Third of pregnant women’s deaths were avoidable, inquiry finds

Women from ethnic minority backgrounds and poorer areas are more likely to die during pregnancy than white women

Experts have warned of a worrying rise in teenage mother suicides (PA)

More than 80 pregnant women who died during a three-year period could have been saved if they had received better care, a major new report has found.

Out of a total of 231 women who died between 2017 and 2019, a total of 37 per cent, or 83 could have been saved if their care had been better. Only 17 per cent, or 39 women who died, were found to have had good care.

A new national report for the NHS, by experts at Oxford University, said while cardiac disease was the single largest cause of death for mothers during pregnancy, suicide remained the leading cause of death in the first year after pregnancy.

Published without any official announcement by NHS England despite it commissioning the work, the report highlighted a “concern” over the rising rate of teenage girl suicides which increased from 2.5 per 100,000 in 2014-16 to 11 per 100,000 in 2017-2019.

Of the 61 women who killed themselves, expert assessors found that better care could have prevented 41 deaths, or 67 per cent.

The inquiry, which examined more than 680 deaths in total, was carried out by experts as part of the MBRRACE or, Mothers and Babies: Reducing Risk through Audits and Confidential Enquiries, project.

The latest report again found stark inequalities for women from different ethnic backgrounds.

Women from black ethnic groups are four times more likely to die in pregnancy than women from white groups, and women from Asian ethnic backgrounds are almost twice as likely to die.

Similarly, pregnant women living in the most deprived areas are twice as likely to die than those living in the most affluent areas.

Women aged over 40 have a mortality rate four times higher than women aged 20 to 24-years-old. Less than a third of women who gave birth over the age of 45 had the recommended care for older women.

Overall, the report said pregnancy remained safe in the UK, with the overall maternal death rate showing a slight decrease. Among 2,173,810 women who gave birth in 2017-2019, 191 died up to six weeks after pregnancy while 495 women died up to a year after their pregnancy.

The researchers warned that clinicians’ focus on pregnancy instead of the overall health of the woman in front of them was putting women at greater risk.

In some cases women who had cancer had their symptoms dismissed and attributed to pregnancy which meant the problem was not investigated. In at least eight cases, the report said the deaths could have been prevented with better care.

Professor Marian Knight, who led the study, said: “This report demonstrates that there are persisting inequalities in maternal deaths, besides recurring structural biases affecting women’s care on the basis of their pregnancy. Addressing these systemic issues is more urgent than ever, particularly as we continue to see the same biases affecting the care of pregnant women with Covid-19.”

Recommendations from the report include making clinicians more aware of the risks and that they can change during pregnancy.

It suggests women who raise concerns about symptoms should be treated the same as a non-pregnant woman unless there is a clear reason not to.

It calls for better coordination between services including GPs, hospitals and mental health services and for care to be more personalised.

Dr Eddie Morris, president of the Royal College of Obstetricians and Gynaecologists, said: “The latest MBRRACE-UK report acts as a reminder of the urgent action required to reduce the inequalities in maternity care that exist due to a woman’s socioeconomic status, age, and ethnicity. It is unacceptable that there has been no significant reduction in maternal deaths in the past decade, and this needs to be addressed.”

He said the government must adopt a target to end what he called the “persistent and harmful unequal maternal outcomes” for ethnic minority women.

Dr Mary Ross-Davie, director of professional midwifery at the Royal College of Midwives said: “Pregnancy and childbirth in the UK continue to be a safe experience for most women. However, we remain deeply concerned that mortality rates among Black women are four times higher than white women and twice as high if you are Asian or from another minority ethnic background. All those involved in commissioning and delivering maternity services must work together to address this unacceptable disparity.”