Childbed Fever

Ailment

Kind	Illness
Cause	Foulness carried into the birth passage by hands, cloths, and instruments, worst after a long or torn labour
Strikes	Mothers of every people that bears live young; worst after hard or handled births; Thaluren, whose young come from eggs, are spared
Contagion	Passed from one mother to the next on the hands and cloths of those who attend them
Mortality	Kills perhaps one mother in ten of those who take it, more in crowded lying-in houses
Treatment	Clean hands and boiled cloths beforehand; fever care, Cleanse Wound, Fever Ease, and Cure Affliction after
Regions	Widespread

The fever that follows a birth, carried in by unclean hands and cloths, which kills mothers in the days after a hard labour.

Overview

Childbed fever comes two or three days after a birth, when the household has begun to breathe again. Most births pass without it. When it comes it is the commonest death of young mothers, and every midwife counts her own losses to it.

Cause

Foulness enters the torn and open body after birth, carried on the hands of whoever attends the mother, on reused cloths and bedding, and on hooks and knives. What passes is too small to see. A long labour, a torn birth, and a birth helped by hand or tool open the way wider, and a midwife who comes from one fevered bed to the next carries it with her.

Who It Strikes

It threatens the mothers of every people that bears live young. Humans meet it most, because they are many and crowded. Elven births pass through a Verdant-marked threshold (see Elves) and are rarer, but the mother is no safer for it. Thaluren, whose young come from eggs laid in spawning waters, are spared, and the dangers to their young lie in the water instead. Kavari mothers give birth in the water, their childbed a sheltered nursery pool, and are not spared; what their young fear is the water itself (see Nursery-Water Sickness). The Wrought are made, not born.

Signs and Course

The mother is well for a day or two. Then she shivers, and the fever climbs. The belly grows tender and swollen, and the flow after birth turns foul-smelling. She cannot keep food, her pulse runs fast, and she may rave. In the better cases the fever breaks within a week and she mends slowly. In the worse, the fever reaches the blood: she grows cold at the hands, grey, and quiet, and dies within a few days. Some survivors cannot bear again.

Contagion

It passes from mother to mother, not on the breath but on the hands, cloths, and tools of those who attend them, which is why it runs through a district behind one midwife, or through a lying-in house, while a lone farm birth escapes it.

Treatment and Its Limits

Prevention works best. Some midwives wash their hands in hot water and strong wine before a birth and boil their cloths, and their mothers die less often; others do not, and the practice is held as wisdom by some and fuss by others.

Once the fever has come, a folk healer cools the mother, gives bitter fever-bark, and washes the passage. A healer may wash deeper with Cleanse Wound and hold the fever down with Fever Ease, which can leave a weak mother too cold if it is overused. Sickness Gate can keep the fever from the blood for a night or days. A priest's Cure Affliction can turn a case outright, but a priest is seldom near a farm bed in time. Every one of these is paid for from someone's lifeforce, and a mother already drained by a hard birth is a poor source.

Mortality

About one mother in ten who takes it dies, many more where a lying-in house or a careless midwife passes it from bed to bed. Those who live may be weak for a season, and some bear no more children.

Lore and Belief

The peoples blame the cold, a chill caught in the birth room, milk gone to the head, or a mother who rose too soon. Many households shut the windows and stop the cracks against bad air, which does no good. Folk wisdom says a midwife whose hands go grey after a hard birth has paid for the mother's life and should be thanked accordingly. In the Leeward Folds newborns are offered to Tamsel the Season-Weaver, and some mothers ask a season of protection for themselves as well.

In the Medieval Era

Childbed fever is met everywhere. Most births are attended by a midwife or the women of the household, and the fever's toll follows how clean they work. Town lying-in houses and great households that call healers of the Vital Magic schools to a birth do better when the fever comes, and worse when it spreads among their beds. The custom of hot water and boiled cloths travels from midwife to apprentice, unexplained and unevenly kept.

Where It Appears

This ailment grows out of the following pages and chapters:

the Writers' Guide chapter Magic in Ordinary Life (a midwife's hands go grey after a hard birth)
Elves (Elven births)
Tamsel the Season-Weaver (a season of protection for the newborn)