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Healthcare providers caring for pregnant patients in the months after the US Supreme Court’s decision to strike down Roe v Wade have been unable to provide standard medical care in states where abortion is effectively outlawed, leading to delays and worsening and dangerous health outcomes for patients, according to an expansive new report. In the wake of the Supreme Court’s ruling last year, individual reports from patients and providers have shed some light on the wide range of harm facing pregnant women in states where access to abortion care is restricted or outright banned. But a first-of-its-kind report from the University of California San Francisco captures examples from across the country, documenting 50 cases in more than a dozen states that enacted abortion bans within the last 10 months, painting a “stark picture of how the fall of Roe is impacting healthcare in states that restrict abortion,” according to the report’s author Dr Daniel Grossman. “Banning abortion and tying providers’ hands impacts every aspect of care and will do so for years to come,” he said in a statement accompanying the report. “Pregnant people deserve better than regressive policies that put their health and lives at risk.” The report collected anonymised narratives from providers who observed complications facing their patients. The most common scenario involved preterm pre-labor rupture of membranes (PPRM), in which the amniotic membrane surrounding the fetus breaks. In several of the cases, patients developed a severe infection, including cases that put patients in hospital intensive care units. Patients in many cases were instead sent home and told to return to a hospital when labor started or when they experienced signs of an infection. In one case, a patient returned to a hospital’s intensive care unit two days after her water broke at roughly 16 to 18 weeks of pregnancy in a state where abortion is banned. “The anesthesiologist cries on the phone when discussing the case with me,” the physician wrote, according to the report. “If the patient needs to be intubated, no one thinks she will make it out of the [operating room].” The report notes that “miraculously” the patient survived. Following the termination of the pregnancy, the patient asked the doctor whether any of them broke the law. “She asks me: could she or I go to jail for this?” the doctor said, according to the report. “Or did this count as life-threatening yet?” Providers also described other cases where patients showed evidence of inevitable pregnancy loss, but their care teams had their “hands tied” under state laws. Health providers also submitted stories of patients experiencing ectopic pregnancies. Delays to treat one patient resulted in a ruptured ectopic pregnancy that required surgery to remove her fallopian tube. Another patient was denied an abortion for a Caesarean scar ectopic pregnancy, a life-threatening condition where a pregnancy implants in the scar of a prior Caesarean section. Other physicians reported the inability to treat patients with fetal anomalies and patients who faced delays receiving treatment for miscarriages. “Unfortunately, this report confirms that our fears about abortion bans are valid,” said Dr Chloe Zera, a maternal-fetal medicine specialist and associate professor at Harvard Medical School. “As someone who cares for patients who have high-risk pregnancies, I need to be able to provide care consistent with evidence-based guidelines,” she said in a statement accompanying the report. “This research underscores the completely preventable harm that is now happening to our patients because of barriers to abortion care.” The report also outlines the moral dilemmas facing physicians operating in states or treating patients from states that have outlawed the potentially life-saving care they previously provided. Some physicians said they were considering quitting or relocating, or noted the immense coordination required between health providers in multiple states to treat patients, and outlined the ways in which restrictive state laws have complicated other care unrelated to abortion. In one case, a physician refused to remove an intrauterine device for a patient who was between 10 and 12 weeks pregnant, despite the partially expelled IUD posing a risk for infection or miscarriage. “The doctor did not feel comfortable” removing the IUD, one physician wrote, according to the report. “The context provided was concern over the recent changes in law that create [the] possibility for felony charges for providers causing abortion in our state shortly after the Roe decision was overturned.” During a “heated exchange” among health providers, “the doctor [said] the patient had... been examined by the nurse practitioner, who was unable to visualize the IUD, and that ‘even if I could see it and it was easily removable, I wouldn’t remove it because of the law,’” according to the physician’s description in the report. “Abortion bans that block providers from offering standard medical care have the greatest impact in