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.

I've just read a good post on Mother at Large's blog about childbirth, pain and expectations about delivery.

It does sometimes seem as though birth has become a bit too competitive, and often I also hear talk of how quickly a mother was discharged, as though speed of discharge is a measure of success. What we shouldn't forget is that, while now comparitively safe, childbirth is a trauma and the historical and natural risks are still as present as ever they were.

While an extended hospital stay is not on anybody's wish list or birth plan, there is merit of staying in for days, rather than hours - as used to be the case. How better to pick up on the warning signs of a complication such as infection than by regular observations by a midwife?

But on that subject, all too often I hear that regular postpartum observations are no longer routine, unless infection is suspected - indeed the NICE guideline on Routine postnatal care of women and their babies [PDF] even says as much for some reason.

This is madness: how on earth is an infection going to be suspected early enough unless it's being checked for?

Another postnatal phrase I hear a lot of is: 'Mother and babe both doing well'. It's what everyone wants to hear and illustrates the feeling of joy and euphoria of a new and safe delivery, but a caveat: Childbed Fever can hit anybody at anytime - even weeks after a trouble free delivery.

I wouldn't want to cast a cloud over anybody's happiness, but never be complacent - please keep an eye on the symptoms, even if your midwife isn't.

Jessica Tate has been pregnant since 2004 and has been examined by countless student midwives.

She is a computer based training package, created by two midwifery lecturers from Swansea University, Susanne Darra and Marian Mclvor.

The project has just won an award at the Royal College of Midwives (RCM) sixth Annual Awards Ceremony, and there is a plan to roll Jessica out to other universities.

It is a genius project, and although Jessica Tate's pregnancy is 'normal' there are just a few minor warning signs thrown in. Susanne Darra, one of the program’s authors, says, “There is a big issue in the western world with ‘problem’ births and it doesn’t have to be like this. We have a strong trend to alert people to problems, but most of the time things turn out fine.”

If only Jessica could develop a fever and a rash, a few days after being discharged from a normal delivery, then she could be a really powerful teaching aid.

External Link: Royal College of Midwives (RCM) Sixth Annual Awards

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.

While the pizza was in the oven tonight I ironed Harry's Karate Gi for tomorrow. That's not remarkable (or at least it shouldn't be) but what I was thinking while I steamed is.

I write, periodically, about some of the most intimate moments of my life, of Jessica's life and death. I'm used to that and it's a conscious decision, with a clear aim of trying to prevent it happening again to some other woman and her heart broken family.

What I never expected was to be inundated with emails and comments on this blog from other women who are prepared to share their equally intimate, graphic and heart rending stories of near disaster, pain and mistreatment.

I'm so grateful for all of this honesty and I hope that these stories as well as Jessica's will help to change things for the next mother, maybe for you.

Hard labour: The maternity service in crisis in the Daily Mail

This is a shocking tale of maternity services in the NHS. It's a story of another mother given a rough ride. It's a miracle she's alive - this was a catalogue of disasters.

Why is a temperature in a mother always excused as something minor instead of being read as the sign of an infection as it once was?

That's not to mention her detached placenta, her baby's distress and increased heart rate, the delayed pain relief and emergency caesarian.

Mum gives birth in car park because 'hospital didn't have midwife' from the Daily Mail

Unless the NHS can ensure adequate midwifery staff numbers and stop its ludicrous plans to close maternity units I fear this is going to happen more and more.

What the bureaucrats seem to forget is that childbirth is a traumatic experience for a mother and her child to go through and it is only safe when you have adequate levels of care in place.

There is going to be a tragedy if things don't change soon enough.

I've just read this horrific story: Premature baby dies after mother has to deliver it herself in new hospital in the Daily Mail.

Where were the midwives that the health service so badly needs? When are we going to lose the initiatives, the spin, the New Labour hypocrisy and get a decent level of maternity care so that childbirth becomes as safe as we keep being told it is. How many more lives must be lost?

Hospital managers have to realise that 'sincere condolences' and 'being kept up to date with changes' is not a substitute for gold standard care. No amount of empty words will console this poor mother.

Rest in peace, Edward.

The Confidential Enquiry into Maternal and Child Health (CEMACH) publishes triennial reports reviewing all cases of maternal death. The most recently published report, 'Why Mothers Die' is for the period 2000-2002, and I have often quoted (both in these pages and to the press) the statistics it found and also its recommendations, few of which seem to be taken up, as they are repeated report after report in alarmingly consistent language.

The next report, for 2003-2005, is now to be called "Saving Mothers' Lives", as I have just learned from CEMACH's updated website, and it will be published this December.

This sounds to me like spin. The report, by it's very nature, highlights the cases of mothers who have died, not the ones who have had trouble free experiences, or even 'near misses'. If they do plan to discuss cases where the NHS has saved an ill mother, I could let them know of many horrendous near miss stories that have filtered through to me, but I suspect that - whatever the name - it will be the same report on the same causes of the deaths of the mothers that weren't saved.

If this Department of Health sponsored report wants to pat its master on the back, it should do so elsewhere. Jessica's case will (confidentially of course) be included in the statistics, reviews and summaries, and I don't for a moment believe that she will be alone in its 'Genital tract sepsis' pages.

In fact, I highly suspect that there won't be much of an improvement on previous triennia, but I'd love to be wrong. The bottom line, though is that what we and the NHS need to know is Why Mothers Die and how to stop them dying.

Whatever the findings, please let them be acted on this time.

Reminder: the petition closes in mid-October, so there's still time to help it make a difference in advance of December's report.