiation to produce about 10,000 international units of the vitamin D. While Dark-skinned individuals may need up to three times as much as the skin has less ability to absorb UV-B rays.

"Enjoying the sun safely while taking care not to burn should help people strike a balance between making enough vitamin D and avoiding a higher risk of skin cancer," said Jessica Harris of Cancer Research UK.

Up until recently, the role of Vitamin D was primarily recognized for building strong bones and teeth. Scientists have also discovered the importance of Vitamin D to every organ and cell in the body - not just for bones and teeth. Scientists are beginning to link Vitamin D deficiencies with many health conditions, including depression, heart disease, insomnia, an overactive immune system, cancer of the pancreas, colon, breast and prostate as well as a vital vitamin that has been touted as being beneficial to improving fertility rates in both men and women.

Female Fertility and the Sun

Vitamins To Get Pregnant - Vitamin D - also appears to play a role in how estrogen acts in the uterus, particularly in regard to development of the lining. In fact when vitamin D levels are low, your uterus may not develop a lining sufficient enough to hold on to your embryo - which in turn frequently leads to very early stage miscarriage.

Astonishingly, Yale University School of Medicine study of 67 women who had problems conceiving and found that 93% of infertile women had overt vitamin-D deficiency and only a mere 7% had normal Vitamin D levels.

Nearly 40% of the women who had ovulatory dysfunction also had a clinical deficiency in Vitamin D. Therefore, it is easy to understand how important Vitamin D is to a woman's fertility. The correct amount of sex hormones in your body is vital to your overall well-being, otherwise you may suffer PMS, PCOS, and sadly, infertility.

"Of note, not a single patient with either ovulatory disturbance or polycystic ovary syndrome demonstrated normal Vitamin D levels; 39 per cent of those with ovulatory disturbance and 38 per cent of those with PCOS had serum 25OHD levels consistent with deficiency." quoted Dr Lubna Pal - the Director of the Program for Polycystic Ovarian Syndrome (PCOS) at the Yale Fertility Center.

Male Fertility and The Sun

Vitamins To Get Pregnant - Vitamin D - levels has shown significant positive correlation with the testoterone levels according to one of the study by Researchers at Medical University of Graz in Austria. The levels of the male sex hormone testosterone in men's blood rise accordingly with doses of Vitamin D.

It was found that men with at least 30 nanograms of vitamin D in every milliliter of blood had much highest levels of circulating or biologically active male sexual hormone - testoterone - than those with less. An hour of sunshine can boost a man's testosterone levels by 69 percent as well as men's Sex drive.

Testosterone is the most important male sexual hormone, mainly responsible for the development of the sex organs, the formation and maintenance of the typical male sexual characteristics, sperm production and the controlling of male desire.

In conclusion, it is obvious to understand how sun and how important Vitamin D is to both male and female fertility. The correct amount of sex hormones in your body is vital to your overall well-being, otherwise you may suffer PMS, PCOS, low sperm count and sadly, infertility. Hence, couples struggling to conceive should consider getting out in the sunshine more often.

Breast Intentions

The strength and ubiquity of the 'breast is best' message in New Zealand means there is greater awareness than ever of the benefits of breastfeeding, increasingly advocated as the risks of formula feeding.

However, women remain unsupported in their choice to breastfeed, from work policies and a lack of timely information and support, to family attitudes and perceptions of a "good baby" as one which sleeps through the night and therefore requires slowly digested formula to do so.

The conflict between the lactating and revered sexual breast in Western society means that while the media is awash with images of 'boobs', public breastfeeding is taboo. A 2009 study found that 36 per cent of Australians said breastfeeding was unacceptable in a cafe or at work. Jennifer James of RMIT University, which conducted the study, said "Part of the issue why young mothers wean their babies too early is societal pressure and isolation from other mothers experiencing the same difficulties."

The result is that many women do not establish breastfeeding, the trauma of which is then compounded by the censure faced when bottle feeding.

In recognition of the experiences of these mothers, Christchurch based counsellor Karen Holmes, is launching a counselling service specifically for "unvalidated grief" around women's breastfeeding experiences.

Holmes explains: "This is something which is just never talked about, but for many women giving up breastfeeding is a very real loss which impacts their lives. It may never be acknowledged as grief - not by others and not even by themselves." This grief therefore expresses itself in other ways, for example through anger at breastfeeding mothers or feelings of resentment at being let down by the health system.

Holmes offers counselling to those impacted by infant feeding grief, trauma or related concerns, including mothers and those who find themselves with issues in their work with mothers. Counselling could be historical, for example with grandmothers, as well as for contemporary issues. In addition to grief from not establishing breastfeeding, it can also arise when a child weans unexpectedly.

Mother of three, Charlotte, comments: "I breastfed my eldest for 23 months. I couldn't breastfeed my middle son and I had to bottle feed, it caused me a lot of negative psychological stress for a while, and I got it into my head that he didn't love me. My third son I breastfed for just over 6 months, then he decided he wasn't interested anymore and preferred food and a bottle. This was a bit of a shock at first."

Infant feeding issues may also arise in pregnancy. For example, one mother who had an eating disorder when younger, had recurring nightmares throughout her pregnancy that she would be unable to feed her baby.

