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.

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?

I've just read a good post on Mother at Large's blog about childbirth, pain and expectations about delivery.

It does sometimes seem as though birth has become a bit too competitive, and often I also hear talk of how quickly a mother was discharged, as though speed of discharge is a measure of success. What we shouldn't forget is that, while now comparitively safe, childbirth is a trauma and the historical and natural risks are still as present as ever they were.

While an extended hospital stay is not on anybody's wish list or birth plan, there is merit of staying in for days, rather than hours - as used to be the case. How better to pick up on the warning signs of a complication such as infection than by regular observations by a midwife?

But on that subject, all too often I hear that regular postpartum observations are no longer routine, unless infection is suspected - indeed the NICE guideline on Routine postnatal care of women and their babies [PDF] even says as much for some reason.

This is madness: how on earth is an infection going to be suspected early enough unless it's being checked for?

Another postnatal phrase I hear a lot of is: 'Mother and babe both doing well'. It's what everyone wants to hear and illustrates the feeling of joy and euphoria of a new and safe delivery, but a caveat: Childbed Fever can hit anybody at anytime - even weeks after a trouble free delivery.

I wouldn't want to cast a cloud over anybody's happiness, but never be complacent - please keep an eye on the symptoms, even if your midwife isn't.

We just had a lovely weekend away, and drove back to London, in heavy traffic, in time for tea. The trouble was, Emily and Harry were so worn out from all the fun that they slept most of the way back.

Roll on to bedtime, and Harry can't sleep. An hour of requests for a cup of milk, a footstep here etc etc, and suddenly it became a little sob from the top of the stairs, so I went up.

There he was, sitting on the step with his two photographs of Jessica laid neatly side by side; the ones that travel with him, and always sit beside his bed.

'I just want to talk about Mummy.'

'OK darling, of course we can. What would you like to talk about?'

'Why did Mummy die? What is an infection anyway? Why do people die too early? How did the doctors know she was dead?'

I tried to field the questions as best I could, in suitable language, without causing extra alarm, worry or distress, but still they came.

'What medicine did they give Mummy? How did she actually die? What other question would be a good one to ask, Daddy?'

I can't lie to Harry about what happened, he has a right to know. But not at six years old, surely? I can't even tell him that all of the answers lie in four lever arch files, each three inches or so thick, full of medical notes, charts, statements, legal and medical analysis and argument - he'll want to read it, and then he'll get angry when I don't let him.

All I can do is promise him that the doctors did everything they could to save his Mummy, after she was admitted to A&E and once in Intensive Care. This reassures him, even if his curiousity isn't satisfied.

One day he's going to ask about before she went to hospital, and he's going to be so angry.

'There's nothing we can do to bring Mummy back, Harry, but that doesn't mean we have to like it.'

'What's Jessica's trust, Daddy?'

'It's Daddy's work - trying to stop other Mummy's dying like yours did.'

'What is child fever, anyway?'

'Childbed Fever? It's what Mummy died of. It's an infection that can kill you after you have a baby.'

'Why Daddy? Why did God want Mummy to die? He controls everything, so he shouldn't have let her die.'

I wish I knew all the answers, like Harry expects me to.

I had a visit from the VAT Inspector this morning. I got a bit behind with my VAT Returns and they wanted to make sure I wasn't up to no good.

Business has been slow to non existant for the past few years, so it didn't take long and we soon started to talk about what I was doing now. I showed her the first proof of Friday's Child, explained Jessica's trust and gave her a card.

"Oh, I heard about childbed fever on Woman's Hour," she told me, both shocked to hear that Jessica was a victim, fully understanding about my change of direction, and also impressed by my home printed business card.

"Can I have another card, to give to my friend? And do you have a poster? I could ask in the office if I can put one up on the notice board."

I don't have a current poster, the only one I've ever designed was promoting the now closed petition to the Prime Minister, so I've spent the rest of the day designing a new one.

