There's been a fair bit of news recently (see here and here) about two poor mothers who gave birth on the same day, in the same hospital, and who both died within three days, just before Christmas. The coverage has focused on the fact that they both had a Group A Strep infection, and there has been much talk about infections (hospital and community acquired) and superbugs.

Luckily, it was acknowledged that GAS is not a superbug and that it is treatable. Unfortunately there was no mention of the fact that these two women died of Childbed/Puerperal Fever, and that it is a well documented and once much feared condition that should not be killing any more.

My heart goes out to these women and their families - how well Harry, Emily and I know their pain and confusion.

I have failed in my New Year's resolution to give up smoking (sorry, Harry) but am so far succeeding in my second - to tidy, sort and organise the house better. I also have a third: to step up the campaign to raise awareness of childbed fever. 2008 was always going to be a big year with the launch of my book, Friday's Child, in June but I want to make more noise and more of a difference than just that.

Thanks to a very kind person who has offered her professional help at no charge, I just may be able to. Many others have also offered to help, and I'm sure I'll be in touch.

Christmas can be so fraught with problems and worries.

The children went shopping today, and I was brightly told that they'd bought me a Christmas present together.

"Do we have any wrapping paper, Daddy?" Harry asked at bedtime.

"Yes, snuggle down now and sleep tight - you can wrap it up tomorrow."

Half an hour later, there were tears and foot stampings. It transpired that the present, previously hidden from me in the wardrobe was missing a part and it didn't flash so it was 'no use'.

"For goodness sake, Harry, you can sort it out tomorrow when Carly (our nanny) is here. Snuggle down and sleep tight."

Twenty minutes later and the bathroom door slammed to much wailing; "It's no use it's broken and we don't need it now anyway."

When I had finally persuaded him that we could sort it out tomorrow and take it back to the shop if necessary, he unlocked the door, wiped his tears on his sleeve and sniffed. Then the little package slipped from under his foot and fell through the floor boards.

"GET IT OUT DADDY."

Mercifully, I could get a coat hanger through the floor boards and hook it into the rail slot at the top of the tiny plastic bag. I promised I wouldn't look, but it was hard not to see what it was as I was retreiving it from the floor, and before I handed it back to a tucked up Harry who'd already found the part that had fallen out.

"Do we have any present labels, Daddy?"

"Yes, Harry, tomorrow. Goodnight."

Now I can't wait to unwrap my flashing badge that says 'World's Greatest Daddy'. I feel all the excitement that I did when I was a six year old, and I'm hoping that's this Christmas' high drama point over and done with.

Harry and I have just been to watch Emily's nursery nativity play. After the wise men had visited Joseph, Mary and baby Jesus in the stable and the Innkeeper had given up all hope of getting back to sleep, Emily arrived on stage as one of the angels.

She walked past us looking beautiful and so pleased to see us; trying to balance some serious acting and a big grin. When she stood on the walls of the stable she was quite definitely the best angel on the end of the line to the far right.

Nursery was collecting for Winston's Wish 'Wish Upon A Star' campaign afterwards. When I'd added a contribution, Harry wrote on a star. "I miss you Mummy love from Harry" and "I miss you Mummy love from Emily" before we stuck it onto a skyscape poster on the door. They were both really pleased, but in the car afterwards Emily burst into tears.

Silly Daddy thought she was saying, "I want my muzzy," when anybody could tell it was Mummy that she wanted. During the rest of the conversation, we decided to head over to the Winston's Wish website after tea, and create a star. Then we'll tell Mummy all about the play and how good Emily was.

"Cos, Daddy, Mummy's with the angels, so she'll know," Emily told me seriously, still with a tear on her cheek.

I have now downloaded a copy of "Saving Mothers' Lives" and am reading through it. A few paragraphs under the Genital tract sepsis chapter have caught my attention:

"As in previous Reports there was failure or delay in diagnosing sepsis, failure to appreciate the severity of the woman’s condition with resultant delays in referral to hospital, delays in administration of appropriate antibiotic treatment and late or no involvement of senior medical staff. There were some cases where doctors said they were already so busy dealing with other urgent problems that they were unable to see women for some time after admission. It was also clear that many doctors, midwives and community midwives were unfamiliar with the signs and symptoms of sepsis, did not realise when a woman was deteriorating or critically ill and failed to appreciate how quickly the clinical condition of a septic woman can deteriorate. There were also failures to take routine basic observations, to recognise abnormal fetal cardiotocograph (CTG) patterns and to ask for senior advice at an early stage."

