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Is childbed fever history?

Today we assume that puerperal fever is history, but women do still get it. While antibiotics have all but eliminated the risk, it's still a good idea to be vigilant

Before the 19th-century, it turned maternity wards into morgues, but today few pregnant women have even heard of puerperal fever, an aggressive infection of the reproductive system following childbirth. It probably changed the course of English history by killing Jane Seymour, third wife of Henry VIII. It destroyed Isabella Beeton and ruined her husband's life and business. It finished off proto-feminist Mary Wollstonecraft, leaving Mary Shelley motherless.

In the 1700s, when it was known as childbed fever, puerperal fever could claim the lives of as many as 20 per cent of new mothers and would sweep through communities in terrifying epidemics. The infection - most commonly the bacteria staphylococcus and streptococcus - was often carried on the dirty hands and medical instruments of doctors and midwives.

Still here today

The Department of Health, in its report 'Why Mothers Die', showed that 16 women died of puerperal fever between 1994 and 1996. The authors conclude that it 'is not a disease of the past, and GPs and midwives must be aware of the signs and be prepared to institute immediate treatment'.

'I have seen one death from it,' says Dr Gabrielle Downey, a consultant obstetrician at City Hospital, Birmingham. 'The woman came in literally navy blue and was dead within the hour. If the patient gets overwhelming sepsis, the essential organs shut down ? but deaths these days are very rare and preventable.'

However, around 50,000 new mums are affected each year by group B streptococcus, which usually lives harmlessly in the vagina or intestines of 10?35 per cent of healthy women.

It is one of the commonest bacteria involved in puerperal fever and infection occurs up to two weeks after childbirth or abortion. Typically it is the uterus that is infected, but injuries to any part of the genital tract can provide a breeding ground.

A fever after childbirth isn't always caused by an infection of the genital tract. Breast, urinary and wound infections are also a possibility. Milk coming into the breasts for the first time can cause the temperature to rise without illness, or a woman may simply have the flu.

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