The number of women dying during pregnancy or soon after childbirth has reached its highest level in almost 20 years, according to new data. Experts have described the figures as “very worrying”.
How many women are dying?
Between 2020 and 2022, 293 women in the UK died during pregnancy or within 42 days of the end of their pregnancy. With 21 deaths classified as coincidental, 272 in 2,028,543 pregnancies resulted in a maternal death rate of 13.41 per 100,000.
This is a steep rise from the 8.79 deaths per 100,000 pregnancies in 2017 to 2019, the most recent three-year period with complete data. The death rate has increased to levels not seen since 2003 to 2005.
Where have the figures come from?
The data comes from MBRRACE-UK, which conducts surveillance and investigates the causes of maternal deaths, stillbirths and infant deaths as part of the national Maternal, Newborn and Infant Clinical Outcome Review Programme (MNI-CORP).
MNI-CORP aims to improve patient outcomes and is funded by NHS England, the Welsh government, the health and social care division of the Scottish government, the Northern Ireland Department of Health, and the states of Jersey, Guernsey, and the Isle of Man.
Why are so many women dying during or just after childbirth?
The main cause of death was thrombosis and thromboembolism, or blood clots in the veins.
The second most common cause was Covid-19. But even when deaths due to Covid were excluded, the maternal death rate for 2020 to 2022 – 11.54 per 100,000 pregnancies – remained higher than the rate for 2017 to 2019.
Heart disease and deaths related to poor mental health were also common, according to a review of the data by the Guardian.
Why is the mortality rate increasing?
The researchers behind the data project, led by Oxford Population Health’s national perinatal epidemiology unit at the University of Oxford, highlight several issues.
They say maternity systems in the UK are under pressure but also point to pre-pregnancy health and the need to tackle conditions such as obesity, as well as critical actions to work towards more inclusive and personalised care during pregnancy.
Is there any good news?
Not really. The maternal death rate among black women decreased slightly compared with 2019 to 2021, but they remain three times more likely to die compared with white women. Asian women are twice as likely to die during pregnancy or soon after compared with white women.
Are there other factors aside from health?
Absolutely. Women living in the most deprived areas of the UK have a maternal death rate more than twice that of women living in the least deprived areas.
Persisting ethnic and socioeconomic inequalities show the UK must think beyond maternity care to address the “underlying structures” that impact health before, during and after pregnancy, such as housing, education and access to healthy environments, said Dr Nicola Vousden, co-chair of the women’s health specialist interest group for the Faculty of Public Health.
Are deaths during pregnancy only increasing in the UK?
No. Maternal death rates are rising in many countries, yet this alarming trend has not been seriously addressed by governments and healthcare systems worldwide.
Rates have doubled in the US over the last two decades, with deaths highest among black mothers, a study in Journal of the American Medical Association found. Indigenous women had the greatest increase.
It is difficult to compare precise death rates between countries because the data is not uniform. But other countries seeing substantial rises in rates include Venezuela, Cyprus, Greece, Mauritius, Puerto Rico, Belize, and the Dominican Republic.
What can be done to reverse the trend?
Urgent action is needed to bolster the quality of maternal healthcare, ensure it is accessible to all, and repair the damage inflicted by the pandemic on women’s healthcare services more generally.
Clea Harmer, the chief executive of bereavement charity Sands, said improving maternity safety also needs to be at the top of the UK’s agenda.
The government said it was committed to ensuring all women received safe and compassionate care from maternity services, regardless of their ethnicity, location or economic status.
Anneliese Dodds, the shadow women and equalities secretary, said Labour would seek to reverse the “deeply concerning” maternal mortality figures by training thousands more midwives and health visitors and incentivising continuity of care for women during pregnancy.
NHS England said it had made “significant improvements” to maternity services but acknowledged “further action” was needed. It has introduced maternal medical networks and specialist centres to improve the identification of potentially fatal medical conditions in pregnancy.
