Women are dying during childbirth at the same rate as 20 years ago, ‘alarming’ new data shows.
An independent study into maternal mortality found that between 2020 and 2022, 293 women died during pregnancy and within six weeks of giving birth.
Experts say the upward trend is the most compelling evidence yet that the failures now “cover the entire maternity system” and “not just involve one or two hospitals.”
They blamed pressure from the NHS, along with factors such as rising obesity and poorer overall maternal health, for undoing the progress made over the past two decades.
The chart shows the NHS trusts in England that recorded the biggest fall in midwifery numbers between September 2022 and July 2023 – according to the latest data available. Northern Care Alliance NHS Foundation Trust has seen its midwifery workforce fall by 12.8 per cent in the past nine months, while Royal Cornwall Hospitals NHS Trust has seen an 8.8 per cent reduction in staff compared to 10 months earlier, NHS workforce data shows
The research by Oxford-led MBRRACE-UK (Mothers and Babies: Reducing Risk through Audits and Confidential Inquiries) found that the increase in deaths was across the board.
Blood clots were the leading cause of death among new mothers, followed by Covid, heart disease and mental health problems.
The data shows that inequality between women in deprived areas is twice as high as that in wealthy areas, and black women are three times more likely to die than white women.
Marian Knight, professor of maternal and child health at Oxford Population Health, Oxford University, said: ‘Our services are not able to prevent women from dying in the way they could, so I think we are very concerned about this. have to transfer.
“We’re not just talking about one or two specific departments; I think it’s something we need to recognize and look at across the maternity system.
“It’s very clear that the trend is going in the wrong direction.”
Nearly 14 in 100,000 women would die during or in the weeks after giving birth in 2022, about the same rate as in 2004, the data show.
Because the data is still preliminary, it is not yet known what proportion of women died in hospital or at home, or how each of the UK countries compares.
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But maternity professionals said it pointed to widespread problems, extending to primary care such as GPs and health visitors, as well as mental health teams.
It follows a litany of failed pregnancies including Shrewsbury and Telford and East Kent NHS Trusts, with a record number of services now failing to meet safety standards.
The Healthcare Quality Commission found that around 65 percent are now assessed as ‘insufficient’ or ‘requires improvement’ in the field of safety.
Last month, Donna Ockenden – the midwife tasked by the Government and the NHS with investigating pregnancy scandals – criticized ministers for failing to provide enough money to tackle the problems.
She is currently leading an investigation into failures at Nottingham University Hospitals NHS Trust, which is expected to be the largest yet, affecting 1,800 families and 700 staff.
Professor Knight added: ‘For most women, childbirth is a normal, happy and uncomplicated experience, but it feels like there is an unspoken assumption that has always been the case.
‘We must recognize that it is thanks to the enormous advances in healthcare that we have reached this position, and to maintain that position we still need that extremely high-quality care.’
Dr. Nicola Vousden, from the Faculty of Public Health’s Women’s Health Specialist Interest Group, said more must also be done to help women improve their health, especially in areas of poverty.
She said: ‘Persistent inequalities across ethnicity and socio-economic status indicate that we need to think beyond maternity care and address the underlying structures that impact health before, during and after pregnancy, such as housing, education and access to a healthy environment.”
Kirsty Kitchen, from the charity Birth Companions, said: ‘It is truly shocking that in one of the richest countries in the world our maternal mortality rate is rising and not falling, and that women in the most deprived parts of the country are increasingly more than twice as likely to die than women in the more prosperous areas.’
The general manager of RCM,
Gill Walton, chief executive of the Royal College of Midwives, said: ‘Pregnancy and childbirth in Britain remain safe for most women, but the rise in deaths is a deeply worrying trend.
‘The figures in the report do not lie: we are going backwards and not forward.
“The government and the entire healthcare system must join forces to immediately reverse this trend.
‘The shortage of midwives is undermining the ability of maternity staff to provide the safest possible care. This is fundamentally a failure of policymakers and the government to quickly get investments where they are needed, on the frontline of healthcare.”
An NHS spokesperson said: ‘While the NHS has made significant improvements to maternity care over the past decade, we know that further action is needed to improve the experiences of women and their families across the country and that is why investment has increased to £186 million a year to grow. its maternity workforce, strengthening leadership and improving culture.
‘The NHS has also introduced maternal health networks and specialist centres, which are a crucial step in improving the identification and management of potentially fatal medical conditions during pregnancy, wherever a woman receives care, and ensuring that England continues to improve its position as one of the largest countries. of the safest countries in the world to give birth.
‘Every local health system now also has a specialist perinatal mental health team, and the NHS has recently published guidance to ensure GPs carry out a comprehensive postnatal check six to eight weeks after giving birth, covering a range of topics such as mental health come. and physical recovery.’
A spokesperson for the Department of Health and Social Care said: ‘Every birth-related death is a tragedy, and we want to ensure that all women receive safe and compassionate care from maternity services, regardless of their ethnicity, location or economic status.
‘We are investing £165 million a year, rising to £186 million from April, to grow the maternity workforce and improve neonatal care across England, and have spent £6.8 million tackling inequalities in maternity care to ensure that all mothers feel safe during and after childbirth.’
‘To improve maternity care, NHS England last year published a three-year plan to make maternity and neonatal care safer and fairer.’