states like Texas that have some of the poorest indicators of maternal health,” according to Dr Kari White, lead investigator of the Texas Policy Evaluation Project at The University of Texas at Austin. “Pregnant people should be able to rely on their healthcare provider to provide the best possible care, regardless of where they live,” she said in a statement accompanying the report. More than a dozen states, mostly in the South, have effectively outlawed or severely restricted access to abortion care after the Supreme Court’s decision in Dobbs v Jackson Women’s Health Organization last June. Read More Alabama Republicans would charge abortion patients with murder under proposed legislation Louisiana Republicans refuse rape and incest exceptions to state’s sweeping anti-abortion law North Carolina governor vetoes 12-week abortion ban, launching Republican override showdown A Texas man sued his ex-wife’s friends for allegedly helping her with an abortion. Now they’re suing him Supreme Court preserves abortion drug approval as legal case plays out

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But Pammie was unaware of how much of a change it would make to her face and urges people not to go ahead with the procedure. Read More Janey Godley shares heartbreaking cancer update as husband reacts: ‘I thought he was being sick’ Bride sparks outrage after documenting everything she ate at her wedding Manspreading remains the most misunderstood of modern evils The vitamins, fruits and vegetables to prioritise as the seasons change A bride has split the internet in half over her wedding menu Gemma Collins urges women to talk openly about incontinence

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Gemma Collins has called on women to discuss the issue of incontinence more openly to dispel stigma around it. The former Towie star, 42, aims to help women overcome shame or embarrassment around the “taboo” subject in a new campaign. Collins recalled an incident when she first experienced incontinence while playing with her nephew on a trampoline. She told BBC News: “I couldn’t believe it, I was on a trampoline, you know, although I’m 42, I still think I’m 21. “And I was on – and you know, like, with your mums and your aunties, you’ve always heard growing up, ‘Oh my God, I need a pad, I’ve got leaks’ and you’re like, ‘Eugh, I will never get to that stage in my life’. “Well, honeys,” Collins continued. “It’s happening. I got on my trampoline with my nephew Hayden and I was having a great time and literally, I was laughing, I was jumping, and the leak just started happening.” Collins joked that the experience made her feel “officially old”, then added: “No, it’s nothing to do with age, so many women get it. One in three are suffering from it.” According to the NHS, urinary incontinence is the unintentional passing of urine and is believed to affect millions of people. The condition affects twice as many women as men due to pregnancy and childbirth, which can impact the bladder, urethra and other muscles supporting these organs. However, Collins said incontinence shouldn’t stop women from going out and living their lives. “Would I have stopped jumping on the trampoline? Hell, no,” she said. “It is really sad to know that women are stopping doing their activities. They might not want to go on holiday now because of their leaks. They might not want to get on a trampoline with their children or their families because of the leaks.” Collins added: “Nothing’s ever going to stop me from doing anything in my life. But why are women so embarrassed to talk about it still?” The TV personality has spoken candidly about her experiences with incontinence in the past. In 2017, she fell into a trap door in a stage while presenting the Radio One Teen Choice Awards in a moment that went viral online. But the following year, she revealed that the embarrassing moment was made worse by the fact she “wet herself” after the fall. “The worst thing about it was that I wet myself as it was such a shock,” she told OK! magazine. “James [Argent] came running down from the audience to make sure I was OK and all I could think was, ‘I hope he can’t tell I’ve wet myself’. “That hole changed my life, it catapulted me into a meme star,” she added. Read More Janey Godley shares heartbreaking cancer update Dwayne Johnson reveals he’s struggled with ‘three bouts of depression’ Manspreading remains the most misunderstood of modern evils Janey Godley shares heartbreaking cancer update Teacher, 25, rushed to hospital with stomach ache diagnosed with terminal cancer How to check if you have skin cancer: Symptoms and signs to look out