"These cases of classical puerperal sepsis due to Group A haemolytic streptococcal infection demonstrate that by the time sepsis is clinically obvious, infection is already well established and deterioration into widespread septicaemia, metabolic acidosis, coagulopathy and multi-organ failure is very rapid and often irreversible. The best defence against this situation is awareness of the early signs of sepsis and early recognition by routine regular basic clinical observations. Earlier detection of pyrexia might have made a difference in these three cases. Postnatal observations of pulse, temperature, BP, respiration, and lochia should be done regularly while the woman is still in hospital and for several days after discharge by her community carers. This is particularly important in women who leave hospital a few hours after birth, ‘early discharge’, or if a woman complains of feeling feverish or unwell."

"In the past, puerperal sepsis or ‘childbed fever’ was a leading cause of maternal death and its signs and symptoms were widely known. Antisepsis, antibiotics and changing practice over the years mean that genital tract sepsis has become much less common and death is rare. The fear and respect with which it as held in the past by obstetricians, midwives and patients has disappeared from our collective memory. Action is now required to raise awareness of the signs and symptoms of sepsis and recognition of critical illness among staff in maternity units or in the community, Emergency Departments, and among GPs and health visitors.

The cases in this Report clearly demonstrate that genital tract sepsis is still a problem, that is repeatedly missed and there is often failure to treat women early and aggressively enough. Some of these maternal deaths may have been prevented if the signs and symptoms of sepsis and developing septicaemic shock had been recognised and treated earlier. Nevertheless the clinical picture of life-threatening sepsis often develops very rapidly and in many of the cases the outcome could not have been prevented."

There are more sections that could well have been cut and pasted from the previous report. And the one before. Why did I ever wonder if there was a point to raising awareness of sepsis? I have a very strong sense of deja vu. I hope these recommendations are followed in the future.

I feel full of despair. Although I haven't seen a full copy of the Saving Mothers' Lives report, I have had sections of it read to me, and other parts have been reproduced in various news articles today - most probably from a heavily edited press release.

All of the talk is of obesity and migrant mothers. This is a distortion of what I know to be true. When the report says that deaths due to substandard care have not risen, are we supposed to applaud the NHS?

Jessica died because of substandard care, from a disease that has been known about for hundreds of years, and is easily treated.

The number of deaths from genital tract sepsis (ie childbed fever, pueperal fever) has gone up by 38%. Is it just me that thinks this is a scandal, and totally unacceptable?

The sense that I am getting is that the NHS and the government are not bothered by the increasing death rate, are not bothered about a properly funded and properly run maternity service because the statistics meet some unknown target. Instead they are blaming us for their failure to be aware, to treat and to run a modern health service.

There is a twist though. Jessica was a petite, middle class, 34 year old woman. Her post mortem report, however, gives her height as 1.61m and her post delivery weight as 82kg. The NHS Direct website has just told me that this means that her Body Mass Index would be 31.6, which is classed as obese.

This is utterly ridiculous - she was anything but overweight, as anybody who knew her would testify to, and the clothes she wore pre pregnancy were size 8-10. I couldn't really believe that she would be classed as obese, so I referred to her medical notes:

In August 2002, when not pregnant, her GP recorded a height of 1.64m and a weight of 55kg. This gives a BMI of 20.45 which is an "ideal weight".

In April 2004, when seven months pregnant, she was 61.9kg (and presumably still the same height) which gives a BMI of 23.01 which is still an ideal weight even for someone who isn't pregnant.

Somewhere between April and June she apparently lost 3cm in height and gained 20kg, even after Emily was delivered, making her an obese statistic. How many other anomalies are there in "Saving Mothers' Lives" that enable them to blame mothers for their own maternal death, I wonder?

What a whirlwind. After yesterday's Independent article, and with the impending release of 'Saving Mothers' Lives', I have been flooded with requests for television interviews on morning TV and news programmes.

Part of me wants to do them, even though I can't do them all.

The increase of sepsis, both in numbers and as a percentage of all maternal deaths tells me I need to be campaigning as hard as I can, but its stirred up a lot of feelings. Jessica is one of the statistics that the report covers, and it has all come flooding back to me - the pain, the fear and the total bewilderment after her death.

I'm just not up to it at the moment, and it sounds like the news coverage is going to be good anyway, with or without me, but I'll bounce back to fight another day.

CEMACH's latest triennial report, now called 'Saving Mothers' Lives' is due to be launched on Tuesday. As I heard on Friday, the Independent on Sunday has seen an advance copy of its findings.

The bottom line is that, overall, maternal deaths are up 13% from 261 (2000-02) to 295, and deaths from genital tract sepsis are up by a staggering 38%, from 13 to 18. The full Independent on Sunday article, Mothers at risk: Britain's real labour crisis, is on their website to read.

