"Childbirth Fever" Treatment Options in TEOTWAWKI

Good Eats at the TEOTWAWKI Café—Making the Most of Powdered Milk in Your Food Storage, the 3rd volume of articles from the Prep School Daily blog, is now available on Amazon.  With over 130 family-friendly recipes using powdered milk—without a hint of that powdered milk taste—your family will have no idea there's a crisis. 

As an amateur genealogist, I frequently study the christening and burial records maintained by Catholic priests.  Death during childbirth or shortly thereafter was not uncommon.  And it was the main reason women nursed other women’s babies and why remarriages occurred so quickly after a spouse died. 

The maternal mortality rate during the colonial period was 2-4% per pregnancy!  With an average of 6-10 pregnancies per woman, the mortality rate for women was easily 25-40%.  One out of four women died due to complications of early pregnancy (ectopic pregnancy, hyperemesis gravidarum), during childbirth, or soon after delivery.[1]

Unfortunately, there is precious little information in off-grid medical references about a condition that was so common before modern medicine, and which may become quite common again if access to modern medicine is limited.  This lack of information really bothers me.  I don’t know if it’s because it was such a frequent issue prior to the advent of modern medicine, resulting in the unnecessary deaths of so many women, or if it is because I had a good friend who was hospitalized to treat this infection and because I have personally experienced complications of retained tissue following a miscarriage and thus the issue hits closer to home. 

While there are several infections that can occur post-partum, the one we’re focusing on today is endometritis.  (Others are mastitis, UTIs, and wound infections from tearing of the skin.)

Symptoms of endometritis include:

• Chills or fever
• Headache or low back pain
• Pain in the abdomen
• Foul-smelling discharge from the vagina

(Unfortunately, it can be very difficult for women to differentiate between pain due to a postpartum infection and that which occurs following routine labor and delivery.)

Some women have only foul-smelling lochia (the post-partum discharge) without any other sign of infection.  An infection with group A strep is more likely to have scanty, odorless lochia.[2] 

Treatment

In any post-partum patient with a fever above 100°F for more than 12 hours, the following dosages are recommended:

• Penicillin V 500 mg, followed by 250 mg every six hours, by mouth, until at least four days after the fever passes.
• In penicillin-allergic patients, erythromycin 500 mg, followed by 250 mg every six hours, by mouth, until at least four days after the fever passes.[3]
• Alternatively, injections of 500,000 units of procaine penicillin, twice per day, for one week, may be administered.  Alternatives are ampicillin, cotrimoxazole, or tetracycline.[4]
• The Western Australia North Metropolitan Health Service advises:   
• For unwell patients, ceftriaxone, 2 g, IV, daily plus metronidazole, 500 mg IV every 12 hours.  (They did list other options of IV antibiotics that are extremely difficult for non-medical personnel to obtain.)  
•  For less unwell patients, they recommend amoxicillin plus clavulanic acid (Augmentin) 875 mg/125 mg every 12 hours.  Another Australian agency recommends the addition of 400 mg metronidazole every 8 hours, for seven days, and also notes that Augmentin should be used for seven days.[5]  The agency also defines the previously mentioned “less unwell” patients as those who do not have a fever.   
• Less unwell patients who are allergic to penicillin may be given ciprofloxacin, 500 mg every 12 hours for 7 days, plus metronidazole, 400 mg every 12 hours for seven days. 

Natural treatment options

While there were several references to herbs being given to women post-partum to aid in contraction of the uterus, there was nothing about any herbs being used specifically to treat post-partum infections. I suspect that Native Americans and others did use herbs to treat these infections, but have nothing to back that up.

As I wrote about last year in an article on activated charcoal, there is a report about a doctor who used activated charcoal “pencils” in his patients who had post-partum infections.  The following comes from that article.  I’m sorry I don’t have more information.

Apparently, there was a Dr. Nahamancher practicing in the 1930s who started using "charcoal pencils" in the uterus of patients who developed infections.  Once he started using this treatment, he never lost another patient to infections following miscarriage or childbirth.   Most of the time, it only took one treatment.  It was reported that once the charcoal pencil was inserted into the uterus, the odor dissipated almost immediately, a sign that the charcoal was working. (This is also the case when sugar is applied to infected wounds--the odor disappears rapidly.)

Dr. Nahamancher produced charcoal pencils by stirring together water, activated charcoal, and starch (cornstarch, flour?) until thickened.  After cooling slightly and thickening a little more, he poured strips of the mixture onto a greased pan.  He let those sit for a while and then dried them overnight in a warm oven.  (Or use a dehydrator set to about 90 degrees.)  They could then be picked up if handled carefully.[6]

Links to related posts:

More Medicinal Uses of Activated Charcoal

Ectopic Pregnancy

Augmentin

Ciprofloxacin

Metronidazole

Ceftriaxone

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[1] Joseph Alton, The Survival Medicine Handbook, 443.

[2] “Postpartum Infections:  Treatment and Management,” Government of Western Australia North Metropolitan Health Service, https://kemh.health.wa.gov.au/~/media/Files/Hospitals/WNHS/For%20health%20professionals/Clinical%20guidelines/OG/WNHS.OG.InfectionPostnatalInfectionTreatment.pdf (accessed 15 December 2020).

[3] The Ship’s Medicine Chest and Medical Aid at Sea, 1978, 353.

[4] David Werner, Where There Is No Doctor, 276. 

[5] “Postpartum Hemorrhage:  Prevention, Assessment, and Management,” Victorian Agency for Health Information, https://www.bettersafercare.vic.gov.au/clinical-guidance/maternity/postpartum-haemorrhage-pph-prevention-assessment-and-management (accessed 15 December 2020).

[6] http://www.charcoalremedies.com/doctors

20 march 2021