The number of women dying during pregnancy or shortly after giving birth has reached its highest level in almost two decades, according to new data. Experts call the figures ‘very worrying’.
How many women die?
Between 2020 and 2022, 293 women in Britain died during pregnancy or within 42 days of the end of their pregnancy. With 21 deaths classified as accidental, 272 of 2,028,543 pregnancies resulted in a maternal mortality rate of 13.41 per 100,000.
This is a steep increase 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 risen to levels not seen since 2003 to 2005.
Where do the numbers come from?
The data is coming from MBRRACE-UKwhich monitors and investigates the causes of maternal mortality, stillbirth and infant mortality as part of the national Maternal, Newborn and Infant Clinical Outcome Review Program (MNI-CORP).
MNI-CORP aims to improve patient outcomes and is funded by NHS England, the Welsh Government, the Scottish Government Department of Health and Social Care, the Northern Ireland Department of Health and the states of Jersey, Guernsey and the Isle of Man. .
Why do so many women die during or shortly 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 excluding deaths from Covid, the maternal mortality rate for the period 2020 to 2022 – 11.54 per 100,000 pregnancies – remained higher than the rate for 2017 to 2019.
Heart disease and deaths from poor mental health were also common, a review of the data by the Guardian found.
Why is the death 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 Britain’s maternity systems are under pressure, but also highlight pre-pregnancy health and the need to tackle conditions such as obesity, as well as crucial measures to work towards more inclusive and personalized care during pregnancy.
Is there any good news?
Not really. The maternal mortality rate among Black women has fallen slightly from 2019 to 2021, but they remain three times more likely to die than white women. Asian women are twice as likely to die during pregnancy or shortly afterwards compared to white women.
Are there other factors besides health?
Absolute. Women living in the most deprived areas of Britain have a maternal mortality rate that is more than twice that of women living in the least deprived areas.
Persistent ethnic and socio-economic inequality shows that Britain needs to think beyond maternity care and tackle the “underlying structures” that impact health before, during and after pregnancy, such as housing, education and access to a healthy environment, says Dr Nicola Vousden, co-chair of the specialist interest group women’s health at the Faculty of Public Health.
Are the number of deaths during pregnancy just increasing in Britain?
No. Maternal mortality rates are rising in many countries, but this alarming trend has not yet been seriously addressed by governments and healthcare systems around the world.
Rates have doubled in the US over the past two decades, with deaths highest among black mothers, according to a study in the Journal of the American Medical Association. Indigenous women saw the largest increase.
It is difficult to compare precise death rates between countries because the data is not uniform. But other countries where interest rates are rising substantially 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 strengthen the quality of maternal health care, ensure that it is accessible to all, and to repair the damage that the pandemic has caused to women’s health care in general.
Clea Harmer, the chief executive of bereavement charity Sands, said improving pregnancy safety must also be at the top of the UK agenda.
The government said it is committed to ensuring that all women receive safe and compassionate care from maternity services, regardless of their ethnicity, location or economic status.
Anneliese Dodds, shadow women and equalities secretary, said Labor would look to reverse “very worrying” maternal mortality rates by training thousands more midwives and health visitors and boosting continuity of care for women during pregnancy.
NHS England said it had made “significant improvements” in maternity care, but acknowledged “further action” was needed. It has introduced maternal medical networks and specialized centers to improve the identification of potentially fatal medical conditions during pregnancy.
