Showing posts tagged with: 'group a strep'


British maternity wards in crisis

Mon 4th Apr 2011 by Ben Palmer.

Some very bleak reading, particularly in light of the recent CMACE report, Saving Mothers' Lives 2006-2008 which tells that sepsis now outranks even pre-eclampsia and eclampsia as the leading direct cause of maternal death. Deaths due to sepsis have risen from 18 in 2003-05 to 26 in 2006-08* - a staggering 44%.

Is it any wonder that we have headlines like this one:
British maternity wards in crisis - Health News, Health & Families - The Independent.

 

* Centre for Maternal and Child Enquiries (CMACE). Saving Mothers’ Lives: reviewing maternal deaths to make motherhood safer: 2006–08. The Eighth Report on Con?dential Enquiries into Maternal Deaths in the United Kingdom. BJOG 2011;118(Suppl. 1):pp36.

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Rising GAS

Tue 24th Feb 2009 by Ben Palmer.

Group A Streptococcal infections are on the increase, according the the Health Protection Agency. The concern so far has been largely in cases of Scarlet Fever, which last December reached a 10 year high, the HPA reported.

The news is that there is now an enhanced surveillance protocol of severe group A streptococcal disease. Not quite the study of cases of childbed fever including those that do not result in death that I'd like to see (and is, I know, in planning) but a welcome step in the right direction.

If group A strep infection is more prevalent in the community at the moment, then there will be more cases of childbed fever as well, one could assume. Let the doctors and midwives be aware and be alert, lest it result in more death.

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Thank you so much

Sat 14th Feb 2009 by Ben Palmer.

Thank you to every one who has already signed this new petition.

It is particularly encouraging to know that not just friends and family of mine/Jessica's have signed it but many others as well - including midwives and doctors - showing that there is real need and desire for simple change that can have such a positive impact on lives.

I'd really like to encourage everyone to ask partners, friends, family and colleagues to sign as well, and there is no minimum (or maximum) age! If you passed the link on to ten or more people (and there's no promise of fame and fortune, nor threat of famine and disease attached to this!) the exponential effect would be very powerful.

Some NHS Trusts are already starting to use Modified Early Obstetric Warning charts, but some use them only for 'at risk' mothers. I'd like to see them being used routinely for every new mum. They are a useful aid in quickly spotting a problem with a mother's health - for any reason - and can be an indication to all midwives and doctors involved that a woman needs prompt medical intervention.

Particularly in the case of childbed fever, timely use of antibiotics can be vital as a group A strep infection can kill in a matter of hours rather than days.

So far, the NHS does not have a clear set of guidelines for the detection and treatment of sepsis which, together with the use of MEOWS, would greatly reduce the chance of severe illness and/or death.

I also believe, without for a minute wanting to alarm or create terror, that all mothers and their partners should know of and understand the risks of a uterine infection, so that instead of thinking that maybe it's a case of flu, they immediately refer themselves back to their midwife or GP, thus saving precious time.

I hope, through the petition, that a large number of other parents and parents-to-be especially agree with this premise, and that together we can show the government that we believe action should be taken now, and not after another unnecessary death from this archaic illness.

Thank you again for your continued and important support.

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Many returns

Mon 8th Sep 2008 by Ben Palmer.

Tonight our long summer holidays end. We've had an amazing time, visiting Scotland and Portugal, enjoying glorious sunshine in both, but tomorrow all three of us start again at school. I go back in my working capacity in I.T., Harry returns now in Upper School and Emily joins us for her first day at 'big school' in Reception.

How vividly I remember Harry's first day three years ago: shy and nervous, clinging to my arm. How quickly he learned to adore his teacher, an adoration Emily is already learning, before she has started, of the same teacher in the same classroom. How happy Emily will be. How proud a mother Jessica would have been.

But enough of holidays and school. I must also reverse the partially deliberate neglection of the blog and Jessica's Trust. I must pick up the reins and gallop into the enormous amount of work, the Charity Commission's queries, notes that need be written for the meetings I have and the speech I must deliver to a conference of midwives in October.

I feel recharged and energised, and as if I didn't already have enough reason to put my back into Jessica's Trust, I have heard from yet more families who have been deeply affected by childbed fever with horrendous long term illness. We must look beyond the statistics of maternal death to these uncounted cases of horrific suffering and pain from genital tract sepsis and its consequences.

