The fifth MBRRACE-UK collaboration’s annual report Saving Lives, Improving Mothers’ Care produced by the National Perinatal Epidemiology Unit shows that the number of women dying as a consequence of complications during or after pregnancy remains low in the UK - fewer than 10 of every 100,000 pregnant women die in pregnancy or around childbirth. However, the report highlights striking inequalities: black women are five times and Asian women two times more likely to die as a result of complications in pregnancy than white women and the authors recommend urgent research and action to understand these disparities.
Heart disease remains the leading cause of women dying during pregnancy or up to six weeks after giving birth, followed by blood clots. Maternal suicide is the fifth most common cause of women’s deaths during pregnancy and its immediate aftermath, but is the leading cause of death over the first year after pregnancy. Although there is greater awareness of the importance of mental health during pregnancy and in the first year after birth, the authors note that there is still a long way to go in recognising symptoms, supporting women with mental health problems and providing access to specialist perinatal mental health care.
The report highlights the risk of blood clots, particularly among women who are overweight or obese, and emphasises the importance of awareness of symptoms, such as leg or buttock pain and breathlessness even in early pregnancy.
Women who are aged 40 or over have three times the risk of dying during or after pregnancy compared to women in their early 20s and although cancer in pregnancy is uncommon, the authors note that women and their doctors and midwives need to be aware that it can happen.
The report emphasises the importance of considering the benefits of starting or continuing medication to treat physical and mental health conditions during pregnancy, as well as the risks. Many medicines are safe in pregnancy, and so ensuring a woman is properly treated while pregnant may be the best way to care for her baby.