The paper, published in the British Medical Journal, shows that despite substantial declines in deaths related to pregnancy and childbirth in high income countries in recent years, mothers in Slovakia and the UK are up to 4 times more likely to die during pregnancy or soon after than mothers in Norway and Denmark.
Writing in the BMJ, researchers compared the number of women who died up to 42 days after the end of their pregnancy and in the perinatal period after 43 days while living in Denmark, Finland, Norway, France, Italy, the Netherlands, the UK and Slovakia.
In all countries but Norway, the maternal mortality rate was at least 50% higher for women born abroad or with a minority ethnic background, and death rates were also highest for women under 20 and over 40.
The study comes after the release of the MBRRACE-UK maternal mortality report which found that across 2018-20 the number of UK women who died during or up to 6 weeks after the end of pregnancy was 24% higher than 2017-19. Increases were steepest in the most deprived parts of the country.
Many of these deaths could have been prevented.
The BMJ paper shows that cardiovascular diseases and suicide were the leading cause of deaths in most countries – a finding also shown by MBRRACE-UK in their report.
Head of Tommy’s Preterm Birth Surveillance Unit Professor Andrew Shennan and colleagues, writing an article accompanying the BMJ report, say that this finding “underlines the importance of women’s mental and cardiovascular health and the need to develop strategies before, during, and after pregnancy to prevent the morbidity and mortality these problems can cause."
“Interventions to prevent these deaths are effective and relatively affordable; strategies must include recognition, training, and access to care that is adequately resourced and staffed.”
In 2018 the Government committed to investing £23m in mental health support for women and birthing people during and after pregnancy, with a focus on areas without specialist perinatal support. Yet in 2020 the number of women who died by suicide during or up to 6 weeks after the end of pregnancy was 3x higher than in 2017-19.
A large number of these women had no formal mental health diagnosis at the time of their death, but did have complex histories of trauma, including domestic violence and substance abuse issues.
The investment in support is evidently not reaching the people who need it most.
Deaths from pre-eclampsia have also risen steeply in the UK. Despite huge advances in developing new tests and treatments, the data shows a 4x increase in deaths. We know that with careful monitoring and management many of those deaths would have been avoidable.
In the PARROT trial, funded by Tommy’s, Professor Shennan and team found a simple blood test – a placental growth factor (PlGf) test – could help diagnose pre-eclampsia and identify those most at risk of developing severe complications.
In March this year the NHS announced that the test would be introduced as standard, although it is not yet rolled out across the whole of the UK. This week’s devastating reports on the rise in deaths from pre-eclampsia show that this roll-out must happen as soon as possible.
Our CEO Kath Abrahams says:
“The UK’s rising maternal mortality rate and the enormous disparities in the number of women dying from the wealthiest and poorest areas, alongside the much higher rate of death among Black and Asian women compared to White women, are indicative of a crisis in UK pregnancy, neonatal and perinatal care.
“If nothing is done, all signs point toward the situation being even worse this year – more families going home without their child and more children growing up without a mother. [These reports] show a very clear link between poor care and tragic outcomes. This cannot continue.
“We are urging the Government to act, and act fast, to invest in the safer staffing and resources needed to reverse this trend of worsening safety for mothers and babies in the UK.”