University of Albany evolutionary psychologist Gordon Gallup believes the grief a mother may experience also operates at the level of biology, commenting: "For most of human evolution the absence or early cessation of breastfeeding would have been occasioned by miscarriage, loss, or death of a child. We contend, therefore, that at the level of her basic biology a mother's decision to bottle feed unknowingly simulates child loss."

A study of 50 mothers conducted by Gallop showed that those who bottle fed scored significantly higher for postnatal depression than breastfeeders.

Feelings of loss at not breastfeeding may be compounded by guilt, and also rejection by having felt undermined by questions when attempts at breastfeeding were underway.

Holmes spent ten years as a La Leche League (LLL) leader and observed that much of the meetings were devoted to discussions about addressing challenges from others toward breastfeeding women. For example "are you sure you've got enough milk", "that baby's got you wrapped around it's little finger", and assumptions about the duration of breastfeeding and the need for supplementation from formula.

Anthropologist Sheila Kitzinger in Ourselves as Mothers (1992) stresses the importance of self-belief when she writes: "The firm expectation that (women from traditional cultures) will breastfeed successfully is much more important for a mother than any specific breastfeeding practices... women can breastfeed under apparently impossible conditions if they are convinced that they will be able to do so."

Breast vs Bottle Polarisation

The polarisation of breast versus bottle hurts mothers and the women at the frontline of breastfeeding promotion. Holmes comments: "There appears to be this big division between breast and bottle feeding, but there are multi-causal factors with infant feeding in Western culture today including historical, cultural, familial and political. In a culture that often wants to point the finger in one direction, in reality it serves no one to do this. I believe we need an honest look at where we are to acknowledge that the two camps have much in common."

Holmes continues: "I think we need to appreciate that all women go through the same ringer when making decisions about feeding their babies - a successfully breastfeeding mother could have had endless struggle, undermining and interference to get to that point, just like a formula feeding mother. But yes, the breastfeeding mother's trauma may be alleviated by her eventual success."

Holmes herself experienced problems breastfeeding so knows first hand what women may go through. Holmes said she wanted to breastfeed her now grown-up daughter for economic reasons and because "it gave me an excuse to be close to my baby", a poignant testament to the independence expected between mothers and infants in Western society.

During the first few days of her daughter's life, and having difficulty feeding, Holmes was "constantly questioned" as to whether her baby was getting enough breastmilk and was "eventually worn down", and gave her baby formula. She then overheard someone saying of her "they just don't try very hard these days do they". However Holmes persevered, and with help from an LLL breastfeeding counsellor regarding positioning of the baby, she went on to breastfeed until her daughter was three years old.

The breast versus bottle debate has lead to an emphasis on breast pumps, by viewing breastfeeding through a bottle feeding lens and equating breastfeeding with breastmilk. However the use of breast pumps are linked to a decrease in milk supply and therefore negatively affect breastfeeding outcomes.

Carol Bartle, coordinator of the Canterbury Breastfeeding Advocacy Service, comments "Breast pump marketing implies that all women need a breast pump to breastfeed, and the only pressing issue is finding out "which pump is right for you". However seductive the pump marketing messages are, with their impressions of the modern mother's need to get away from her baby, fathers' need to give bottles, and images of attractive women with their backpack and pump, the reality of pumping is that of a complex and time consuming practice that is hard to maintain. I have yet to meet a woman who enjoys pumping but have known hundreds who love to breastfeed once they have established breastfeeding".

Bartle, who has 30 years' experience working in neonatal intensive care, where women try and establish their milk supplies using breast pumps, continues: "Many pumps are inefficient and do not remove milk effectively enough to maintain milk supply. Women who give breastmilk to their babies in bottles, and do not put their baby to the breast at all, are at the highest risk of serious milk supply problems."

This observation is confirmed by a 2009 study from Stanford University School of Medicine, California, which found that "pump suction alone often fails to remove a significant fraction of milk as more can be expressed using manual techniques". So to ensure pumping is done effectively, and the milk supply is maintained, pumping needs to be done in combination with hand massage techniques. Something few women are aware of.

Barriers to breastfeeding

It is very clear that women should not take sole responsibility for their breastfeeding experiences. Holmes identifies that grief issues "depend on self-image and expectations", so that when women are given unrealistic ideas of breastfeeding and at the same time undermined on the way to achieving breastfeeding, the grief and sense of failure can be significant.

New Zealand's National Breastfeeding Advisory Committee (NBAC) in its 2008-2012 national plan for breastfeeding detailed a list of 13 Social and environmental barriers to breastfeeding. These included the perception that artificial feeding enhances the father's opportunities to bond with the infant, attitudes that make breastfeeding embarrassing or uncomfortable for the woman, societal expectations about the acceptable duration of breastfeeding, a culture that portrays bottle-feeding as normal, and returning to work, by choice or through financial necessity.

The World Health Organization (WHO) says that "virtually all mothers can breastfeed, provided they have accurate information, and the support of their family, the health care system and society at large".

These sentiments are reinforced by the pro-formula backlash, for example the book Bottle Babies by Adelia Ferguson (1998), which catalogues letters from bottle feeding mums - many of which are a testament to a fundamental lack of support around their breastfeeding experiences.

