MBRRACE-UK: Saving Lives, Improving Mothers’ Care Report

The MBRRACE report looking into maternal deaths and morbidity was released yesterday. The report examined in detail the care of women who died during or up to one year after pregnancy between 2014 and 2016 in the UK and Ireland from mental health conditions, blood clots (thrombosis and thromboembolism), cancer, and homicide, and women who survived major bleeding (haemorrhage). 

Here is a brief summary of the main points raised in the report. The full report can be found here.

Fewer than 10 of every 100,000 pregnant women die either during pregnancy or childbirth. Heart disease is the leading cause of death followed by blood clots. During pregnancy, or shortly after; suicide is the 5th most common cause. Suicide is however the leading cause of death in the year following a pregnancy.

There are stark inequalities which show that black women are a huge 5 times more likely to die as a result of complications and Asian women 2 times more likely to die in comparison to white women. The report recognises that urgent research and action needs to be taken regarding these striking inequalities.

Of the deaths recorded, most of the women had multiple health issues or were vulnerable in some way (abuse, domestic violence for example). The report highlights possible improvements that could be made to help prevent future deaths. It also recognises that on the whole societal changes play a factor stating “Women now are often older, heavier and have more complex physical and mental health conditions when they become pregnant. They may be vulnerable in other ways too. They are therefore at higher risk of pregnancy complications.” 

A related finding was that women who are pregnant in their 40’s are 3 times more likely to die during or after pregnancy than women in their early 20’s. 

To prevent crucial signs being missed, the report states that healthcare professionals need to sometimes challenge their own presumptions about reported symptoms, employing the services of specialist teams outside of maternity when needed. Women also need to be encouraged and given the confidence to speak out about concerns / worrying symptoms.

Advice for pregnant women from the report:

Don’t assume that all medicines are bad for your baby. Talk to your GP before stopping anything that you regularly take.

Stay alert to changes in your body. If in any doubt, always get checked out.

Ongoing, severe pain should always be acted upon.

Calf, buttock pain or severe breathlessness (especially if aged over 35) could be a sign of a blood clot and needs to be assessed asap.

Placenta problems are on the increase. Please read our article here about risk factors and what you need to be aware of.

Whilst cancer during pregnancy is rare, you should not put off reporting any worrying symptoms. Some types of investigations and many treatments can still be given safely during pregnancy.

Know the signs of mental health issues that you might need support for. Don’t try to ignore difficult thoughts you may be having. Please see our page here for help and note that pre-natal depression also needs to be treated in the same way.