If your social life has ramped up now that it’s spring, it can be easy to let the little things you do for your health slip a bit. But it’s just as important to ensure you get all the right vitamins and minerals as the seasons change. So what should we be prioritising right now? Vitamin D You may be getting more sunlight now but it is still important to maintain good levels of vitamin D. “Levels of vitamin D will be low at the end of the winter and moving into spring”, Public Health Nutritionist Dr Emma Derbyshire from the Health & Food Supplements Information Service (HSIS) says. “Vitamin D is important for the absorption of calcium and healthy bones and teeth as well as for immune function. “The UK government recommends that we all take a 10 microgram daily supplement throughout the year but especially in winter through to spring. If you haven’t taken vitamin D throughout the winter your levels will likely be low, so top up now with a supplement.” Vitamin C “Vitamin C is a powerful antioxidant,” says Derbyshire. “With warmer weather you will be spending more time outside with more exposure to the outside air. “Vitamin C protects cells from the oxidative damage caused by pollutants. [It] also helps with the absorption of iron. Many women are short of iron particularly during their reproductive years so boosting vitamin C intake helps to reduce the risk of iron deficiency and the tiredness and fatigues that can cause.” You can find it in citrus fruits, tomatoes and peppers. “For those finding it hard to eat their five fruit and vegetables a day, then I would recommend taking a multivitamin and multimineral supplement to ensure your body is fuelled with an a-z of vitamins and minerals including vitamin C and iron,” Derbyshire adds. B vitaminshttps://twitter.com/johnnyxbrown/status/1650549580080066565 B vitamins include thiamin (vitamin B1), riboflavin (vitamin B2) and vitamin B6, niacin (vitamin B3), pantothenic acid, vitamin B6 (also known as pyridoxine) and biotin (vitamin B7). “Vitamins B one, two and niacin help release energy from food and are essential for the health of the nervous system,” says Derbyshire. “[This season] we want to feel energetic and for our nerves to be healthy so that we can best enjoy all the activities we have missed over the winter. These B vitamins help to reduce tiredness and fatigue.” Look for thiamin in peas and nuts, riboflavin in eggs and mushrooms, niacin in meat and wheat flour, and pantothenic acid in avocado and liver. Vitamin B6 can be found in pork, peanuts and bananas, but we only need very small amounts of biotin and the NHS say it’s not clear if we need additional biotin from our diets or supplements. Vitamin B12 Though it is a B vitamin, it is important to look at vitamin B12 independently, says Derbyshire, as it impacts so many different aspects of our health. “Vitamin B12 is essential for several issues we need help with in the spring – from immune function to tiredness and fatigue. “Spring is also a time when you might decide to cut back on the stodgier foods of winter. You might opt for a plant-rich diet which is healthy but if you cut out meat and other animal-source foods you are at risk of vitamin B12 deficiency. “If you decide to make a change to your diet this spring take a multivitamin supplement to make sure you are topped up with the nutrients that could be missing from your diet,” adds Derbyshire. Folate “Folate is vital for immune function which may have taken a battering by springtime. It’s also important for reducing tiredness and fatigue,” says Derbyshire. “Top up your levels by eating kale, broccoli, spinach, chickpeas and a supplement containing folic acid.” Read More Charity boss speaks out over ‘traumatic’ encounter with royal aide Ukraine war’s heaviest fight rages in east - follow live 5 top tips to increase the chances of selling your property faster Drag queen Ella Vaday plans on ‘bringing camp to the campsite’ in 100km trek A beginner’s guide to topiary

A woman who lost her hair to stage four cancer at just 25 had a sun tattooed on her head as a “f*ck you” to the disease. Madison Baloy was diagnosed with adenocarcinoma, a type of cancer that forms in the glandular tissue, in March 2023 after experiencing stomach aches for a year. The former kinder garden teacher was at a music concert with her friends in June 2022 when she started experiencing stomach aches. Over the course of 2022, she lost 60lbs and her tummy pain become more consistent, but she didn’t think anything of it. Madison was teaching in her classroom when she started feeling nauseous and called in the school nurse who told her to go to the emergency room. Madison was told she might have cancer and underwent a CT scan at, HCA Florida Brandon Hospital, Florida, which revealed a cluster tumours pushing down on her large intestine, causing the stomach aches. After an emergency surgery and a biopsy in February 2023, Madison was diagnosed with stage four adenocarcinoma cancer in March 2023. Her cancer can be managed but not cured so she will be living with the disease for the rest of her life. In what she describes as a “f*ck you” to the disease, Madison got a sun tattoo on her head - after losing her hair to the disease. The tattoo took an hour to complete with Madison saying it wasn’t painful. Madison, a former kinder garden teacher who had to give up work due to her illness, from Tampa, Florida, US, said: “Some of my attitude towards cancer is probably naivety. Being 25 and not being able to come to terms with being terminal. “In America, we idolise hustle