Showing posts tagged with: 'death'


Why, Daddy?

Sun 16th Mar 2008 by Ben Palmer.

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.

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Intervention

Tue 29th Jan 2008 by Ben Palmer.

For the last two weeks we've been without our nanny, who's on leave. In the past, being without help for this amount of time would have filled me with fear, dread and at times depression.

For the first time since Jessica died I feel I am coping. Maybe it's because both children are at school/nursery during the weekday, but I don't think that's the extent. Possibly I've graduated as a Mum (albeit with a very basic level of qualification) or possibly it's because I also feel I'm able to help do something about the terrible condition that killed our wife and mother. Something, anything that prevents another's death is good.

Children's bedtime tonight was prompt and relatively struggle free, but Emily interrupted our bedtime rituals with, 'Daddy, I really miss Carly [our nanny] and Mummy.'

"We'll see Carly again soon, darling, and ..."

"But I still miss Mummy, Daddy."

"... we know we can't see Mummy, but we can look at her photograph, because she's safe in Heaven now. Mummy doesn't want you to be sad, Emily."

"Oww. But I reeeally miss my Mummy. I want to see her now, Daddy."

Even when they're without tears, these conversations leave me in no doubt as to why I want to start the ball of change rolling.

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Woman's Hour - Childbed Fever

Wed 23rd Jan 2008 by Ben Palmer.

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.

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Screen for GAS

Tue 8th Jan 2008 by Ben Palmer.

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 

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Wish upon a star

Sun 6th Jan 2008 by Ben Palmer.

Amongst other Christmas goodies, I gave Harry and Emily a very special present. It wasn't immediately the most exciting, nor the biggest, but it has had a big effect, and one which I hope will last them for the rest of their lives.

I gave them a 'Name A Star' gift box, with a registration form for the star at RA:0h30m33s, DEC:3°13'29" which, after great discussion, is now called Jessica Palmer's Star, or Mummy's Star to us, but that could be confusing because, "another Mummy might have a star, Daddy".

The idea stemmed from the great work that Harry has been doing with his Skyscape of Memories at the Winston's Wish website (which I commend to anyone with children who have lost a loved one of any age or generation) and even if the star is not visible to the naked eye, it will forever be close to our hearts.

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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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Floods

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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Jessica: Friday's Child

Fri 16th Nov 2007 by Ben Palmer.

fridays_child_cover.jpgI'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.

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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.
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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.
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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.
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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.
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