Holmes comments: "Many bottle feeding mums feel extremely traumatised by their persistent efforts to breastfeed to the point where they will not ever try again with subsequent babies. Sadly much of this experience is due to inaccurate breastfeeding information. However, there are successful breastfeeding experiences after some extreme circumstances. This is done knowing how breastfeeding works and that others have done it successfully."

In 2008, the UK's Scientific Advisory Committee on Nutrition said of the latest Infant Feeding Survey in 2005 that "The reasons mothers gave for abandoning breastfeeding suggest that relatively few mothers truly chose not to breastfeed. Three-quarters of breastfeeding mothers... said they would have preferred to breastfeed for longer had they been able. These findings suggest that most women who start to breastfeed are committed to it but stop because they encounter problems and find that skilled support is not readily available."

In recognition of this, the Canterbury Breastfeeding Advocacy Service provides not just information about breastfeeding but practical support in the form of networks between health care professionals, local groups and mothers. Bartle comments "We are trying to shift the culture to one that supports and protects breastfeeding women, rather than just promoting breastfeeding without support structures in place to really make a difference. For example, I have just been working with a mother who said that the most useful assistance she could have received while trying to establish her preterm baby on the breast after going home from the hospital, was home help."

Meanwhile, commenting on the national situation in New Zealand, outgoing LLLNZ Director Barbara Sturmfels, says: "Legislative changes to improve conditions for breastfeeding mothers in the paid workforce, a public advertising campaign to promote breastfeeding in public, and support for the implementation of UNICEF's Baby Friendly Initiative in New Zealand are some of the ways that the government is seeking improvements in breastfeeding rates through institutional and societal change."

Many problems need not prohibit breastfeeding were they seen as part of the breastfeeding journey and if consistent support and information were on hand in the crucial first days and weeks. Denise Digman in Breastfeeding in New Zealand: Practice, Problems and Policy (1998), says the medicalisation of breastfeeding has detracted from "perceiving the range of physical sensations and difficulties experienced while breastfeeding as part of the normal spectrum of events". This is echoed by NBAC which talks of "insufficient knowledge about the normal course of breastfeeding, including common problems and the solutions".

Holmes gives an example from her own life to illustrate this point: "In her first weeks, my youngest daughter was putting on very little weight and this was of concern to the Plunket nurse. I explored what factor might be creating the problem and discovered a cowsmilk intolerance. As soon as this was eliminated from my diet her weight gain improved. Without this knowledge, this could have turned into a safety issue."

New Zealand's breastfeeding rates compare favorably with those of other developed nations. Different countries measure the rates in different ways and for different years, but for a broad comparison, rates for exclusive breastfeeding are: New Zealand 2008 16% at 8 months; Canada 2008 14.4% at 6 months, Australia 2007 14% at 6 months, USA 2006 13.6% at 6 months, UK 2005 less than 1% at 6 months.

However seen globally, it is clear the impact Western values may have on breastfeeding. WHO recommends that infants be exclusively breastfed for the first six months and for breastfeeding to continue "up to two years of age or beyond".

The top 5 countries for exclusive breastfeeding at 6 months (Unicef 2008) are Rwanda 88%, Kiribati 80%, Sri Lanka 76%, Solomon Islands 74%, and Peru 69%. At aged 20-23 months, Sri Lanka, Burkina Faso, Ethiopia, Bangladesh and Nepal all had breastfeeding rates of over 80%, with Nepal at 95%.

In New Zealand, rates for Maori and young mothers are much lower than average, and Maori currently have the lowest exclusive breastfeeding rates in the country. This is also a hallmark of Western society: As Glover et al explain in Maori Women and Breasfeeding (2008) "Beliefs and practices introduced to Maori by European immigrants to New Zealand have supplanted Maori infant feeding practices". The report therefore recommends that "promotion of breastfeeding to Maori should focus on re-establishing breastfeeding as a tikanga (right cultural practice)".

As well as Karen Holmes new counselling service, Christchurch is fortunate in having the Young Parents' Breastfeeding Group Whangai U "Matua Puhou". Headed by public health advocate and breastfeeding peer counselling administrator Susan Procter, the group has over 20 regular members and meets regularly to support breastfeeding families where the mother is aged under 25.

Procter comments: "The impact the group has had is enormous, both in terms of breastfeeding success and also in giving several of the mums a passion and motivation to apply to enter the health care professions to advocate for breastfeeding and to support other young mothers."

Breastfeeding as Patriarchy

A further irony of the breastfeeding debate is that when a mother does successfully breastfeed, she is likely to be censured if she continues past an arbitrary cut off point of a few weeks or months.

Part of the problem is that motherhood, the archetypal female domain, is accused of becoming a patriarchy with male values overlaid upon it. For example the reverence of science over instinct, of experts over the mother's voice, and of consumer products over the mother's body. This is particularly relevant with the medicalisation of birth, with the rising number of cesarean sections impacting negatively on the establishment of breastfeeding.

Dr Truby King is a controversial example of the mothers' expert, having founded New Zealand's Plunket Society in 1907 "to help the mothers and save the babies" and the Karitane Product Society (KPS) in 1927, which consolidated King's production of infant formula.