culture and I was heavily into that culture and prioritised being the best teacher I could. “My diagnosis had made me idolise things differently. “When I first started losing weight, I thought it was god answering my prayers. “I thought the universe was giving me the perfect body - but I was dying and none of us knew. “When I got diagnosed my family were in the hospital room with me, I had a jokey reaction and said my doctor should be paid for giving people bad news. “I said I had no idea why everyone was crying as I would get the coolest head tattoo ever after losing her hair to the disease. “I am in a ‘f*ck it’ mentality. Honestly, what is the worst thing that is going to happen?” Madison was at Bonnaroo Music Festival, in Manchester, Tennessee, US, in June 2022, when she started feeling unwell. While dancing along to Stevie Nicks with her friends, Madison started experiencing stomach aches but put it down to dehydration and being out in the sun all day. After the festival had finished, Madison continued to experience pain in her stomach, which would come in bursts, either lasting a few seconds or a few minutes, but didn’t think anything of it. Madison said: “Over the course of a year, I lost around 50 to 60lbs and had pretty consistent stomach aches. “During President’s Day weekend, my stomach aches were there, and I started getting nauseous. “I went back into school on Tuesday and tried to push through but, on Wednesday I got sick and had to call the school nurse who told me to go to urgent care.” When Madison arrived at Express Care of Tampa Bay medical centre, a nurse told her her stomach aches could be due to cancer and told her to go to the emergency room. After arriving at HCA Florida Brandon Hospital, Florida, Madison was put into a wheelchair and examined. Her CT scan revealed a cluster of tumours pushing down on her large intestine, causing stomach aches. Just 48 hours later, on February 24, 2023, surgeons performed emergency surgery and did a biopsy which revealed Madison had stage four cancer and she spent 10 days in the hospital recovering. Madison said: “They found that I had adenocarcinoma cancer - cancer that forms in the glandular tissue - and found it was spreading around my body. “The biggest struggle has been my body image because I was happy and healthy. “I was 25 years old - I was in my prime, I was teaching, making good money, going out with my friends - I felt amazing. “Then it all flipped and now I have no hair and all these scars on my stomach from the surgery.” Due to the nature of her cancer and how advanced it is, Madison will never be considered cancer-free, but her cancer can be managed. She said: “Now, I am collaborating with two cancer centres in Florida. “My primary cancer clinic is Florida Cancer Specialists, where I have a family of oncology people who take such amazing care of me. “We also work with Moffitt Cancer Center for additional testing and second opinions. “I will have this forever - the best outcome long term is that I will be able to live and take a pill every day and just got in for regular appointments. “It is hard, it is super hard. The hardest part is the reality shift I have had but it hasn’t got me down as much as I thought it would. “I am doing chemotherapy every three weeks and it has been working in the sense that it’s keeping my cancer at bay.” When she received her diagnosis, Madison was surrounded by her family and decided to make light of the situation. “When I got my diagnosis, my family was with me, and I thought I was going to be told I had Crohn’s disease. “My surgeon comes in - wearing his street clothes - and I started joking that he was handsome. “He is looking very serious, and he comes to sit on the edge of the bed, and I told him to buy me dinner first. “He then told me I have stage four cancer and I said I didn’t understand why people were crying as I am gonna get the coolest head tattoo ever.” Madison got her head tattoo on May 4, 2023. She said: “I called my tattoo guy, Nick, and asked about his availability. “I decided on what I would get the night before, I wanted the sun on my head. “I don’t know where I was coming from, but I wanted to get something happy.” Read More Janey Godley shares heartbreaking cancer update as husband reacts: ‘I thought he was being sick’ Woman diagnosed with skin cancer after spotting telltale sign in selfie Hairy Bikers star Dave Myers says one food has helped him return to work after cancer treatment Janey Godley shares heartbreaking cancer update as husband reacts Hairy Bikers’ Dave Myers says one food has helped him with cancer recovery Mother left ‘looking like Freddy Krueger’ reveals first skin cancer warning sign

