NHSE introduces new standards in effort to cut maternal deaths

Every maternity service in England will be required to meet new clinical standards under plans set out by NHS England (NHSE) aimed at reducing maternal deaths.

The standards target blood clots, strokes, cardiac disease, suicide, sepsis, obstetric haemorrhage and pre-eclampsia, which together account for 52% of maternal deaths.

With blood clots now the leading cause of maternal mortality, all pregnant women will receive an early risk assessment for venous thromboembolism before their first antenatal appointment, and those identified as high risk will be offered preventative blood-thinning treatment within 72 hours.

Maternal suicide remains the leading cause of death between six weeks and one year after pregnancy, accounting for 33% of deaths in that period between 2022 and 2024.

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In view of this, routine mental health assessments will be introduced via a consistent set of questions and a report provided at antenatal appointments, with referral to specialist perinatal services where required.

Women with epilepsy will have access to specialist teams and personalised care plans, including appropriate medication during pregnancy.

There will also be earlier escalation of care for women experiencing significant bleeding after birth, with revised thresholds to ensure faster involvement of senior obstetric and anaesthetic staff.

Full implementation of the new framework is expected by March 2027, with progress against each clinical standard to be presented to NHS trust boards, and escalation to regional and national level if local delivery does not meet expected plans.

According to the latest official data, there were 252 maternal deaths between 2022 and 2024, compared with 257 between 2021 and 2023.

For the latter reporting period, research found that improvements in care may have made a difference to the outcome for almost half (45%) of women who died, NHSE said.

Kate Brintworth, chief midwifery officer for England, said: ‘Every death during or after pregnancy is a tragedy especially when differences in care may have changed the outcome.

‘By setting out these clinical standards and holding hospitals to account we can significantly reduce avoidable deaths and prevent future tragedies.’

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The standards form part of a wider maternal care bundle developed with clinicians and partner organisations, informed by findings from MBRRACE-UK.

Alongside the clinical measures, up to £5m has been allocated this year to improve maternity facilities and care systems.

A digital monitoring tool, the Maternal Outcomes Signal System (MOSS), will analyse routinely collected data to identify emerging safety concerns. Findings from the MOSS will be published every six months.

NHSE said the changes would also strengthen the role of 17 maternal medicine centres across England, which support women with pre-existing medical conditions or conditions that arise during pregnancy.

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Last month it was announced that a new taskforce had been set up to deliver ‘urgent action’ on maternity care – and that the chief nursing officer for England, Duncan Burton, was among the 17 members confirmed.

The taskforce will be charged with delivering action on the recommendations of the independent national investigation into maternity and neonatal services in England, led by Baroness Amos, which will be reviewed in June.

Interim findings from the investigation last month revealed that maternity and neonatal services in England are failing to deliver consistent, safe and equitable care, with staffing pressures and structural racism among the most serious concerns.