Linda Bryder says of King in A Voice for Mothers (2003) "The diagnosis of the problem and the solutions put forward were the same everywhere: mothers were ignorant of the correct methods of child-rearing and needed to be educated". Meanwhile Sheila Kitzinger claims that King "Destroyed women's confidence in breastfeeding and made loving mothers feel inadequate and guilty."

One hundred years later, that charge was still being leveled at Plunket for the promotion of scheduled feeding, based on the digestion time required for formula, rather than for quickly digested breastmilk. The emphasis has shifted recently with Plunket advising that "your baby may wake wanting frequent feeds. For breastfed babies these feeds are important to help establish and maintain breastfeeding". However the organisation remains out of step with international WHO guidelines by recommending breastfeeding only "until they are at least 1 year or older".

Plunket's controversial partnering of breastfeeding promotion with corporate interest through King's formula production, continues today with Wattie's sponsorship of Plunket. Wattie's promotes Nurturebaby formula and markets "Stage 1" baby foods for "4-6 months onwards", in conflict with WHO's recommendation of "exclusive breastfeeding for 6 months" and Plunket's recommendation of "breastfeeding exclusively until around 6 months". The Plunket logo appears on the packaging of Wattie's Stage 1 foods, giving the perception that Plunket endorses feeding solids at 4 months, despite the clear conflict with Plunket's own policy. The presence of the Plunket logo also gives the impression that Plunket is endorsing that particular brand of baby foods above both competitive brands and baby food prepared at home.

The patriarchal legacy remains a tangible presence for women, their partners and families today. Holmes comments: "Progressively, women were told that their instincts, their feelings and everything else they may have previously believed were wrong and they needed to listen only to the experts if they wanted their babies to live. This creates internal conflicts which may become problematic, especially the thought that something must be wrong with a woman as mother."

Holmes continues "It is with this that I want to work, for example validating grief, feelings, impacts. Helping women to understand what creates these conflicts and giving them permission to feel what they feel. I would hope also that in doing this women may regain a sense of their own wisdom and feel empowered to make informed choices."

Holmes stresses that the understanding and support of fathers is a crucial part of this process. Holmes comments: "Breastfeeding is a human issue, not a women's issue. Men have a valuable and active role in supporting women to breastfeed and in protecting it." This is reinforced by Sturmfels who says "Informed and skilful mother-to-mother support can really make a difference. A new mum needs the love and support of her partner and family."

Holmes concludes: "What is most important is that all mothers are honored in their experiences around infant feeding. That mothers feel supported, valued and confident in their own ability as a mother."

Thursday, November 7, 2013

Coverage and Other Important Details of Family Health Insurance

Ones health is almost compared with weather, which is never predictable. The healthiest person may one-day cramp to such an extent that they pull an enormous demand of money and pose many economical problems to the family. So deciding on a well contributing insurance plan would always help at times of need. The two main categories of family health insurance would be as follows...

  1. Indemnity family health insurance plans (reimbursement plans)-This would allow the user to choose their own medical practitioner

  2. Managed care family health insurance plans -This applies to only selected medical practitioners and not mapped to every medications too.

  • HMO-Health Maintenance Organizations

  • PPO-Preferred Provider Organizations

  • POS-Point of Service Plans.

The coverage would include medication, drugs, treatment, diagnosis, maternity care, vision care, audio aid, mental health benefits, Hospital expenses of room bed and other accessories, surgical expenses of surgeons fees, consultation expense. These health insurance plans also offer other allowances such as co-payment for consulting doctor regularly at least monthly once, deductible amount that are spent annually on medications, coinsurance. One must consider few issues before getting into this type of insurance,

  • What is the waiting period of the plan you select?

  • Does the insurance company has good reputation?

  • What are the co-pay, co-insurance, deductibles on that plan?

  • Does the health insurance plan offer full coverage to all the family members?

Decide whom you are about to add to your group health insurance policy and enroll after deciding. This would be helpful when you decide over offers and services they provide according to the members you chose. Remember one cannot add any member just in the middle of your investment scheme exception being a newborn kid in your family. This would pose lot of complications in your health insurance plan. If you want to move away from one plan to another be sure about your families financial status and check the coping up capability. Compare various health insurance quotes made free by many insurance providing companies. This would be the best way to analyze and check out the most feasible policy. Than individual insurance, health insurance would be better at cutting cost with the widest coverage for your entire family. Always keep in mind that individual insurance favors the company and group health insurance plan favors the insured. Hence it is better to rely on family health insurance rather than individual insurance. Some of the available options for you to choose would be,

  1. Short term family health insurance

  2. Private companies family health insurance

  3. Group family health insurance

Exercise and Pregnancy - 70 Things Every Pregnant and Non-Pregnant Woman Should Know

The following are 70 things every pregnant and non-pregnant woman should know about exercise and pregnancy in general:

1. Myths surrounding exercise and pregnancy:

Exercise during pregnancy was thought to cause miscarriage, hormonal imbalance, over-stressing of the joints, redirecting blood flow away from the fetus, to the muscle, overheating the fetus, uterine bleeding, displacement or rupture of the placenta, entangled umbilical cord, breech position, increase risk of c-section, high blood pressure, abnormal genes in the baby, growth retardation, meconium-stained amniotic fluid, premature labor, prolonged labor, fetal distress, still birth, low birth weight, low apgar scores, difficulties for the baby after birth, and difficult maternal recovery after birth.

