Alarming Trends in Maternity Safety: An Urgent Call for Change

The Imperial College London report, “National State of Patient Safety 2020,” has highlighted a troubling picture of maternity safety in England. For the first time in a decade, rates of maternal and neonatal deaths have risen, and stark disparities in outcomes for women from Black and Asian ethnic backgrounds remain unaddressed. This worrying trend not only underscores an urgent need for accelerated improvement but also raises fundamental questions about equity and safety in maternity care.

A Worsening Crisis in Maternity Safety

Between 2020 and 2022, the rate of maternal deaths increased by 52.3%, rising from 8.8 to 13.4 deaths per 100,000 maternities. This marks a significant reversal of years of steady decline. Similarly, neonatal death rates, which had seen a promising 17% decrease between 2013 and 2020, rose by 15.4% in 2022, while stillbirth rates also showed an upward trajectory, increasing by 8% in 2021 before dropping slightly in 2022.

The report highlights that systemic shortcomings are to blame, as performance in key maternity safety measures has deteriorated. These alarming trends put the UK off track to achieve its ambitious targets for reducing stillbirths, neonatal mortality, maternal mortality, and serious brain injuries by 2025.

Persistent and Stark Disparities

The inequalities highlighted in the report paint a deeply concerning picture. Maternal deaths among women from Black ethnic backgrounds remain almost three times higher than for White women. These women are also up to six times more likely to experience severe birth complications during hospital delivery. Similarly, maternal mortality rates among women from Asian ethnic backgrounds are twice as high as those of their White counterparts.

The disparities extend beyond ethnicity. Women in the most deprived areas face maternal mortality rates more than twice as high as those in the least deprived areas. These inequities are mirrored in public perceptions, with a national survey showing that people from Black ethnic backgrounds are significantly more concerned about maternity safety than any other demographic group.

A System Under Stress

This decline in maternity safety is emblematic of broader systemic challenges in the NHS. Almost half of maternity units inspected by the Care Quality Commission were rated as ‘inadequate’ or ‘requires improvement’ in 2024. Additionally, patients report declining levels of support during and after hospital stays, further highlighting the strain on services.

The Cost of Unsafe Care

Beyond the human toll, unsafe care has profound financial implications. The spiraling costs associated with poor maternity outcomes underscore the need for systemic change. Investments in safety measures not only save lives but also reduce the economic burden on the NHS.

An Urgent Call to Action

The findings of this report are a stark reminder that maternity safety must be a national priority. The lives of mothers and babies depend on it. Addressing these issues requires:

Equity-Focused Interventions: Targeted efforts to eliminate disparities in outcomes for women from Black and Asian ethnic backgrounds.

Improved Safety Standards: Accelerating improvements in maternity care quality and safety.

Support for Deprived Communities: Dedicated resources to address the socioeconomic factors driving disparities.

Enhanced Monitoring and Accountability: Ensuring all maternity units meet rigorous safety benchmarks.

For too long, progress in maternity safety has been too slow. The rise in maternal and neonatal deaths demands immediate, coordinated action. Every mother and baby deserves the best start in life, and it is our collective responsibility to ensure that no one is left behind.