Showing posts tagged with: 'hygiene'


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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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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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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