2. How the myths came and went:

Many of the myths, about the effects of prenatal exercise, were perpetuated by both the fitness and medical community out of fear and ignorance. Such myths have been dis-proven by modern medical research.

3. How exercise affects the woman's fetus:

Currently, all medical studies point to positive effects on the fetus as a result of exercising throughout the pregnancy. There are less complications during pregnancy when exercising. The woman's fetus becomes tougher, leaner, and more able to adapt and handle stress.

4. Roles of pregnancy hormones:

The following are the six hormones that are produced during pregnancy and their roles: Relaxin, is a hormone that relaxes and softens the cartilage and ligaments that support the joints to prepare the body for an easy pregnancy; Androgen, is a hormone produced in men, and helps to give the pregnant woman more strength, energy, and sex drive; Progesterone is a hormone that supports the growth of the fetus, uterus, breast, and even speeds up the metabolism. Progesterone also is responsible for fat accumulation to cushion the uterus and storage during the first and second trimester; Estrogen is a hormone that works with progesterone to maintain the pregnancy. In pregnancy, estrogen makes the uterus more elastic, softens the joints, retains fluid, and increases the size of the breast; hCG, human chorionic gonadotropin, is a hormone produced by the placenta to stimulate the ovaries to produce estrogen and progesterone; Insulin, a hormone that permits glucose to enter the muscle cells, can cause hypo or hyperglycemia in a pregnant woman if blood sugar levels are not maintained with a proper diet.

5. Diastasis Recti:

Diastasis recti (abdominal separation) occurs when the abdominal muscles are stretched out, as they are in pregnancy. Diastasis is the space in the mid abdominal region. Such separation generally occurs in the second or third trimester and is painless.

6. Dizziness and faintness in pregnant women:

When a pregnant woman feels dizzy or faint, it is usually due to poor circulation. This poor circulation may be caused by blood pooled into the legs from lying in the supine position or standing for an extended period of time.

7. Dizziness alleviation:

Use the legs to help pump blood around by moving around or walking. Remember to eat often and do not go more than four hours without having something to eat.

8. Primary reasons not to exercise during pregnancy:

The ACOG recommends that women who are pregnant, should not exercise if certain conditions or risk factors are present. Such factors include cardiac, vascular, pulmonary, and/or thyroid diseases. Other contradictions include diabetes, seizure disorder, obesity, hypertension, anemia, and problems with the back, joints, and/or muscles.

9. Pregnancy induced hypertension:

A woman who suffers from pregnancy induced hypertension is in a high-risk pregnancy and should not take part in a regular exercise program. Some light exercises and slow-moderate walks may be performed.

10. Best method for a pregnant woman to measure exercise intensity:

Due to the fact that the resting heart rate of a pregnant woman can rise up to twenty beats per minute over normal levels, measuring exercise intensity with heart rates will simply not work. The rate of perceived exertion should be used to measure exercise intensity because it involves listening to one's body and is easy to use.

11. Ten workout guidelines for beginners:

  1. Start slowly and gradually increase exercise intensity.

  2. Consult with a doctor, and get written permission before beginning any exercise program.

  3. After each workout, cool down and stretch slowly and carefully.

  4. Listen to your body and change the program as you see fit.

  5. Move your legs and walk around between exercises.

  6. Do not exercise in hot or humid weather.

  7. Practice proper posture, alignment, and muscle control.

  8. Avoid interval training.

  9. Get a complete physical before you start any exercise program.

  10. Do not exercise at altitudes of 8,000 ft or higher.

12. Benefits of strength training during pregnancy:

Strength training will improve muscle tone and strength. The added strength can aid in carrying the added weight of pregnancy, improve stability, balance, energy, sense of well-being and self-esteem. The threshold for pain will also be improved.

13. Popular sports and activities pregnant women should avoid:

Gymnastics, roller skating, snowboarding, softball, soccer, and volleyball.

14. Three basic exercises to include in an exercise program:

Kegels, Abdominal Pulses, and Pelvic Tilts.

15. How to do Kegels, Abdominal Pulses, and Pelvic Tilts:

Kegels- Visualize the pelvic floor muscles, starting at the anus. Squeeze the muscles around the anus tightly. After a few times, focus on the sphincters around the opening of the vagina. Squeeze them tightly and then relax. Then squeeze and pull the perineum in and up, holding as long as possible before relaxing. Remember to exhale as you squeeze and pull up, and inhale as you release.

Abdominal Pulse- Begin by sitting on the buttocks with the legs crossed up against your wall or bed. Inhale and let your lungs expand with air. Relax the abdominal muscles. Exhale and contract the abdominal muscles tightly by pulling them in. Repeat for ten to fifty repetitions for two sets.

