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.)

It's not all rubbish that's spouted on twitter, despite whatever your newspaper may say! Amongst conversation, debate and information sharing, there is an army of supporters on twitter who pass on messages and information about the Jessica's Trust campaign – often tagged with the #maternalhealth hashtag – and some of them are adept at bringing the cause to celebrity attention.

With some success:

In April Jonathan Ross (Wossy - an extremely popular twitterer) and his wife Jane Goldman (FerretPrincess) both signed and alerted their followers, saying respectively

wossy: I am signing this petition. You might like to as well . Give it a look ! http://bit.ly/2zlSfI Read http://bit.ly/kzYuX PLS RT
[link]

and

ferretprincess: RT @jessicastrust: @ferretprincess #uk #maternalhealth petition needs your support: http://bit.ly/2zlSfI Read http://bit.ly/kzYuX & PLS RT
[link]

ferretprincess: @jessicastrust Signed and retweeted. Very, very best luck with the petition - a highly important and worthy endeavor indeed #maternalhealth
[link]

Three members of Take That – Mark, Gary and Jason – have signed as well, although they're not on twitter themselves, a friend of one of theirs is.

More recently, a couple of days ago, a twitter friend of mine sent a request to Stephen Fry, asking him to retweet information about Jessica's Trust. He gets a lot of requests and has a very strict policy on how he does it, so success is rare. At the time his #fryretweet stream was also being spammed. The two of us were unsure whether the tweet would even be seen and we discussed it openly on twitter.

Two minutes later, Stephen Fry sent a DM (private message on twitter) assuring me that he was ignoring the chaff. I thought, 'wow that's nice of him to say, but he'll forget about us in a minute or two.'

How wrong I was. Yesterday morning at a little after 10am, messages of congratulations started flooding my twitter stream: “you got this week's #fryretweet,” people were telling me. And there it was:

stephenfry: This week's #fryretweet cause is http://www.jessicastrust.or... a very excellent use of twitter.
[link]

An endorsement from the King of Twitter himself! For the next five or six hours our web server held up magnificently under heavy load – and it only resumed normal levels after about 12 hours.

It didn't stop there though, the beautiful Queen of British Soul, Beverley Knight, got involved too. During an exchange of messages after she signed the petition, she wrote:

@jessicastrust yes of course no worries! i'm small but i got fight!! let's get 'em signing!! xxx #maternalhealth
[link]

and, urging her followers to get behind #maternalhealth and sign as well, she also encouraged Wossy to mention us again – which he did.

So if any more big twitterers would like to spare three minutes to sign and support us, we're here: where else can a tiny charity win the ear of such heavy weight influence?

Click the picture to enlarge it, then please sign our petition, if you haven't already.

http://petitions.number10.gov.uk/maternalhealth/

I'm not just blogging blindly; I'm interested in what other people think and say, and I also am interested in how people find this website, and where people are linking to it.

I watch referring sites in my log stats, and often visit back. It was in this way that I came across a parenting forum this weekend.

A mother of three posted with a link to Jessica's Trust, urging people to read the information contained herein and, if they feel as strongly as she does, to sign the petition.

I was, though, dismayed to read a third reply to her post, from another mum, who didn't think that MEOWS charts were necessarily a good thing. She felt they could lead to unjustified intervention, use of prophylactic antibiotics, and only benefit 1 in half a million women.

Oh how I was dismayed! Where do I begin?

Midwives already take temperatures and observations. They already record them in a mother's notes. If there were more midwives who had more time to spend with the increasing number of mothers delivering and recorded observations more frequently, that would be a good thing. Surely no one would dispute that.

The use of MEOWS charts - which is already standard in a small but growing number of units - is widely supported and encouraged. It is not a new test/observation, but a different and inherently clearer way of recording observations. This means that a women who is beginning to deteriorate will be picked up faster and given any treatment that she requires for a range of conditions including, but not exclusively, childbed fever (CF). This means that severe illness and/or death can be avoided.

I am not an advocate of prophylactic use of antibiotics, indeed more women than are saved from sepsis may die of allergic reaction.

