Misconception that matters

Mon 12th May 2008 by Ben Palmer.

When I picked Emily up from school this afternoon (and I can hear what she'd say to me here, "It's not school, Daddy, it's NURSERY school") I said hello to the head teacher as Emily came rushing out.

"I saved this for you," she said, "It's missing a bit but I thought you'd be interested." She handed me a pulled out spread from a newspaper.

When I got home I started reading it. It was an article from Times2 last week, Save the independent midwife, along with a personal tale, right at the end in the on-line version, written by a mother, Alex O'Connell, who had had a horrific first delivery, and had opted for a home birth the next time, assisted by an independent midwife.

I finished reading it on-line and something jumped out at me. It was the reference to Alex's post-puerperal fever after discharge from hospital first time. How lucky she was that it only took two doses of antibiotics to shift it, and how wrong she was to assume that the lack of infection second time around was because she was far from a maternity ward.

Yes you can acquire an infection in hospital - MRSA, C diff etc - but puerperal/childbed fever is not a hospital acquired infection - it is caused by community bacteria, and nobody is safe. I'm going to go on and on saying it. I'm even going to shout it. NOBODY IS SAFE FROM THIS HORRIFIC DISEASE, whether they deliver in hospital, a birthing centre, their own bedroom or the back of a taxi.

It doesn't matter whether they are young, old, fat or thin. It  doesn't matter if the midwife is independent or NHS employed, it just matters that the symptoms are spotted in time to give you your antibiotics.

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Headed paper

Sat 10th May 2008 by Ben Palmer.

I had a letter from my MP yesterday. I'd had a meeting with her a while ago, and we've exchanged several letters and emails. She, along with other parliamentarians, is committed to helping Jessica's Trust, and wrote to Alan Johnson, the Health Secretary to ask for a meeting. His reply was attached to the letter.

Although he didn't say yes or no to the meeting, his letter was encouraging: pointing out that I had already met with the National Clinical Lead for Maternal Health and Maternity Services, had had a productive meeting and have an open line of dialogue.

What was really encouraging to hear, on headed paper, was that "We value highly the work of Jessica's Trust" and that he hopes that the Trust will "play an even greater role in reducing the number of deaths from [childbed fever]" based on the existing relationship with the Department of Health.

I'm encouraged as this is a much more positive governmental acceptance of the need to do something about childbed fever than I have had to date. I believe that there is the desire for change, even if it is taking Jessica's name to achieve.

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Don't test, tell

Thu 1st May 2008 by Ben Palmer.

Back in January, I wrote in the blog about Screening for Group A Strep (GAS). Since then I have thought about it a lot, and discussed it with various medical professionals.

I am convinced it is a worthless exercise. Worse than that, it could be dangerous. Why?

A woman can be colonised with GAS at any point in her life*, let alone in her pregnancy or puerperum, so all a test would do is say that she does or does not carry the bacteria at this very point in time.

What if she was colonised the day after the test? She would have been given a false sense of security by a negative result. If GAS was only introduced some time after delivery, and it caused a genital tract sepsis, the last thing on her mind would be childbed fever, because she was 'clear'.

It is of far more value to skip the testing and instead take every woman's temperature and pulse regularly in the days after delivery. Then tell her about the condition and how to recognise that she might have it. She must also be told of the vital importance of being seen, swabbed and treated if infection is suspected, before her health and her life are in danger.

* up to 30% of us may be carrying Group A Strep in our throats or on our skin

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Time for T

Mon 28th Apr 2008 by Ben Palmer.

A little over seven years ago, Jessica met a group of fellow first time pregnant girls at her first ante-natal class.

Two girls emigrated, but five of them went on going to the classes, every week for six weeks or so. The classes came to an end and one by one they gave birth within the space of a few weeks: four boys and a girl.

The five of them continued to meet every week, usually for lunch on Wednesdays, until the children started going to nursery school. The meetings became more irregular, but they stayed in touch and sometimes us Dads joined them for dinner. In the years since, the number of children has grown to eleven.

Since Jessica's death the girls have welcomed me into their group as an honorary Mum, and have supported me hugely in the years since. Her death could not have affected them more - they were such a close knit group.

Today we formed a new group of our own: Jessica's Trust is now formalised with the five of us as trustees. The change from 'trust' to 'Trust' in the masthead reflects this.

I am hugely grateful to the girls for agreeing to help me. There is much to be done, but first we apply to become a Registered Charity.

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A chilling hot lunch

Tue 22nd Apr 2008 by Ben Palmer.

I had lunch with two of Jessica's girlfriends today. Soup and garlic bread in the glorious sunshine, and really nice to see them both.

We were talking about Jessica and her trust, and in the course of the conversation I fetched a copy of Saving Mother's Lives 2003-2005 to illustrate a point. Then something I had looked at again and again jumped out and smacked me in the face.