Pelvic Tilts- This exercise can be performed supine, standing, seated, side lying, on all fours, or on a ball. Begin by sitting on the ball and walking forward, rolling with it until the shoulders and head are resting on top of the ball. Pull the abdominal muscles in and contract your glutes as you tilt your pelvis forward to round the lower back and exhale. Perform ten repetitions for two sets.

16. Three exercises to help pregnant women stretch the lower back:

Pelvic Tilt, Cat Stretch, Opposite Arm and Leg Raise.

17. Physical and psychological effect of confined bed rest:

After just twenty-one days of total bed rest, the body deconditions by twenty-five percent. Psychological effects include depression, anxiety, low self-esteem, and a negative mentality.

18. Not confined to bed rest, but still considered high risk:

Chronic hypertension, thyroid, cardiac, vascular, or lung disease, fetus in the breech position, anemic, and a mother carrying twins.

19. How posture, stretching, relaxation, breathing, and yoga are beneficial:

Practicing good posture will decrease the strain on the musculoskeletal system. Yoga and stretching lengthen the muscles, improve posture, and aid in relaxation. Breathing techniques help to expand lung capacity, helping to offset the pressure of the growing uterus on the lungs.

20. Advice for women experiencing neck and shoulder pain:

Strengthen the upper back and neck; Stretch the chest; Stretch the neck forward, to the sides, and in half-circles from one shoulder to the other; Use a firm mattress; Wear a bra at night; Get neck and shoulder massages; Use hip mobility exercises; For severe pain, walk with crutches until pregnancy is over.

21. Five yoga positions a pregnant woman may want to avoid:

Avoid shoulder stands, down dog, back bends, plow pose, and seated forward bends.

22. Diaphragmatic breathing:

Sit comfortably in a chair while holding the belly button with both hands. Breath in and concentrate on slow inhalation, letting the chest and abdominal cavity fill with air. Expel the air out slowly, and feel the abdomen deflate.

23. Possible result of women having very low body fat before and/or during pregnancy:

If a woman has very low body fat before and/or during pregnancy, her estrogen production may decrease, which could cause infertility or even miscarriage. If fat is extremely limited, the mother will use protein sources for energy and that can inhibit the proper development of the baby.

24. Weight gain distribution of 24-28 pounds in a pregnant woman:

Forty percent of the weight gain is accounted for by the fetus, and the other sixty percent is from maternal change. Most of the weight that is gained is extra water. Much of the necessary maternal fat gain is deposited internally and externally in the pelvic and abdominal region during the first trimester. The baby will accumulate its own fat and fat cells during the last ten weeks of pregnancy.

25. Morning sickness:

Morning sickness is a physical reaction to the hormonal influx and other changes your body is experiencing. This may increase estrogen levels and, in turn, increase sensitivity to certain smells which may cause nausea. A high intake of complex carbohydrates and protein can help decrease nausea. Eating smaller meals more often will also help and vitamin B6 has been shown to alleviate morning sickness.

26. Why a pregnant woman should avoid hair coloring and chemicals:

It is important that pregnant women do not use hair coloring and other chemicals because they can be toxic to the unborn baby. Do not inhale or let chemicals touch the skin.

27. Suggested servings of water when pregnant:

A pregnant woman should drink at least 10 cups of water throughout the day because dehydration can increase body temperature, slow blood and nutrient flow to the baby, and cause premature labor.

28. Most important vitamin to stock up on before conceiving:

Folic acid is the most important vitamin to stock up on before conceiving. The body needs to have enough folate in storage before implantation of the fertilized egg in order to prevent spinal and brain deformations called neural tube effects.

29. Reconsidering consumption of milk as part of an everyday diet:

Milk, non-fat or full fat, it may exacerbate and/or contribute to a variety of problems, such as heart disease, cancer, arthritis, migraines/headaches, allergies, colds, asthma, ear infections, thyroid and metabolic problems, behavioral problems, skin problems, fluid retention, bloating, abdominal cramps, and osteoporosis.

30. Five benefits of exercising during pregnancy:

Exercise, during pregnancy, increases blood volume, heart chamber volumes, maximal cardiac output, blood vessel growth, the ability to dissipate heat, and the delivery of oxygen and nutrients to the tissues.

31. Bone density, muscle tone and ligament integrity during pregnancy:

During pregnancy bone density is maintained and ligaments relax while changes in muscle function are unclear.

32. Several early pregnancy issues:

Several early pregnancy issues include miscarriage and congenital defects. Miscarriages are basically spontaneous abortions of the fetus and are common. Congenital defects are due to abnormal development of the placenta.

33. Steps to avoid miscarriage:

Stay hydrated, eat multiple meals throughout the day, and exercise regularly.

34. How exercise affects fertility:

Exercise has not been shown to decrease fertility in women, but actually slightly increases fertility.

35. Physiological effects of beginning an exercise program during pregnancy:

Starting a regular fitness program during pregnancy increases birth weight unless the volume of exercise is very high. Starting exercise in the second month reduces birth weight and newborn fat mass, but only if exercise intensity and frequency are very high.

36. Regular exercise and premature birth:

Continuing a regular, vigorous exercise throughout pregnancy does not increase the incidence of either membrane rupture or premature birth.