As for benefitting only 1 in 500,000 - how wrong is this. Purely looking at sepsis, in 2003-2005 the Confidential Enquiry into Maternal and Child Health recorded 18 deaths (0.85 per 100,000) from Genital tract sepsis (GTS). This would be 4.25 per 500,000, but more women than that give birth in this country each year. The average number of deaths per annum from GTS/CF is 6.

Far, far more are affected (no data is recorded, but it should be) by childbed fever than this. I continually hear tragic stories of illness from survivors.

Would any of them not have wanted to receive earlier antibiotic treatment?

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.

At first I started, through curiousity, on a high protein diet of @stephenfry, but then I was reading an interview with a man who started a charity in memory of his wife. He'd been recommended Twitter(.com) as a good means of raising awareness, so I thought...

Anyway, if you tweet, follow @jessicastrust, and please feel free to spread the word or retweet.

I'm really really pleased with the signing rate on the petition, please keep it up and don't forget to spread the word, by tweet or by mouth!

Jessica's Trust needs your help

Please sign our petition

We have started a new petition on the Downing Street website, asking 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 and is given clear information and advice on the recognition of childbed fever (also known as puerperal fever and genital tract sepsis) and that doctors and midwives are given clear sepsis guidelines."

More information

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Childbed fever is a serious form of postnatal septicaemia which can lead to toxic shock syndrome, organ failure and death.  In 2003-05 sepsis accounted for 14% of maternal deaths in the UK. A complication free delivery is no guarantee of safety from sepsis and any mother can be affected. MEOWS charts are a sheet on which observations (pulse, blood pressure, temperature) can be recorded. They are clear and provide a graphical way of quickly seeing a mother's health.

Borderline and dangerous readings are entered in boxes coloured yellow and red respectively. One red or two yellows at one time call for early intervention, so a mother developing a critical condition will be treated before it is too late.

Sepsis is often already life threatening by the time it is clinically obvious: the best opportunity to intervene is based on the early warnings. It is not yet standard practice to use them in all NHS hospitals and there are no standard guidelines for the recognition and treatment of sepsis.

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This petition will remain open for 9 months.

However, please sign our petition now, with one name per line - signing as 'Mr & Mrs Smith' will only count as one signature! Every British citizen or resident can sign if they have a unique email address.

When you have signed please remember to click the link in the confirmation email you will receive, then please  share the link to this page with anybody who you think might like to sign it as well.

For more information about the petition, childbed fever, MEOWS and Jessica's Trust please read our website.

Online donations and fundraising

Since becoming a registered charity, we have partnered with Justgiving.com to allow us to receive online donations.

All money donated or raised through sponsorship will enable us to continue raising awareness of childbed fever through printing and distributing leaflets and posters, running our website and striving to achieve our aims.

Keep up to date with our work

Bookmark our website or join our update list to keep abreast of what we're doing.

Thank you

Thank you for your help. Together we can make a difference.

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.

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.

When I stand out in our garden, like just a moment ago, and I can hear Emily sitting in the bathroom, gently singing a word - and almost tune - perfect rendition of 'Twinkle, Twinkle Little Star' my heart bleeds for her, and for Harry.

I ask myself, 'What can I do to make their lives better?' I know where my weaknesses as a parent are, and I know where my strengths are. I need to work on some things, but I think I'm doing an OK job, and they are, essentially, happy.

I can't, though, fix what is really broken, but I can try and stop the same breaking for other children, and I'm always trying to think of new ways of achieving it. However, I can't do it alone. I need help, so please; pass on an email to all your family and friends about my website and ask them to spare a minute to sign the petition, because the more people that know, the less likely a repeat of Jessica's death is, and because the more people who sign, the more likely that the government and the NHS will take notice of our need for our mothers.

If you're on Facebook, you can help spread the message by joining the group, Petition to end Childbed Fever. Then, please, invite all your friends to join and encourage them to sign the petition too. It'll only take a second, but it could delay one other Diamond in the Sky.