Showing posts tagged with: 'campaign'

Unfamiliarity breeds infection

Wed 5th Dec 2007 by Ben Palmer.

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.


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Masses of bodies

Tue 4th Dec 2007 by Ben Palmer.

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?


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Mon 3rd Dec 2007 by Ben Palmer.

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.


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Dying to be a mother

Sun 2nd Dec 2007 by Ben Palmer.

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.


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The petition's response

Wed 14th Nov 2007 by Ben Palmer.

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.


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End of Act One

Sat 13th Oct 2007 by Ben Palmer.

So the petition closed last night. 3,880 people signed it and Thank You to all of you who did. It reached number 48 in over 8,200 petitions, and was 12th in over 1,000 Health related petitions, which shows how much we mind about our Mums.

I wish I'd been able to tell more people that it was there for the signing - if I had I know there would have been even more signatures. I look forward to hearing the government's reply to it. (A response to any petition with over 200 signatories is promised.)

It is not the end though. The objective wasn't to get thousands of signatures, but to save lives, and the work will go on.

I have to mention some fellow bloggers. These ladies have really helped by condensing this website into one succinct post, and have written more eloquently than I could have hoped for. In chronological order, thank you to:

BreastfeedingMum, LittleLegends, Manicmama, IngeniousRose and 21st Century Mummy

Thank you also to everyone who has emailed their friends, posted in a forum or mentioned this website on their own site or over a coffee.

Please, don't stop helping to save a mother's life. We can do it, one at a time.


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Hair today

Sat 6th Oct 2007 by Ben Palmer.

I've neglected the blogosphere a bit lately - I've just had too much to do, but now it's a quiet Saturday and the supermarket has been suitably raided for the week, calm is (temporarily) restored to the Palmer house.

When I watch Harry on the sitting room floor, painstakingly drawing individual leaves on a tree, I am proud. When I watch Emily putting together an underwater scene jigsaw, with the six hair clips, two bunches, twelve hair bands, necklace and two bracelets that she made me put on her this morning, I am proud.

I couldn't wish two more beautiful, loving and kind children on anybody.

But I would do anything I could to stop the fate that has fallen on them from hitting another child.

To say "Goodbye, see you later" to your mother and go to nursery one morning and never see her again, to only be held by your mother for the first five days of your life is wrong. It is also unnecessary.

I hope that by speaking up I am making a small difference, but I won't rest until this country (at least) is free of this Third World disease of the Middle Ages. I loved my wife too much and I love her memory and our children too much.


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Karate slice

Mon 24th Sep 2007 by Ben Palmer.

While the pizza was in the oven tonight I ironed Harry's Karate Gi for tomorrow. That's not remarkable (or at least it shouldn't be) but what I was thinking while I steamed is.

I write, periodically, about some of the most intimate moments of my life, of Jessica's life and death. I'm used to that and it's a conscious decision, with a clear aim of trying to prevent it happening again to some other woman and her heart broken family.

What I never expected was to be inundated with emails and comments on this blog from other women who are prepared to share their equally intimate, graphic and heart rending stories of near disaster, pain and mistreatment.

I'm so grateful for all of this honesty and I hope that these stories as well as Jessica's will help to change things for the next mother, maybe for you.


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Petition - a final push

Mon 17th Sep 2007 by Ben Palmer.

The petition on the Downing Street website will close on 12th October. Please add your name to it, if you haven't already, and ask anybody else you know to do the same.

Already it is in the top 1% of all petitions, but there's still time to make it go higher with more signatures.

Every signature will help to make the Health Department take notice of this horrific illness and save mothers' lives.

Thank you for your support.


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Dear NHS, please wake up

Sun 16th Sep 2007 by Ben Palmer.


Aarrggh. I could scream.

I heard a story at lunch today that made my skin crawl. A mother (a friend of a friend and I don't know her, so I won't use specifics) was unwell a couple of days after delivering a baby in a London hospital. Told that she had tendonitis in her foot, she was sent home.

Progressively worse, she took herself to A&E and demanded to be taken seriously as she couldn't possibly be feeling that ill just because of a foot complaint.

When humoured by the staff and given proper attention, she was then told that if she was any more unwell she would have been dead. She was treated in Intensive Care for two and a half weeks and told that it might be up to a year before she was back to full health.

What (as if you need to ask) was wrong? She was suffering from Puerperal Sepsis. Childbed Fever. The hospital were amazed - they 'didn't think it still happened'.

When will somebody, anybody, wake up and listen? Mothers' health should not be ignored like this. Mothers do still get Childbed Fever, and yes, some of them do die. Those that don't seem to live by the skin of their teeth. I have almost lost count of the number of stories that I have heard in the last few years and although most (but not all) of these stories have happy endings, nobody, let alone a mother after childbirth, should be getting so ill in the 21st century.

If I've heard of all these stories, why hasn't the NHS, and why are they not getting the picture. How many more Jessica's have to die before they will?


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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.
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.
more »
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.
more »

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.