37. Active pregnant women vs sedentary:

Women who exercise tend to be leaner both during and after the pregnancy and recover faster than sedentary women.

38. Can women continue exercise throughout pregnancy:

Yes, women can continue to exercise throughout their pregnancy and in fact should, but if exercise is suddenly stopped mid or later in pregnancy the baby could become "fatter" than normal babies. This should not happen if regular exercise is continued for the entire pregnancy.

39. Psychological benefits of exercise for pregnant women:

Pregnant women who exercise regularly tend to maintain a positive attitude about themselves, their pregnancy, and their soon to be labor and delivery.

40. Positive points to implement:

Remember that you will come out of your pregnancy leaner than most sedentary women if you continue to regularly exercise throughout the pregnancy. Not only that, but your baby will be stronger, leaner, and more able to adapt to its surroundings if regular exercise is continued throughout pregnancy.

41. Four big contra-indications to exercise:

The big four contra-indications to exercise are injury, disease, pain, and bleeding.

42. Spontaneous patterns of exercise performance after birth:

There were many active women who resumed exercising within the two weeks following the birth of their child. Many of these active women, within the first year after birth, returned to their formal pre-pregnancy fat levels and even exceeded pre-pregnancy exercise performance levels. It is okay to exercise after pregnancy if it does not hurt or make the women heavily bleed.

43. Key points for exercise during the first six weeks after birth:

The woman should exercise 3 or more times a week; all exercises should feel good and enhance her sense of well-being; adequate rest is essential.

44. Key rules for exercise after pregnancy:

Be sure that the amount of exercise is enough, but not too much; be sure that the exercises feel good; pay attention to the little things; do not chart your performance progress; do not ignore fatigue or pain.

45. Three "absolute contra-indications" to exercise after pregnancy:

Bright red bleeding that last for several hours. If it hurts anywhere then stop, and breast infection or abscess.

46. Instructions and safety concerns for both the mother and baby:

Focus on monitoring performance, well-being, and the growth and development of the baby. One concern is milk production and can be used as an index for monitoring the growth and development of the baby.

47. How exercise has been proven to be a stress reliever:

Just taking walks on most days of the week can elevate your mood and prepare your body for the changes that occur in pregnancy. Other aerobic activities also relieve stress.

48. Stability:

Stability is the capacity of the body to maintain or return to a state of equilibrium. Exercising before, during, and after pregnancy helps to improve stability.

49. "Move from the core"

The phrase "move from the core" refers to when the deep muscles of the spine and the abdominal muscles that support the spine react quickly to the changes in movement which respond first in keeping the spine aligned.

50. Why the kegel exercise is important for the expecting mother:

Kegel exercises help to strengthen the pelvic muscles, which in return help to prevent urine leakage during and after pregnancy, as well as restoring muscle tone after delivery. If a pregnant woman should avoid strengthening the pelvic floor muscles, she may experience bowel and bladder incontinence problems later in life. It is for the above reasons that kegel exercises are the most important exercises a pregnant woman can ever do.

51. Why blood pooling is dangerous and what can be done:

Blood pooling is dangerous, because it shifts blood flow away from the internal organs and puts additional stress on the heart, causing less oxygen to travel to the brain and the fetus. This could cause pregnant women to feel faint or even pass out. To avoid blood pooling, it is important that the legs are in motion when not exercising to increasing blood flow back up to the heart. An effective cool-down helps to reestablish circulation and prevent blood pooling.

52. Four common changes during early pregnancy:

1. The pregnancy hormones tend to slow the digestive system.

2. The pressure from the enlarged uterus relaxes the pelvic floor muscles.

3. Emotions are affected by the new pregnancy hormones.

4. The growing uterus puts pressure on the diaphragm.

53. How a pregnant woman can reduce the incidence of nausea:

The incidence of nausea can be reduced by doing the following: Eating small, frequent meals throughout the day which will help prevent over-distending of the stomach while providing the much-needed nutrients; take prenatal vitamins with evening meal so, if they upset your stomach, it is while you sleep; keep crackers by the bedside to snack on in the morning; eat calcium-rich foods; suck on ice cubes; sniff or suck on lemons; wear a sea-band; place three fingers on your right hand on the inner aspect of your left wrist with the ring finger of the right hand directly over the wrist and hold firmly.

54. Reducing constipation during pregnancy:

Constipation and eventually hemorrhoids are caused by the increase in progesterone which slows the digestive tract. Drinking eight to ten glasses of water a day along with eating high fiber foods should help relieve constipation. Exercising also helps to relieve constipation.

55. Steps to take to reduce leg cramps during pregnancy:

The primary cause of leg cramps in pregnant women is slowed circulation, calcium deficiency, and consuming too many carbohydrate drinks. For leg cramps at night, place a pillow between the knees to help improve circulation. For calcium deficiency caused cramps, be sure to consume adequate amounts of calcium in your diet or take a calcium supplement. Vitamin C may also help to prevent leg cramps. If you feel cramping, flex the foot of the affected leg so the toes point toward the head. If cramping persist or is hot to touch then seek medical advice.

