A mother and her newborn developed sepsis within hours of giving birth.
Sarah Smith, 29, was delighted when in January 2017 she discovered she was expecting twins with her fiancé Richard Townsend, 32.
Their joy was short-lived, however, when the 12-week scan revealed one of the babies had acrania, a rare condition where the skull does not form properly. The prognosis was so grave they made the heartbreaking decision to terminate the pregnancy.
Four months later, the beautician became pregnant again. Just four hours after baby Joshua was born, however, he was diagnosed with sepsis caused by group B streptococcus (GBS) bacterial meningitis.
The new mother, who was unknowingly “colonised” with the bacteria and passed it to her son during labour, was also struck down with sepsis.
Pregnant women are not routinely tested for GBS in the UK, however, it can be detected during checks for other infections.
With both mother and baby making a full recovery, Smith has urged pregnant women to carry out an at-home GBS test for as little as £35 ($42.85). It is unclear how accurate or beneficial these tests are.
Are pregnant women tested for GBS in the UK?
GBS is one of many bacteria that people can carry without any side effects.
Around one in five pregnant women in the UK are thought to have GBS in their vagina or digestive tract.
During labour, there is a “small risk” babies may come into contact with the bacteria and become “colonised”.
Around one in 1,750 newborns delivered in the UK and Ireland every year develop “early-onset GBS infection”, which occurs in the first week after birth.
Most pregnant women with GBS have healthy babies.
Some develop life-threatening complications, however, this is “not common”.
The majority of infected babies who are successfully treated make a full recovery.
In rare cases, GBS can also cause complications in the mother, like sepsis.
If GBS is found in a woman’s vagina, bowel or urine during pregnancy, she should be offered antibiotics during labour to reduce the risk of passing the infection to the baby.
The UK National Screening Committee does not recommend routine GBS screening of all pregnant women.
This is because many carry the bacteria without experiencing any harm to themselves or their baby.
Screening is also not entirely accurate.
‘In the end, we had to go with our gut’
Smith wondered whether she would ever have a family naturally after being diagnosed with endometriosis in 2015.
The painful disorder occurs when tissue that normally lines the uterus grows elsewhere in the body.
Like with a period, the tissue thickens and breaks down with each menstrual cycle.
Fertility problems are a recognised side effect.
After undergoing endometriosis treatment, Smith became pregnant, but was forced to go to hospital when she developed mysterious pains in January 2017.
“Doctors initially thought I might be in pain because the pregnancy was ectopic, which is where a fertilised egg implants itself out the womb,” she said.
“They did a scan and it turned out it wasn’t ectopic at all, I was having twins.
“Looking back, they think the pain may have just been my body getting used to the flood of hormones”.
Smith discovered the acrania complication several weeks later.
The twins were identical and sharing a placenta.
Therefore, despite just one baby having severe acrania, doctors reportedly told Smith it was highly likely she would have eventually miscarried or given birth to two stillborns.
Speaking of the termination, she said: “It was a horrible situation to be in, to be faced with having to make that decision.
“In the end, we had to go with our gut. All of the options were difficult. I was a mess.”
Smith had the termination at 13 weeks.
‘It really looked as if Joshua was going to die’
Smith became pregnant again four months later, but struggled to become excited by the news.
“I wanted to be pregnant and I wanted a baby, but the ones I’d lost”, she said.
Her 12-week scan fell on what would have been the twins’ due date, 29 September 2017.
“I was thinking, ‘Is this fate telling me it’ll go wrong again?’,” said Smith. “I cried before they even got the scanning equipment out.
“This time, though, everything was fine. After that, I was less anxious, but still not convinced it would be okay.”
Smith had a seemingly healthy pregnancy, with Joshua arriving on 12 April 2018.
“As he was delivered, I began feeling very shaky and sweaty,” she said.
“I was cold, but my temperature was spiking.
“I felt so weird I couldn’t even hold Joshua. Looking back, we know that was the first symptoms of postpartum sepsis”.
Smith and Joshua were taken to a postnatal ward to recover, where the new mother noticed her son was restless and grunting.
At just 18 hours old, the newborn had a seizure while his father – a builder – was bottle feeding him.
“It was terrifying,” Smith said.
“In the hour that followed, he had five more seizures.
“It almost looked as if he was choking.
“He was going blue around the mouth and medics were rushing round, attaching him to wires and putting a ventilator tube in his mouth.
“It was like something you see on Holby City. It’s scary enough on TV, but even worse in real life.
She added: “It really looked as if Joshua was going to die.”
‘I was sweating, shivering and really weak’
The newborn was sedated and put on a ventilator.
Once stable, Joshua was transferred to St Peter’s Hospital in Chertsey, Surrey, but Smith was not well enough to go with him.
“I wanted to be with him and when they told me they were transferring him, I took my cannula out and tried to pack my bag, but my mum and midwife said they thought I was too ill to go”, she said.
“I slept for a couple of hours and they brought Joshua to see me before they transferred him.
“At that point I couldn’t stand up. I was sweating, shivering and really weak.”
Joshua and Smith were swabbed for a suspected GBS infection, with both coming back positive.
A lumbar puncture, where a needle is inserted into the spine to retrieve cerebral fluid, also confirmed Joshua had meningitis.
Smith was given antibiotics to combat her sepsis and joined her son at St Peter’s Hospital on 13 April.
She was eventually discharged on 17 April, while Joshua was transferred back to Frimley Park Hospital in Surrey, where he was born.
Slowly, he started to respond to antibiotics and finally went home at 15 days old.
“We didn’t know what to do when we finally got him home,” said Smith.
“We just put him into a carry cot and stared at him.”
‘Testing pregnant women can save little lives’
Smith is campaigning for greater GBS awareness. She has arranged for informative leaflets to be given out at her local hospital during antenatal appointments.
The mother-of-one is also urging pregnant women to consider taking a private or at-home GBS test.
“It is just £35 but it could literally save a life,” she said.
Jane Plumb MBE, chief executive and founder of Group B Strep Support, added: “This case is a terrible insight into how families’ lives can be almost destroyed by a GBS infection, especially since most GBS infections in newborn babies can be easily prevented.
“Testing pregnant women can save little lives and we want to see routine testing of pregnant women for GBS.
“Pregnant women can take this simple, safe test between 35 and 37 weeks.
“We are calling on the NHS to provide all pregnant women with information on GBS and make testing available to them”.