There seems to be some confusion within the government about the true picture - the Health minister, Ann Keen, seems to think that this means we have a death rate of 7 per 100,000 pregnancies, but the real figure is 13.95 per 100,000. How much longer can they keep burying their heads in the sand?

We need to take control, as parents, and show the NHS and government that we are not prepared to slide further into this third world state, and that no more unnecessary maternal deaths are acceptable.

I encourage you to write to your MP and let your feelings be known.

I went out to dinner with the Mums from Harry's class again last night. It was a good turn out, a newly renovated pub with good food and a steady flow of wine and conversation.

At one point talk turned to Harry and how he has coped with not having a Mummy, and one of the Mums told me about a telly program, The Mummy Diaries in which Julie Stokes, the founder of Winston's Wish, helps young families cope with their mothers' terminal cancers.

Purely by chance, because I wasn't looking for it, I flicked over to it tonight just as the last of the three programmes in the series was starting. It was a gentle and beautiful programme about some very brave people. In their planning and understanding of the possible death of Mummy I could see so much of our family since Jessica's death - the same fears and worries were there.

I am humbled by some of the bravery I have seen. Children are stronger, more resilient and wiser than we adults may always credit and I am proud to be made aware of how well Harry and Emily measure up in those respects.

Next time we get together as a class, we're going to try and get the Dads to come along as well.

I've been circumspect about what I've up to for a while, but after a very good meeting with my editor last night I can finally say what Project X is. I've written a book: Friday's Child, A Devastating Story of Love, Loss and Hope.

Six months after Jessica died I starting writing down what had happened to her and what it was like for us, so that Harry and Emily would one day have all of the facts in their hands. The thought of them knowing what happened to their mother breaks my heart, but it is their right, and I have always wanted them to know what they went through, when they are older. Already they don't fully remember.

To start with it wasn't going to be a real book - but as it developed, and as I told people that I was writing things down for the children, some of them suggested that it might have a wider appeal.

My reason for publishing is simple. The more people that read the full version of what happened in June 2004 and the years since, the less chance there is of it happening again.

Friday's Child will be published in June 2008.

At long last the Government has posted its response to the petition I started seven months ago.

I never expected there to be any sort of substance to it, but even so it is still alarmingly arrogant:

"Maternal deaths in the UK are extremely rare. Each is a tragedy, which is why the Government takes any maternal deaths seriously and funds the Confidential Enquiry into Maternal Deaths (CEMD). Each avoidable maternal death is one too many."

Funding the CEMD is not actually taking action. The CEMD only produces a report of recommendations. With regard to sepsis, it has been making the same recommendations in report after report, to little or no effect. The incidence of sepsis/childbed fever/puerperal fever/whatever you care to call it has been rising since 1984, and a worrying number of healthcare professionals are ignorant of its cause, symptoms and devastating outcome.

"In the last published report of the CEMD for 2000-02, only five of the 13 women who died from infection, out of more than the 2million who delivered safely, died from what is known as puerperal fever (sometimes also known as child bed fever) after a normal delivery."

The other eight women died of the same disease, with the same symptoms, their deaths are just labelled differently because they had a caesarian. Their lives are just as important, which is why I prefer to include them and talk about 13 deaths (which accounts for 12% of all deaths that were a direct result of pregnancy/delivery during 2000-2002.)

These deaths are avoidable, so saying that it is a small proportion of the safe deliveries is arrogant, insulting and misleading. None of those women should be dead. It is not an acceptable percentage of risk. When talking about a life, one is too many. This point was made in the first paragraph of the response, but obviously not meant as it was countered by this statistic. It sounds pretty much like Ivan Lewis' response to a parliamentary question my MP tabled.

"The CEMD's next report, Saving Mothers' Lives, due to be published on December 4, will update healthcare professionals on clinical guidelines for the management of serious illnesses affecting pregnant or recently delivered mothers. The recommendations of the report are circulated to all maternity professionals and, in future, their implementation will be audited by the Healthcare Commission. Since the last report was published, the National Institute for Health and Clinical Excellence has also published clinical guidelines for both birth and post-natal care."

The CEMD's next report will again report on the mothers whose lives were not saved, including Jessica. The title of the report is again misleading and insulting spin. I have written about it before, here. The bottom line though, is that it will be another report full of statistics that won't actually address the issue or achieve anything. See above for comment on the perpetual lack of attention to these reports.

All I wanted was the Government's recognition of the unnecessary waste of life and a positive determination to drag us out of the dark ages and protect our mothers. Tonight I feel stupid for even bothering to hope for that. Tomorrow I'll do something myself.