RuPaul’s Drag Race star and actor Nick Collier, who performs as Dagenham drag queen Ella Vaday, is embarking on a 100km trek with CoppaFeel! alongside celebs including Frankie Bridge and Giovanna Fletcher. The 100km trek is raising funds for breast cancer support, and as his mother has been suffering from breast cancer since 2021, Collier is eager to do his bit.The Drag Race runner-up is really close to his mum. “I am the eldest of three, and me and my mum are very similar in many ways. I left home at 16 to train in dance and musical theatre, but I am always looking out for my mum.” “She has had breast cancer since 2021. She’s actually just finished her treatment and she is nearly there with injections,” he explains. The opportunity to take on this adventure and raise some funds “came at a really great time,” for Collier. “It’s nice to celebrate my mum, as she has had cancer for a second time. This is my way of giving back, celebrating her journey and also putting myself to the test and raising some money.” Many may be thinking the hardest part of this trek would be the actual walking, but as a former dog walker and fitness fanatic, Collier isn’t worried about the fitness aspect, instead, his concerns are “the weather and… sleeping in a tent. I am not looking forward to that, but I am bringing the camp to the campsite,” he jokes. This year, he has taken some time to really focus on his fitness and wellbeing, and is “in the gym five days a week,” improving his strength and stamina as a performer. Since he trained as a performer at Bird College, he has been keen to look and feel good. Collier has faced the physical demands of Drag Race and taken on that challenge, reaching the final. And, with hindsight, he sees just how intense and physical that challenge was. In the competition, he flawlessly impersonated much-loved British culinary sensation Nigella Lawson, performed showstopping live vocals and even dressed up as a striking Dagenham Ford worker. “It was so full on, so intense. You don’t see half of what goes on, with the early mornings and long days, the lack of connection to the normal world. There are elements of mental and physical fatigue,” Collier shares. “It was the best experience ever and I feel like the trek will be similar.” But, ahead of the finale, disaster struck Collier as he sustained an injury to his back. “I was injured for the finale and the morning of the finale I couldn’t even put my socks on, but I had no choice but to get through filming. “That was a moment I had to fight through, to be able to get home to see my partner, Marco, and my family.” Having performed on the West End for several years in shows including The Book Of Mormon and Wicked, while also running his dog-walking business, Collier is no stranger to hard work. His resilience and ability to push through tough times is a trait Collier is proud of, one that will support him in his trek and one that he believes he has really acquired as an LGBTQ+ person. “We have always been faced with obstacles, the first being having to come out, which really sucks,” he explains. “The fact I have to tell people what my sexuality is, is an obstacle. Discovering your identity when you are put in a box, is an obstacle to overcome.” He has also found that despite the acceptance of LGBTQ+ people in the entertainment industry, “in the acting world, as an outwardly gay person, it is hard to get chosen for straight roles and it is really frustrating sometimes,” he explains. This June, Nick Collier will be completing the ‘CoppaTrek! with Gi’ in Hadrian’s Wall Country alongside Giovanna Fletcher, to raise vital funds and awareness for breast cancer charity, CoppaFeel! To donate, please visit coppafeel.org/give. Read More Charity boss speaks out over ‘traumatic’ encounter with royal aide Ukraine war’s heaviest fight rages in east - follow live A beginner’s guide to topiary Irish premier Leo Varadkar’s partner apologises for ‘poor judgement’ coronation posts 9 actually useful things you can do to support teens this exam season

A woman who was left “severely epileptic” following multiple brain surgeries and whose seizures often leave her “black and blue” has said “Specsavers saved (her) life” as she had four unexpected and “frightening” convulsions during a routine eye examination and they were able to deliver first aid in her home. Jackie Rice, 56, who lives with her partner of 13 years Louise Cartwright, 55, who is paralysed and uses a wheelchair, was diagnosed with epilepsy about three years ago. As a result of her condition, Jackie, who lives in Harrogate, North Yorkshire, said she takes up to 20 pills every day and does not leave her home as she is “too frightened” that she will have a seizure. She cannot cook as she may burn herself or “set fire to (her) place” if she has a seizure; she has lost her driving licence, and she often sustains severe bruising from “smashing (her) face and head” during convulsions. Her seizures often cause her to wet herself as well, which she said is “embarrassing”. Because she is afraid to leave the house, she is reliant on the support of remote services, such as the Specsavers home eye tests, and is visited by a carer once a week . It was during a recent sight test visit that she had several epileptic seizures and started “banging her head against the wall”. Although she has no memory of it now, she believes she “would have been dead” if the Specsavers team had not visited her home that day. “They saved my life,” Jackie said. “My partner was in a different