Showing posts tagged with: 'government'


No.10 has responded to our petition. Or has it?

Mon 21st Dec 2009 by Ben Palmer.

The Number 10 e-Petitions website has responded to the Maternal Health petition. Or has it?

The response considerately quotes paragraphs from the National Institute for Health and Clinical Excellence (NICE) guideline Routine postnatal care of women and their babies (2006) which sets out what should happen.

It then quotes the Saving Mothers’ Lives report from the Centre for Maternal and Child Enquiries (CMACE, 2007) which really says that more needs to be done.

Lastly there is another quoted recommendation for the use of MEOWS charts.

Most of these documents have been mentioned and linked to from this blog in the past. They are not an answer to the Maternal Health petition, they are the evidence that it was necessary.

We asked the Prime Minister to ensure that every new mother has regular observations recorded on a Modified Early Obstetric Warning System (MEOWS) chart in hospital and in the community, the response merely encourages their use, rather than requires it.

We also asked that new mothers be given clear information and advice on the recognition of childbed fever, specifically, not just the general advice recommended by NICE.

You have quoted us others' reports. Where is your response, Mr Brown? What are you actually going to do? What would Mrs Brown recommend?

(The Number 10 response is here.)

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'Midwife numbers to fall short'

Thu 16th Apr 2009 by Ben Palmer.

With a weariness I read today yet another story about midwifery staffing levels falling short of the number required  for the government to meet it's own declared standard of care.

BBC: Midwife numbers 'to fall short'

I've said it before, and I expect I'll say it again; please look after our mums properly. The fact that the government thinks that this is one of the safest countries in the world to give birth (actually, it's one of the worst in Europe) is no reason to spread maternity care too thinly.

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Headed paper

Sat 10th May 2008 by Ben Palmer.

I had a letter from my MP yesterday. I'd had a meeting with her a while ago, and we've exchanged several letters and emails. She, along with other parliamentarians, is committed to helping Jessica's Trust, and wrote to Alan Johnson, the Health Secretary to ask for a meeting. His reply was attached to the letter.

Although he didn't say yes or no to the meeting, his letter was encouraging: pointing out that I had already met with the National Clinical Lead for Maternal Health and Maternity Services, had had a productive meeting and have an open line of dialogue.

What was really encouraging to hear, on headed paper, was that "We value highly the work of Jessica's Trust" and that he hopes that the Trust will "play an even greater role in reducing the number of deaths from [childbed fever]" based on the existing relationship with the Department of Health.

I'm encouraged as this is a much more positive governmental acceptance of the need to do something about childbed fever than I have had to date. I believe that there is the desire for change, even if it is taking Jessica's name to achieve.

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Power to you, Mums

Tue 19th Feb 2008 by Ben Palmer.

Never under estimate the power of the Internet, or of mums.

My sister in law very kindly posted a request for help with our awareness survey on a very busy Mums website earlier this afternoon.

The response has been absolutely fantastic: in seven hours well over 100 people have filled in the survey form and the website has been busier than in ages.

The information so far is:

a) extremely useful
b) very interesting
c) anonymous (so please add your honest response as well)

What really touch me are the comments added on the response forms. They're under wraps, but let me just say that I feel encouraged, supported and useful.

There's no official end to the survey as yet, but at some point I will be showing the overall results to some big decision makers, to illustrate the need for a change of attitude, so please, add your voice and help us make changes - we don't want any more unnecessary tragedies.

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Maternity resources

Wed 30th Jan 2008 by Ben Palmer.

BBC NEWS | Health | 'No plans' for migrant birth rate

The government should have done more to help the NHS cope with the increase in foreign-born mothers using maternity services, the Conservatives say.

How can the government keep saying that they are working towards having a named midwife for every mother, when the number of midwives is so low? 36 midwives per 1,000 births are required, yet the average is only 31 and it is as low as 26 per 1,000 in some NHS Trusts.

If the birthrate continues to rise (whether caused by immigration or not) then maternity services are going to be even more stretched unless this vital area of care is properly resourced. There is no way that any midwife can provide the recommended level of care if she is spread amongst too many mothers. That is the case in hospital and within the community.

CEMACH recommends* that 'routine observations of pulse, BP, temperature, respiratory rate, and lochia should be made in all recently delivered women for several days postpartum' and yet most women are turfed out of hospital within a few hours, and often receive only one or two visits from a midwife in the community. How is anyone going to spot the signs of serious illness?

* Saving Mothers' Lives 2003-2005, p102

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Stretching Midwives

Wed 9th Jan 2008 by Ben Palmer.

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.

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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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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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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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