I think it's clear what the message is, I hope it's suitably targetted at Mums, but before I press print, I'd love to know what you think of it. Please leave your thoughts, good or not-so-good, and suggestions in the comments below.

If you have somewhere that you can pin one up I'd love to hear from you as well. When it's fully refined I can make a hi res download available. If anyone knows a friendly (read 'low cost') printer as well, I might get some properly done.

Download the new poster [Link removed  7/3/08 pending redesign]
Update 30/05/08: The new poster and leaflet are now on-line

Thanks to Virgin Books and my hard-working editor, Friday's Child is almost finished. It'll be ready to print in a few weeks, in time for the June launch. It's got an updated cover as well, and for the first time I've seen the full book jacket - now I can imagine it on the bookshelves. I hope the reviewers are kind, though - it's my life, my inner thoughts and feelings. I also hope that it changes people's understanding of this cruel, painful killer.

From the jacket:

'In the summer of 2004, Ben Palmer was overjoyed when his wife Jessica gave birth to a beautiful baby girl. Emily was their first daughter and a little sister for their three-year-old son Harry. They had everything they had ever wanted.

Six days later, Jessica died of childbed fever, an archaic illness that causes blood poisoning, a condition that can be easily detected and prevented.

This is Ben’s raw, moving account of dealing with his grief while raising two small children as a single parent, and of how he successfully sued the NHS for negligence. As he struggles to comprehend his loss and to care for their two young children, he is overwhelmed by shock, anger, despair and guilt, before finally finding hope in the future, thanks to the love and support of his friends and family.

A story of living with a cruel and needless loss, this is also a story of two people who loved each other for richer, for poorer; in sickness and in health; till death tragically parted them.'

Friday's Child is now available to order from Amazon

I've just been alerted to a Woman's Hour discussion on childbed fever this morning. I listened to a recording of it on the BBC website.

The author of a new book, The Bone Garden discusses childbed fever with the presenter and a professor, but in the context of the past. They highlight the pain and agony of dying from this terrible disease, and how doctors used to be the cause of epidemics - by spreading it - but unfortunately there was no mention of the underlying natural causes - so often Group A streptococcus, a community bacterium.

Towards the end there is recognition of the fact that 16 women died of it in the mid 1990s, and that one woman (Jessica, I wondered) died of it in 2004. Why not go further and quote the more up to date statistics of 1997-99, 2000-02 and 2003-05 or mention the two more recent cases of childbed fever in Winchester last December as well?

I hope that when Friday's Child is published I may get the opportunity to bring the story up to date and highlight its continuance.

This evening I created a new Facebook group, also called Jessica's trust.

For those of you who use Facebook, you may like to join the group, and help spread the word about our campaign to raise awareness of childbed fever by inviting your online friends to join as well.

Thank you all for your recent messages of encouragement, and thank you for your support.

This year I want to really widen the campaign efforts, and I've been really fortunate to have been introduced to a professional campaigner by my brother.

Gill Kirk of Lyric Communications is helping, pro bono, to plan and setup the next stages of the campaign, and we have many exciting ideas - so watch this space. A huge thank you to Gill for this.

In the meantime, I'd be really grateful to get a little bit of feedback to help us in our planning, so please spare a few moments to complete this survey - there are only a few questions!

Childbed Fever Awareness Survey

The Daily Telegraph has a story today, Midwives struggle in labour ward crisis. The Evening Standard has also run it, Shocking figures show mothers and babies are at risk due to chronic shortage of midwives.

This isn't a new story, but the figures go on and on showing the crisis that maternity services are sliding into.

I'm just glad it keeps popping up in the news. If there's enough pressure on the government and their promises, they might one day be fulfilled.

I believe that one answer to Childbed Fever (amongst other issues) is to have midwives with enough knowledge, experience and time to be able to spot the symptoms before they can become life threatening. If there aren't enough midwives, that certainly isn't going to happen.