Childbed Fever - Death by Any Other Name
In June 2004 my wife, Jessica, gave birth to a 9lb 13oz baby girl - our second child. It was a short, uncomplicated delivery and we were overjoyed and enthusiastically spread our good news around our family and friends.The next day, however, and although we were blissfully unaware, things started to go wrong. Jessica had a temperature and was tachycardic, and so her discharge was delayed until a Senior House Officer saw her. The doctor rubber-stamped Jessica and she was discharged without comment.
Even though Jessica had a very high temperate of nearly 40°C that first night at home, the community midwife didn't see fit to visit Jessica until the second day after her discharge, despite the fact that you are supposed to be seen within 24 hours. When she did visit, the midwife didn't have a thermometer so didn't take Jessica's temperature, and didn't think anything of a red rash on her abdomen, but instead advised that she should take paracetamol if she felt feverish and recorded in her notes that 'All is well.'
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A further two days passed, during which time Jessica was prescribed powerful painkillers for 'sciatica', when in reality she was in agony from a raging infection of the uterus.
Eventually she was seen by a GP who sent her straight back to hospital in an emergency ambulance, where, after a noble overnight fight in intensive care, Jessica died of multiple organ failure six days after delivery.
My family's lives were shattered in an instant but since that day it took over two and a half years to get a sort of justice, whereby we won an admission of liability and compensation in the High Court. Any amount of money is little compensation for the loss of a woman's life, a father's soul mate and the mother of two little children and since that horrific day, my determination to try and make a difference and prevent this terrible, needless waste of life has grown steadily as that can be the only way that good can come out of our nightmare and that there will be justice for mothers.
Jessica died of Childbed Fever (I still prefer to use the old name in order to keep it from being buried in the dark ages, but it is most frequently now called Puerperal Sepsis), and since starting my campaign to raise awareness of it, I have received so many messages, through comments on my blog and even more by email, from women who have survived Childbed Fever that it deserves comment. It is an archaic disease that is seen by many, if not most, to belong solely in the 18th and 19th centuries. It is defined as infection of the uterus following the birth of a child. It is not caused by poor hygiene - although historically it was lack of hygiene that lead to its spread in epidemic proportions - and it does not have to be caused by retained placenta or any error or misjudgement at birth.
To underline the problem, Jessica had a totally normal, textbook delivery. In the aftermath of her death and during the legal investigation every aspect of ante-natal, delivery and immediate post delivery care was scrutinised and no fault was found.
A perfect, complication free delivery is no guarantee of safety from sepsis. Jessica died because Group A Streptococcus invaded her uterus. Group A Strep is a relatively common bacteria, which some people have quite harmlessly on their skin, in their nose, throat or genital tract - indeed ‘Strep Throat’ is a much more common complaint that it causes.
It is a nasty and highly toxic organism and if it is able to take hold in the site of a wound, or in the ideal conditions of a post partum uterus and if the symptoms of infection are not caught early enough, death is a very real outcome as it will overcome even the healthiest of mothers' immune system. In fact, the faster the body kills the bacteria, the faster its decaying cells give off toxins which will lead to toxic shock, which is why Jessica spent the last twelve or so hours of her life on a blood filtering dialysis machine as well as being pumped with intravenous antibiotics.
Whatever the cause, any infection in mothers should ring alarm bells, and the trigger should be any sign of fever or general feeling of unwell. Do not put a temperature down to 'mother’s milk coming in' unless you are certain it cannot be infection. When I was born my mother and I spent over a week in hospital so any infection would, had it occurred, in all probability have been picked up quickly enough. The fact that mothers are now turfed out of their beds in as little as six hours does not mean that the risk of childbed fever has diminished in any way.
It is purely complacency and cost saving. The risk is as strong as ever, and the stories that I have heard of so-called ‘dirty’ mothers with an infection pleading to be readmitted is heart rending. All too often it has been an understanding family GP with experience of working in third world countries that has insisted on admission and thereby saved the poor woman’s life.
It makes me weep to know that there may be another Jessica any day. The reality is that there probably have been several, but I just haven’t heard yet. The good news is that I have heard of two cases where the mother was re-admitted to hospital and successfully treated for Childbed Fever because of Jessica's story. That's a good start.
Please sign the petition at Downing Street Maternal Deaths Petition and help spread the word.
More information about Childbed Fever, Group A Streptococcus and the campaign to raise awareness of Childbed Fever can be found on the website at Jessica's Trust
Ben Palmer 2007
Possible Symptoms of Childbed Fever*
General feeling of unwell**
Headache
Sore throat
Raised temperature
Rash
Vomiting/diarrhoea
Adbominal/leg pains
Swelling
* one or more symptoms may be an indication & must be checked by a doctor
** i.e. not 'just tired' |
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