Oxford’s scientists from the Population Health’s National Perinatal Epidemiology Unit, in collaboration with MBRRACE-UK, have published a report which helps identify improvements needed in the maternity sector.
The study, Saving Lives, Improving Mothers’ Care report, comprehensively outlines the number of expecting women who died during, or up to a year after, pregnancy between 2019 – 2021. The report is unique in terms of covering the period of time in which the Delta variant of COVID-19 was most wide-spread and could have had an effect on maternal deaths.
The report carefully analyses and evaluates the care received by the women who died, and simultaneously suggests solutions to prevent deaths in the future. The data also draws attention to the underlying fact that disparities in maternal health currently endure.
The report highlighted racial factors, indicating that in the peak COVID-19 period (2019 – 2021) women from Black ethnic background were four times as likely as White women to die during or up to six weeks after their pregnancy. Additionally, compared to their White counterparts, women from Asian ethnic backgrounds were subjected to an almost two-fold increase in the rate of maternal deaths.
Data from the report has also revealed the impact of economic factors. Indeed, women living in the most deprived areas of the UK were twice as likely to die in comparison to women living in the least deprived regions. Further, 40% of maternal deaths can be associated with mental health related causes with maternal suicide remaining the main cause of direct deaths between in the period.
In addition, 12% of women who died during pregnancy, or up to a year after, were at several of multiple disadvantages. The report shed light on the concern that maternal healthcare staff were often expected to care for women with multiple vulnerabilities or complex medical conditions without proper training, which meant that specific care needs were not met.
Between 2019 – 2021, the leading cause of maternal deaths, in excess of any other cause, was the COVID-19 virus. Vaccine hesitancy, confused and uncertain medical messaging on risks, coupled with being denied access to basic treatment for COVID – 19 were likely contributors to mortality figures.
Women were often uninformed when making choices regarding medication and care. In order to ensure better maternal care, the report’s key recommendations include that pregnant women must be included in medical and vaccine research, the need for tailored postnatal care and access to training resources in order to promote collaborative decision making on medication use during and after pregnancy.
Professor of Maternal and Child Population Health at Oxford Population Health, and maternal reporting lead, Marian Knight MBE, said: “This report shows persistent inequities impacting the care of pregnant, recently pregnant and breastfeeding women. Improvements in care may have been able to change the outcome for 52% of the women who died during or up to a year after pregnancy. This demonstrates an even greater need to focus on the implementation of the recommendations within this report to achieve a reduction in maternal deaths.”
