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‘Worrying’ lack of progress on maternal deaths

Little progress has been made on reducing the rate of women dying during pregnancy or shortly after giving birth despite government efforts to make maternity care a priority, new figures show.

The latest Confidential Enquiry into Maternal Deaths, commissioned by the Healthcare Quality Improvement Partnership and carried out by research programme MBRRACE-UK, shows that 8.5 women in every 100,000 died in 2012-14.

The report noted that meeting the government target of reducing maternal death by 50% by 2030 would be “a challenge” and would require co-ordinated action across different specialties.

Cathy Warwick, chief executive of the Royal College of Midwives (RCM), said: “I want to reassure women that the number of maternal deaths in the UK is very low. However, this report shows that governments have a long way to go in reducing maternal deaths. 

“There has been some progress, but not enough and the lack of significant change in the overall maternal death rate is worrying. Behind each statistic is someone who has died, and whose death perhaps could have been prevented.”

The National Maternity Review recommended introducing more personalised care to reduce mother and baby deaths. Last month, NHS England announced seven STP sites where it will pilot the reforms.

The MBBRACE-UK report showed that the most common cause of death in pregnancy or in the early weeks after childbirth was heart disease, which killed two women in every 100,000.

Suicide, which has been reclassified by the World Health Organisation as a direct cause of maternal death, was the most common cause of death in the year after pregnancy.

Warwick said the rate of maternal suicides “starkly illustrated” why more resources and funding were needed for mothers with mental health problems, including more specialist midwives and mother and baby units. The new CCG Improvement and Assessment Framework for 2016-17 also revealed that over half of CCGs are rated as ‘needs improvement’ for maternal and mental health care.

MBRRACE-UK called for more co-ordinated care to ensure that mother’s heart problems are communicated to everyone in their team, and for post-mortem studies of women who died of cardiac arrest with a view to screening for problems in their relatives.

However, the report did note success in reducing other common causes of maternal death, including pre-eclampsia, and hypertensive disorders.

There was also a decrease in deaths due to influenza, but this was put down to a decline in influenza activity, and that vaccinations for pregnant women must remain a priority.

Professor Marian Knight, who led the research, said: “High-quality care has clearly reduced the number of women who die from pre-eclampsia. In order to reduce the overall maternal death rate, we now need to provide women with heart disease and other medical and mental health conditions the same high quality care.”

(Image c. David Jones from the Press Association)

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