In the meantime, my apologies for going AWOL and my warmest thanks to all those who have left messages of support and appreciation.

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In the grip

Tue 17th Jun 2008 by Ben Palmer.

I was sent an early copy of a new book, Touching Distance, last week. I was gripped by it from start to finish and it consumed most of my weekend.

I have also been alerted to a post by dovegreyreader who has also spotted the link between Touching Distance and Friday's Child.

Touching Distance is set in 1790, in the middle of an epidemic of childbed fever in Aberdeen. A young doctor, Alexander Gordon, discovers - and sacrifices his career and his marriage to publish the fact - that it is he, his peers and midwives who are spreading the disease.

To continue the brief history lesson, Oliver Wendell-Holmes published the same information in 1843. He too was ridiculed by his peers. A few years later, and Ignaz Semmelweis, drew the same conclusion, markedly reducing maternal death by using a chlorinated lime solution for hand washing. He too was ridiculed.

Medicine has moved on: in the West, hygiene practice means that childbed fever does not reach epidemic rates of occurrence - it is not being spread by doctors or midwives. What has not changed is that streptococcus, the cause that Gordon et al couldn't have known of, is still with us. It may wax and wane in prevalence, but it is in us, on us and with us at all times. It is still causing deaths from childbed fever.

We cannot assume that hand washing makes our mothers safe. We can't vaccinate and we can't wash it out of the world, but we can spot the symptoms of its infection while there is still time to treat a mother before she requires long term hospitalisation, a hysterectomy or she dies.

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Misconception that matters

Mon 12th May 2008 by Ben Palmer.

When I picked Emily up from school this afternoon (and I can hear what she'd say to me here, "It's not school, Daddy, it's NURSERY school") I said hello to the head teacher as Emily came rushing out.

"I saved this for you," she said, "It's missing a bit but I thought you'd be interested." She handed me a pulled out spread from a newspaper.

When I got home I started reading it. It was an article from Times2 last week, Save the independent midwife, along with a personal tale, right at the end in the on-line version, written by a mother, Alex O'Connell, who had had a horrific first delivery, and had opted for a home birth the next time, assisted by an independent midwife.

I finished reading it on-line and something jumped out at me. It was the reference to Alex's post-puerperal fever after discharge from hospital first time. How lucky she was that it only took two doses of antibiotics to shift it, and how wrong she was to assume that the lack of infection second time around was because she was far from a maternity ward.

Yes you can acquire an infection in hospital - MRSA, C diff etc - but puerperal/childbed fever is not a hospital acquired infection - it is caused by community bacteria, and nobody is safe. I'm going to go on and on saying it. I'm even going to shout it. NOBODY IS SAFE FROM THIS HORRIFIC DISEASE, whether they deliver in hospital, a birthing centre, their own bedroom or the back of a taxi.

It doesn't matter whether they are young, old, fat or thin. It  doesn't matter if the midwife is independent or NHS employed, it just matters that the symptoms are spotted in time to give you your antibiotics.

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Don't test, tell

Thu 1st May 2008 by Ben Palmer.

Back in January, I wrote in the blog about Screening for Group A Strep (GAS). Since then I have thought about it a lot, and discussed it with various medical professionals.

I am convinced it is a worthless exercise. Worse than that, it could be dangerous. Why?

A woman can be colonised with GAS at any point in her life*, let alone in her pregnancy or puerperum, so all a test would do is say that she does or does not carry the bacteria at this very point in time.

What if she was colonised the day after the test? She would have been given a false sense of security by a negative result. If GAS was only introduced some time after delivery, and it caused a genital tract sepsis, the last thing on her mind would be childbed fever, because she was 'clear'.

It is of far more value to skip the testing and instead take every woman's temperature and pulse regularly in the days after delivery. Then tell her about the condition and how to recognise that she might have it. She must also be told of the vital importance of being seen, swabbed and treated if infection is suspected, before her health and her life are in danger.

* up to 30% of us may be carrying Group A Strep in our throats or on our skin

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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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No news would have been good news

Sun 6th Jan 2008 by Ben Palmer.

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.

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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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