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British maternity wards in crisis

… in light of the recent CMACE report, Saving Mothers' Lives 2006-2008 which tells that sepsis now outranks even pre-eclampsia and eclampsia as the leading direct cause of maternal death. Deaths due to sepsis have risen from 18 in 2003-05 to 26 in 2006-08* - a staggering 44%.

Is it any wonder that we have headlines like this one:

British maternity wards in crisis - Health News, …

Maternal deaths are an outrage

"In the 21st century, no woman should have to give her life to give life."

U.N. Secretary-General Ban Ki-moon ( Reuters 19 May)

"We must find a way to get maternal mortality recognized as a key indicator of a functioning health system. Let us work together to make sure maternal mortality is a …

MEOWS: Recommended

… top 10 recommendations to save mothers' lives in it's 2007 report, using prevention of deaths from sepsis as an example:

Early warning scoring system

9. There is an urgent need for the routine use of a national obstetric early warning chart, similar to those in use in other areas of clinical practice, which can be used for all obstetric women which will help in the more timely …

Life saving treatment wanted asap

… I am not an advocate of prophylactic use of antibiotics, indeed more women than are saved from sepsis may die of allergic reaction.

As for benefitting only 1 in 500,000 - how wrong is this. Purely looking at sepsis, in 2003-2005 the Confidential Enquiry into Maternal and Child Health recorded 18 deaths (0.85 per 100,000) from Genital tract sepsis (GTS). This would be 4.25 per 500,000, but …

Thank you so much

… days.

So far, the NHS does not have a clear set of guidelines for the detection and treatment of sepsis which, together with the use of MEOWS, would greatly reduce the chance of severe illness and/or death.

I also believe, without for a minute wanting to alarm or create terror, that all mothers and their partners should know of and understand the risks of a uterine infection, so that instead …

Don't miss the bear

… trusts. We need to ensure that women are aware of risks & that there are guidelines for e.g. sepsis in pregnancy.

Thank you to CEMACH for inviting me to speak, and for permission to use these comments.

[It has to be said, it's more of a surprise if the video isn't titled before you watch it!]

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… and advice on the recognition of childbed fever (also known as puerperal fever and genital tract sepsis) and that doctors and midwives are given clear sepsis guidelines."

More information

Childbed fever is a serious form of postnatal septicaemia which can lead to toxic shock syndrome, organ failure and death.  In 2003-05 sepsis accounted for 14% of maternal deaths in the UK. A …

She doesn’t know her mother is dead

… across a heart rending story about Karmeh, who still doesn't know her mother died of post-partum sepsis.

Developing world childbirth is far, far more dangerous than it is, for example, in this country, but I believe that charity begins at home and that means fixing the problems at home as well. The work that so many organisations - such as the White Ribbon Alliance - does is vital, but …

1-2-3, Go

… should be in use nationally. Mandatorily and now.

3. Every doctor and midwife to have a clear sepsis guideline.

It is lamentable that such does not exist. I'm going to add our voice to those already calling for it.

We acknowledged that finding time to work on Jessica's Trust can be hard at times, but the passion is there, and the open line of communication with CEMACH just may give it …

MEOWS

… idea is, a mother who is developing a critical condition will be treated before it is too late.

Sepsis (for example) is often already life threatening by the time it is clinically obvious. Therefore the best opportunity to intervene is based on the early warnings.

These charts are not routinely used, though. Some units do use them, others are looking at using them, and I believe there may …