Yesterday’s report looking at mothers who died in 2018-20 by MBRRACE-UK made for sobering reading. There has been another increase in the number of mothers dying, particularly in the post-natal period, and a sharp focus is needed to prevent maternal deaths and injuries.
The themes and main causes of death are very similar to those highlighted in previous maternal mortality reports. But have we learned anything as a result of these pieces of work? Are we making necessary system and policy changes? And are we equipping health professionals with knowledge that might save lives? Baby Lifeline’s research shows that, in many Trusts and Health Boards, training provided to health professionals is patchy and often not related to the main causes of death for women and birthing people.
Last year, Baby Lifeline published its third ‘Mind the Gap’ report, which surveyed health professionals working in maternity, and those responsible for training their local maternity workforce. The survey audited national continuous professional development, with 83% of NHS Trusts taking part.
In our analysis, we compared our survey’s findings with previously research findings reported by organisations including MBRRACE-UK. We looked at reasons why women were dying and considered whether the training being provided was giving team members the information they needed to be able to deal with the factors that most often lead to deaths during and after pregnancy.
The graph below has been adapted from the Mind the Gap 2021 report to incorporate today’s figures from MBRRACE-UK’s latest maternal mortality and morbidity report. The graph shows a stark disparity between the main causes of death for mothers, and training prioritised for the frontline.
Fewer than three quarters of organisations surveyed offered training relating to the five main causes of death identified by MBRRACE-UK – with all but Covid-19 offered in half of organisations or less. Significantly, cardiac disease has been a main cause of death for over two decades, and yet fewer than a third of organisations surveyed reported that they provided training in this topic.
Another thread that runs through the MBRRACE-UK report is the persisting inequalities for Black and Asian women when compared to their white counterparts. This disparity has been known about for decades with reports such as The Black Report highlighting national disparities in 1982. Yet, Baby Lifeline’s Mind the Gap 2021 report found that fewer than one-third of maternity service providers included training in the identification of clinical signs in people with Black and Brown skin in their Emergency skills & drills training.
Speaking at the MBRRACE-UK virtual conference today, Sandra Igwe, a member of Baby Lifeline’s Family Voices Group, advised that “the white body as ‘the norm’ needs to be dismantled”. We fully support this.
There are many national policy changes, system changes, and much research that must be done to prevent adverse outcomes for women, birthing people, and their babies. However, if we do not give professionals regular, relevant, and effective training based on the latest research and interventions on the main causes of mortality and morbidity, then we are missing a big opportunity to save lives.