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.

BBC South Today has tonight reported further in the aftermath of the two tragic deaths at The Royal Hampshire County Hospital in Winchester.

The hospital has, to reassure its patients, implemented a screening programme for Group A Streptococcus, but it doesn't plan to continue with it beyond the short term.

So, is it just a PR exercise, or is this test an accurate and useful weapon against childbed fever (still nobody calls it that, it is still 'complications caused by...') There may 'only' be an average of six maternal sepsis deaths a year, but even one avoidable death is enough to warrant prevention, isn't it?

If the test is not accurate then why are they doing it? If it is not 'cost effective' to continue it or take it nationwide, does the NHS not consider what yet another death could cost it?

If there was anything that could stop mothers dying, surely a responsible government would want to implement it, when 30% of the population carry Group A Strep?

I hear so many stories from mothers who have only just survived a Group A Strep infection that, if the problem is not taken seriously, it will be a time bomb that we are sitting on.

If only infection rates were measured and not just deaths - this is a far more common problem than we are led to believe.

Watch the BBC's report 

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.

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?

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.

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.