The key findings of the MBRRACE-UK ‘Saving Lives, Improving Mothers’ Care Core report: Lessons learned to inform maternity care from the UK and Ireland Confidential Enquiries into Maternal Deaths and Morbidity 2018-20’, published today (Thursday 10 November 2022):
- There remains a more than three-fold difference in maternal mortality rates amongst women from Black ethnic backgrounds and an almost two-fold difference amongst women from Asian ethnic backgrounds compared to white women
- Women living in the most deprived areas are more than twice as likely to die as women living in the wealthiest areas
- 11% of the women who died in the UK in 2018-20 were at severe and multiple disadvantage: a mental health diagnosis, substance use and/or domestic abuse
- Psychiatric disorders and cardiovascular disorders are now responsible for the same number of maternal deaths in the UK; together these two causes represent 30% of maternal deaths
- Thrombosis and thromboembolism remain the leading cause of direct maternal death during or up to six weeks after the end of pregnancy
- Deaths from mental health-related causes account for nearly 40% of deaths occurring within a year after the end of pregnancy, with maternal suicide remaining the leading cause of direct deaths in this period
Sara Ledger, Head of Research and Development at Baby Lifeline, said:
“Today’s MBRRACE-UK report makes for extremely sad reading, but unfortunately its findings are not a great shock to us at Baby Lifeline.
“In November 2021, we published our own Mind the Gap research into the training provided within NHS maternity services across the UK (covering April 2020 to March 2021). Eighty-three per cent of all UK NHS Trusts took part in our study, which revealed significant inconsistencies in the extent to which services equip team members with knowledge and understanding of women’s individual circumstances, and the factors that continue to increase the risk of them dying during or after childbirth.
“The government wants to reduce maternal mortality in England by 50% between 2010-2025, but maternal mortality has in fact increased by 8% since 2010-12.
“It’s clear from today’s report that many women need the support of complex intersecting services before, during and after the birth of a child – but the role of midwives, obstetricians, obstetric anaesthetists and maternity support workers is crucial in providing individualised care.
“Yet our research found that NHS maternity services are not always providing team members with the information and insight they need to be fulfil this role.
“In preparation for caring for women with co-morbidities and/or high-risk pregnancies, fewer than half (46%) of UK organisations included training for maternity professionals in diabetes in pregnancy; even fewer (29%) provided training in cardiovascular diseases. Meanwhile, only one quarter (24%) of organisations included training in management of women with obesity/post-bariatric surgery.”
“Today’s MBRRACE report confirms that thrombosis and thromboembolism remain the leading cause of direct maternal death during or up to six weeks after the end of pregnancy; however, our research found that fewer than 40% of organisations provided training related to thromboembolism.
“Deaths from mental health-related causes (substance misuse and suicide) account for nearly 40% of deaths occurring within a year after the end of pregnancy.
Training in both perinatal mental health and substance misuse was provided by just over half of organisations (53%).
“Women with Black and Brown skin are once again overrepresented in the maternal deaths. Black women were 3.7 times more likely to die than white women and Asian women were 1.8 times more likely to die than white women. 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 We need to adapt training to represent the maternity population
“Baby Lifeline Training responds to these findings by developing and providing courses for healthcare professionals designed to fill gaps in knowledge and information. The data published today by MBRRACE-UK only strengths our resolve to continue what we’re doing as we strive to play our part in reducing the number of women and babies who are dying.”