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

Link to article: BBC NEWS | Health | Care not top priority - NHS staff

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

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.

I've been so focussed recently on finishing a project that I have let many things slip when I hadn't meant to.

I read a bed time story tonight to two very over excited and giggly people and was given cause to reflect. Mr Messy, because he's all pink, is Emily's current favourite book. At the end of the book, when the story warns of a visit from two people, Mr Neat and Mr Tidy, Harry giggled again and gave me a knowing look.

Yes, Harry we could do with a visit from them - I need to have a very good sort out, but so do you with your toys!

It wasn't his only word of advice to me today. Just before bedtime, while we watched Macca Pacca, Upsy Daisy and the Ninky Nonk (I don't get it, but they love it) Harry handed me a present from the supermarket: 'Simple tips to help you give up smoking for good'.

"Daddy this is for you." Giggle. "You need to stop buying your smokers."

I don't always like it when the flow of good advice from parent to child is reversed, but how can I argue? I gave up for him once before, so I can do it again, but I'm not quite ready to stop procrastinating. Bad Daddy.