Showing posts tagged with: 'death'

Doctors are gentlemen, and gentlemen's hands are clean.

Fri 22nd Jun 2007 by Ben Palmer.

I've just been, as I sometimes do, trawling the Internet for stories, comment and opinion on puerperal sepsis with the help of my friend. It really bothers me that there is so much opinion, comment and belief that childbed fever/puerperal fever/puerperal sepsis (call it what you will) is still caused by lack of hygiene and of handwashing.

Yes, if a mother has an internal examination by someone who has been performing autopsies without washing their hands in chlorinated lime, they're in trouble. What Ignaz Semmelwies discovered was the cause of the spread, in epidemic proportions, of sepsis.

Group A Streptococcus is, as far as I'm aware, the biggest puerperal sepsis causing bacterium. It is also naturally occuring on and within many of us quite harmlessly. The attitude that handwashing, sterile gloves and the passing of centuries has rid us of the original problem is at the heart of Jessica's problem.


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Death by any other name

Sun 10th Jun 2007 by Ben Palmer.

I've now received so many messages, through comments on this blog and mostly by email, from women who have survived Puerperal Sepsis (or Childbed Fever) that it deserves comment.

Often the sepsis is due to retained placenta, but equally often - as in Jessica's case - it is not. To underline the problem, Jessica had a totally normal, textbook delivery. In the aftermath of her death and during the legal investigation every aspect of delivery and immediate post delivery care was scrutinised and no fault was found.

A perfect, complication free delivery is no guarantee of safety from sepsis. Jessica died because Group A Streptococcus invaded her uterus. Group A Strep is a relatively common bacteria - 'Strep Throat' is a more common manifestation. What is amiss is not to recognise the symptoms of Group A Strep when it takes a hold. It is a nasty and highly toxic organism and unless the symptoms of infection are caught early enough, death is a very real outcome.

Whatever the cause, infection in mothers should ring alarm bells, and the trigger should be any sign of fever or general feeling of unwell. Do not put a feverish temperature down to mother's milk coming in unless you are certain it cannot be infection.

When I was born my mother and I spent over a week in hospital so any infection would, had it occurred, in all probability have been picked up quickly enough. The fact that mothers are now turfed out of their beds in as little as six hours does not mean that the risk of childbed fever has diminished in any way.

It is purely complacency and cost saving. The risk is as strong as ever, and the stories that I have heard of so-called 'dirty' mothers with an infection pleading to be readmitted is heart rending. All too often it has been an understanding family GP with experience of working in third world countries that has insisted on admission and thereby saved the poor woman's life.

It makes me weep to know that there may be another Jessica any day. The reality is that there probably have been several, but I just haven't heard yet.


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Cake and candles

Tue 22nd May 2007 by Ben Palmer.

Mummy’s BalloonIt's Jessica's birthday today. She should be 37, but she will always be 34 in our hearts and in our memories.

I've bought a helium balloon, and at the children's request, a birthday cake as well. We'll have our little tea party and then, like we always have, we'll write our messages of love on the balloon and let it go from our garden and watch it rise magnificently.

Usually there's a wind that blows it over the roof of the house and out of sight, to go wherever it will, but today is calmer than in previous years and so with luck we'll see it keep rising, until it's a speck, up to Mummy in Heaven.

It's hard to believe it's nearly three years since we saw her; at times it seems like just yesterday, the memories are so strong. At other times it seems like a lifetime ago.

It is, for Emily.


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The right way

Sun 20th May 2007 by Ben Palmer.

When you're bereaved, people invariably want to say the right thing. That's if you're lucky; if not they'll want to impart some great wisdom that is based not on fact, but misguided supposition.

One of the things I was told a few years ago was that, “at least you'll be able to bring up your kids the way you want to.”

An interesting thought. It's true – Jessica and I didn't always agree. We were equally capable of disagreeing on any of a range of subjects, child-raising included. We both enjoyed having our own view points, but knew that the core of our beliefs was firmly founded in the same mould as the other's.

Thus, although a disagreement about parenting was likely, there was no doubt in each of our minds who Harry's (and albeit briefly, Emily's) best mother and best father were.

The art now is not in bringing the two of them up in the way that I want, but rather in the way that they would have been, despite the circumstances.

I'm sure that if Jessica were to comment now, she would have a list of things I wasn't doing right, but I also feel sure that she'd look at her children and smile, knowing that she was still doing a good job.


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It could be you

Fri 18th May 2007 by Ben Palmer.

“Is anybody listening?” I sometimes wonder. Do people think I'm just a sad old widower having a rant?

Yes, I've ranted to myself and to my friends in the past, but I've come through that. I know what childbed fever means, and I know the ecstatic highs of birth followed post haste by the devastation of death. I know the roller coaster of fear, anger, despair, self doubt and guilt that follows it, and I know the utter waste and needlessness of loss of life in this way, but am I not explaining it?

The NHS machine has treated Jessica's death as a statistic, collateral damage maybe, but has it learned? Have we as parents learned?

There really is no reason at all for women to die from infection after childbirth. It can stop and I hope it will stop, but first we have to accept that it is happening. Jessica's story is not just a sad tale worth a moment's attention and maybe a brief tear, it is an opportunity to reflect and to drag ourselves out of the dark ages.

Universally, the reaction to her death has been the same, whether in her best friends, a doctor or an internet-using car builder, but that isn't enough; we actually have to do something in the face of our doubts that anything can change.

If the end of childbed fever meant years of expensive research, new wonder drugs and hi-tech equipment I could understand the 'nothing will change' mentality, but none of that is needed. The research was done years ago by Ignaz Semmelweis, the drugs needed are ordinary antibiotics, and the hi-tech equipment? A thermometer. The only difference between his time and now are the hygiene standards that luckily prevent the epidemics of old. Otherwise it's still exactly the same old disease.

So, know that childbed fever is still real, believe that it doesn't have to be, and understand that yes – it could happen to you.


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Pasta and pesto

Sat 12th May 2007 by Ben Palmer.

"Did it hurt when Mummy died, Daddy?" is not your average conversation opener during children's tea.

Coming from a five year old boy, clearly it warranted a considered reply. "The doctors made Mummy as comfortable as they could, and in fact, she was asleep for a long while before she died." On a ventilator too, but I omitted that bit.

"But, do you know, Harry, the last thing that Mummy and Daddy talked about before she died was you and Emily. She loved you so, so much."

He beamed at that. It reminds me (not that I need reminding) why I feel such a strong urge to make a difference. There shouldn't have to be any more children that are like Harry and Emily.


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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.
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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.