room, waiting for a carer, so she couldn’t help – it was awful. “I would have been dead – there are no two ways about it because there was nothing Louise could have done.” Nearly three years ago, Jackie said, Louise found her “unconscious in bed” as she had “collapsed”. After being taken to hospital, it was discovered Jackie had a hearing infection and three abscesses on the brain, which she believes were left undetected for a while. Jackie, who does not have any children and no longer works, remained unconscious and underwent three brain surgeries before waking up at Leeds General Infirmary (LGI) three weeks later. She said the procedures have left her deaf in her left ear and severely epileptic, and she now has about one seizure per week. “Four weeks after I had to put my dog to sleep, that’s when Louise found me,” Jackie said. “When I came around, I didn’t know where I was, I didn’t know who I was, or anything. “Because of the operations on my brain, it sent me delirious.” Jackie said she was told she tried to climb out of a hospital window during the recovery period, and she was not discharged until three months later. As a result of her epilepsy diagnosis, Jackie said she now takes up to 20 pills every day, and only leaves the house, accompanied by a carer, for necessary appointments or check-ups. Jackie said she does not know what triggers her seizures, but they often leave her “black and blue”. “The seizures come out of nowhere,” Jackie said. “I’m just recovering from a seizure at the moment – I have black eyes, a busted head and a banged-up face. “I’m black and blue again.” She said she spends her days with Louise, playing Candy Crush on her phone and watching sport on TV – she is a huge Liverpool Football Club fan. She is reliant on remote services to help her look after her health and wellbeing, but she never anticipated that she would have multiple seizures during a recent eye examination at home with Specsavers. All she can remember is starting the eye test and then “coming round in hospital three days later”, which she said was “very scary”. “It really does scare you when you wake up,” Jackie said. “I just thought, oh, where’s Louise? What’s happening? “You have no recollection of where you are.” Domiciliary optometrist Paula Conway, 52, who works for Specsavers based in York, covering the North Yorkshire area, remembers the day vividly. She and her optical assistant Charlotte Wilson visited Jackie’s home on January 13 for the routine eye examination. Just days earlier, on January 9, Paula explained that they had undergone first aid training from instructor Karl Whittaker at St John Ambulance. Little did Paula know that this training would be invaluable when visiting Jackie, as Karl talked in depth about what to do in the event that someone has a seizure. “I was about to proceed with the sight test and, all of a sudden, she just started rocking backwards and forwards, and I just thought, oh, this looks like a seizure,” Paula said. “She started to bang her head against the wall, so I managed to get a cushion behind her, and I knew I had to move all the objects out the way.” Paula said Jackie had four seizures “one after the other”, but with the support of Charlotte, they were able to put a duvet cover down on the floor to protect her. They then placed her in the recovery position while she was unconscious and called for an ambulance, after which paramedics arrived and took Jackie to hospital. While Paula and Charlotte were able to “stay calm” and keep Jackie safe during her seizures, Paula said it was an “extremely frightening experience” and they “both felt quite shaken afterwards”. “I think it was just really lucky that we were there, and we knew how to handle the situation,” Paula said. “Without the first aid training, I really don’t know what we would have done, it could have been a completely different situation altogether.” While Jackie does not remember what happened, she said the team “saved (her) life” – and she feels “very lucky” that Paula and Charlotte were there that day. She has since given them a bouquet of flowers, as a token of her appreciation, and wants to raise awareness of the Specsavers home visits team and the importance of first aid training. “I’d like to say thank you to the team for saving my life and for looking after Louise,” Jackie said. “If they hadn’t have used first aid, I don’t know what would have happened to me, so I think everyone who does home visits needs to have first aid training. “I didn’t know I was going to fit that day, I never know, so it could have been a very different outcome.” For more information about Specsavers home eye tests, visit www.specsavers.co.uk/home-eye-tests. Read More Blind people at risk due to ‘inaccessible’ health information from NHS, charity warns WHO issues warning over using sweeteners for weight control How to check if you have skin cancer: Symptoms and signs to look out for Charity boss speaks out over ‘traumatic’ encounter with royal aide Ukraine war’s heaviest fight rages in east - follow live

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