56. Three tips to help reduce water retention during pregnancy:

1. Avoid ingesting large amounts of sodium.

2. Perform ankle circles throughout the day.

3. Whenever possible prop feet up on a chair or stool.

57. Pregnancy gingivitis and how it can be avoided:

Pregnancy gingivitis is when the gums swell and bleed which may lead to infection and discomfort. To prevent gingivitis brush your teeth at least twice a day with a soft nylon brush. It is ideal to brush after every meal and before bed. See your dentist at least twice during the pregnancy for checkup and cleaning.

58. Importance of diaphragmatic breathing for the expecting mother:

Diaphragmatic breathing stimulates the parasympathetic nervous system, which calms the body. The more relaxed the women is during labor and delivery, the less discomfort she will experience.

59. Nostril breathing and its benefit:

Nostril breathing is the process of breathing through one nostril for up to five cycles at a time to help aerate the sinuses and bring balance into both sides of the nose.

60. Optimal range of weight gain during pregnancy:

The general guidelines recommend that a pregnant woman gains 25 to 35 pounds during pregnancy. The preferred scenario is that you gain about 4 to 6 pounds the first trimester, 11 to 15 pounds the second trimester, and 11 to 15 pounds the third trimester.

61. Average amount of Calories a healthy pregnant woman should consume:

The average amount of calories a pregnant woman should consume is around 1800 Calories. Active women who exercise an hour or more a day should consume 2400 Calories. Calorie intake should be increased by an additional 350-450 calories per day during the second and third trimester.

62. Five tips for avoiding excessive weight gain during pregnancy:

1. Eat an adequate breakfast. Skipping meals will attribute to eating in excess amounts later in the day and could possibly make you feel light head mid morning.

2. Drink at least eight glasses of water each day because dehydration can be interpreted as hunger causing the ingestion of unnecessary Calories.

3. Choose foods that are high in fiber, low in fat, and low in sugar because fatty foods can make you feel tired, and sugary foods can spike insulin.

4. Plan meals to balance your diet ahead of time with the essential nutrients you need.

5. Avoid eating with people who want you to overeat. Such individuals can cause you to eat an additional 750 extra calories for social reasons alone.

63. Some foods to avoid during pregnancy:

Do not eat raw seafood that is not frozen and sealed tightly with an "A" rating, soft cheeses, and free range eggs.

64. Benefits of weight-bearing exercise for the expecting mother:

Improved stamina; more energy; enhanced ability to handle heat stress; improved musculoskeletal function; increased metabolic capacity; increased insulin sensitivity; decreased maternal discomforts; easier labor and delivery; positive attitude and outlook of the pregnancy.

65. How exercise improves the mothers ability to handle heat stress:

Exercising regularly helps to increase blood flow to the skin which in turn helps dissipate heat. Exercise also decreases the core temperature threshold for perspiring.

66. How exercise can improve labor and delivery:

Women who continue a regular weight-bearing exercise program throughout their pregnancy have shown a marked decrease in the need for pain relief during labor, in the incidence of maternal exhaustion, and in the need for artificially rupturing the membranes to progress the labor. Women who follow a weight-bearing exercise routine throughout their entire pregnancies also have a lower incidence of induced labors, episiotomies, abnormal fetal heart rates, and the need for operative interventions.

67. Symptoms of over-training:

Some symptoms of over-training include fatigue, pain, loss of motivation, increased susceptibility of injury, and common infections. Over-training can negatively affect the baby by limiting its oxygen supply and nutrients.

68. Avoid pressure on the Inferior Vena Cava during the second trimester:

It is important to avoid pressure of the Inferior Vena Cava because it interferes with blood flow getting to the heart and lungs and results in less blood going to the aorta to the baby. When exercising on your back, putting pressure on the Vena Cava, you not only restrict blood flow to your muscles but also to your baby.

69. Healthy food plan for new mothers and benefit of exercise during first month after birth:

The daily diet of a new mother who is trying to lose her pregnancy fat should consume the following postpartum each day: 6 servings of whole grains; 2 servings of low-fat dairy; 2 servings of lean protein; 1 serving of nuts, legumes; at least 4 servings of vegetables; 2 servings of fruit; 2 servings of plant oils. The following should be consumed when lactating: 9 servings of whole; 3 servings of low-fat dairy; 2 servings of lean protein; 2 serving of nuts, legumes; at least 4 servings of vegetables; 3 servings of fruit; 2 servings of plant oils.

Exercise during the first month after delivery helps the mother recover postpartum, return to pre-pregnancy proportions, and increase energy.

70. Examples for developing a lifetime of fitness for the whole family:

  • Plan family fitness time at least twice a week.

  • Choose activities that allow everyone to participate in.

  • Follow good exercise principles, including warming up, cooling down, and stretching.

  • Include other family members.

  • Emphasize the importance of having fun.

  • Use physical activity as a reward, not food.

  • Dance with your family.

  • Provide space in your yard for sports.

  • Always use the stairs going down and up, if you and your family can tolerate it.

  • Keep fresh fruits and vegetables washed, cut up, and ready to eat for quick snacks.

  • Take a family fitness vacation such as skiing, canoeing, camping, or hiking.

  • Select fitness oriented gifts for birthdays and holidays.

Disclaimer: Always consult with your doctor before starting any exercise program.