In those three years, the leading direct cause of maternal death was thrombosis/thromboembolism with 41 deaths. The second highest place was tied, 18 deaths apiece, between pre-eclampsia/eclampsia and Genital Tract Sepsis. (=childbed fever/puerperal fever/puerperal sepsis)

Why is it that pregnant mothers are told about, warned about and aware of pre-eclampsia (some antenatal classes are especially good at letting you know it's a danger, even if you're not totally sure what it is) but nobody tells you about childbed fever, even though it is just as much of a danger?

After an involuntary shiver, they agreed to join me in trying to change that.

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Update

Wed 16th Apr 2008 by Ben Palmer.

I've given the navigation menu a makeover today, allowing for greater flexibility and more space for extra pages.

Not a great deal of extra information to put on the site just yet, but there is a new Information for Parents page, lifted from the new leaflet which, together with the poster, is hopefully almost ready for release.

Hopefully more information and some great news soon.

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Taxing talk

Wed 16th Apr 2008 by Ben Palmer.

Harry and Emily love art. They love SMart and SMarteenies as well, and regularly watch more CBBC than CBeebies now, often catching Newsround. However, I don't know if they saw the coverage of Mark Speight's death on the programme.

The coverage, which I also missed, has evoked much sentiment and anger, I read. Why is this? Do we think that children cannot cope with death? Must we shield them from All That Is Bad?

What then when it happens closer to home? How will they cope with it?

It is important for children to understand the process of life, of aging and of death - but we can teach them this without instilling fear and uncertainty, without the gore and trauma, and without the stigma of suicide in this particular case. Which is what I understand the BBC did.

It can't be better to say nothing, even when they notice that a presenter has left their favourite program without saying goodbye - that would be too big a betrayal of their love and confidence.

Children are wiser than we sometimes credit them for, and they need to understand, but in a way that makes them feel safe and loved - even if that means we do have to face up to our own fears and insecurities.

There are only two certainties in this life, and children really don't need to know about tax just yet - that's too cruel.

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No crawling

Tue 15th Apr 2008 by Ben Palmer.

So, the man from the big company came and looked at my floorboards yesterday - the ones outside the house that I replaced last week - and confirmed woodworm. 'The quickest survey I've ever done,' he told me. He did examine the rest of the floorboards, upstairs and downstairs, and has prescribed 'fogging' under the ground floor. The rest of the house has a clean bill of health, fortunately.

His array of quotes, measurements, costings and policy documents covered the kitchen table as he gave me a not-unreasonable quote, which I accepted there and then. 'The sooner the better,' I said to him, and so the men in masks come tomorrow.

I was worried about the effects that wood-boring critter-killer would have on small children, but the answer was reassuring: 'Just don't let your children crawl under the floor for 24 hours, that's what Health & Safety guidelines say.'

This morning Harry went back to school, but could we find his holiday homework folder before he went? Not a bit of it.

My best guess is that it got swept up with quotes and policies, so it was interesting explaining to the Form teacher today, 'Harry did do it, but we can't find it... We think the wood worm killer has it by mistake.'

At least it's more original than saying that the dog ate it.

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Inquiry into deaths of three new mothers - Telegraph

Mon 14th Apr 2008 by Ben Palmer.

Inquiry into deaths of three new mothers - Telegraph

Necrotising Fasciitis is most commonly caused by Group A Streptococcus, which is also the most common cause of Childbed Fever. It's a pity the article doesn't make the link and say that's what it is, but 'flesh-eating bacteria' sounds nastier, doesn't it?

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BBC NEWS | Health | Care not top priority - NHS staff

Wed 9th Apr 2008 by Ben Palmer.

Link to article: BBC NEWS | Health | Care not top priority - NHS staff

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What is childbed fever?

Childbed fever is an infection of the womb in new mothers which can lead to septicaemia. If left untreated infection will cause organ failure and death - even in young, fit mothers.
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What are the symptoms? »
Childbed fever: the facts »

What's the aim?

We would like every parent and every midwife and doctor to know that childbed fever is still a very real threat to a mother's life.
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Can I help? »

Who is Jessica?

Jessica Palmer was a Mum. She died in June 2004, at 34 years old, of childbed fever caused by Group A streptococcus.
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This website contains general information about childbed fever. The information is not complete or comprehensive. You should not rely on the information on this website as an alternative to medical advice from your doctor or healthcare provider. If you have any specific questions about childbed fever (or any other medical condition) you should consult your doctor or other healthcare provider; and if you think you may be suffering from childbed fever (or any other medical condition) you should seek immediately medical attention. You should never delay seeking medical advice, disregard medical advice, or discontinue medical treatment because of information on this website.
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