Maternal Mortality

Question

Asked by

To ask His Majesty’s Government what action they plan to take in response to the finding in the MBRRACE-UK report Maternal mortality 2022–2024, published on 8 January, that the maternal death rate in pregnancy rose by 20 per cent between 2009–11 and 2022–24.

My Lords, MBRRACE’s report highlights the need to improve maternity safety, to which this Government are fully committed. We have commissioned an independent investigation that will present recommendations in the spring, while the National Maternity and Neonatal Taskforce, chaired by the Secretary of State, will transform these into a deliverable national action plan to drive change. In the meantime, we are taking various actions, including piloting Martha’s rule and expanding the maternal medicine networks.

I thank my noble friend for that Answer. She will know that the Conservatives promised to halve maternity mortality by 2025. Instead, as the report shows, it has risen substantially, with stark disparities for older women and those from BME and disadvantaged backgrounds. Between 2021 and 2023, over 600 women died either during or shortly after pregnancy—a tragedy compounded by the fact that, in the majority of cases, this was from a preventable complication of the pregnancy itself. I know the Government are taking certain actions, to which she referred. Those are welcome, but they are not being applied consistently in every area. More importantly, trusts are not required to inform NHS England of the plans they are making. In short, I say to my noble friend that there seems to be a lack of robust oversight. How will the Government ensure that the standards and new procedures that they want to implement will be implemented effectively by every trust and in relation to every pregnant woman?

My noble friend is right to use the word “tragedy” in respect of maternal deaths, particularly those from preventable causes. She is also correct that, sadly, most aspects of the maternal safety ambition that was set under the previous Government are very unlikely to be achieved. We have to make sure that, for any future target, the system can deliver. As one example, the maternal care bundle sets clear standards across all services for implementation by NHS providers and commissioners, and is focused very much on the main causes of maternal death and harm, as my noble friend asks for.

My Lords, the Government have launched a maternity inquiry, but we have already had lots of maternity inquiries and reports from the charity sector, such as the Muslim Women’s Network— I declare my interest as its CEO—Five X More and Birthrights, all with similar findings and recommendations. Instead of having more inquiries, why do the Government not just get on with it and implement actions? What do they expect to find that they do not already know? Can the Minister share how she is implementing existing recommendations?

I understand what the noble Baroness is saying and her frustration, which I am sure many of us share. The purpose of the investigation by my noble friend Lady Amos is to pull together all the learning and all the inquiries. She has, for example, given a real voice to those affected, speaking to 170 affected family members. Those voices are what has been missing, and that cannot go on. We are determined to draw a line under where we have unfortunately been and to move forward, while taking direct actions, including, for example, a national programme to support struggling trusts to make improvements.

My Lords, recent Health Service Journal investigative journalism has found that the Chief Midwifery Officer wrote to trusts last year identifying gross failures in home births safety, yet the Government have chosen to keep this information private while women are pushed into unsupported births. Is it acceptable for NHS England to hide this evidence of systematic safety risk from the public when the home birth services of 14 trust have effectively ceased to exist, despite the legal duty to provide them?

I am not fully up to speed with the article that the noble Lord raises, but I undertake to look at it and get back to him, because this is a very important matter.

My Lords, many NHS trusts are facing deficits in midwives. There is not a sufficient workforce. What are the Government doing to tackle this issue? New parents, and new mothers during their birth, are not being supported, and there are significant problems as a direct result of this.

Midwives are absolutely crucial, and I pay tribute to them and to the wider maternity team. As of October 2025, there has been an increase of some 3.6%—that is 878 more midwives—compared to October 2024. Importantly, we are seeing the introduction of a range of initiatives to improve retention in the maternity workforce, including in midwifery. That will include mentoring and giving better advice and support on pensions and flexible retirement options, because we are keen to retain the long years of service that many midwives and other staff have.

My Lords, touching partly on the question from the noble Baroness, Lady Gohir, data from MBRRACE-UK shows that black women are three times more likely to die during pregnancy or childbirth than white women. Do the department and NHS England have any evidence on the reasons for these disparities that the Minister can share with the House? Will she tell noble Lords how NHS England and the department intend to tackle these disparities?

I am glad to say that my noble friend Lady Amos will be very much focusing on this area. I referred earlier to the maternal care bundle, which focuses on the five main causes of maternal death and harm, as well as on setting up best practice. A number of the risk factors are particularly associated with groups who live in areas of greater disadvantage, those who have pre-existing conditions and, as the noble Lord rightly says, sadly, black women, who are three times more likely to die—something that is totally unacceptable in any day and age, but certainly now. We cannot allow this to go on. That is why we have picked up a key recommendation from the Black Maternal Health inquiry for mechanisms for surveillance of severe maternal morbidity. The first data are expected in the summer.

My Lords, a confidential inquiry into maternal deaths is a good indicator of the quality of maternity services. The fact that the rate has gone up from 9 per 100,000 in my time to 12.8 now suggests that there is a failure of maternity services. To use an example, 155 women who had a history of psychiatric problems—mental health problems—died within a year of delivering a baby. That compares to the total number of 611 maternal deaths. It is a significant number, and yet the specialist perinatal maternity health services that are supposed to look after women with a mental health history have failed. It should be a duty on ICBs to produce a plan, so that women with a mental health history are looked after and have a care plan during pregnancy.

This is absolutely crucial. I welcome that, as of June last year, maternal mental health services are available in all parts of England. We also now have 153 operational mother and baby unit beds providing in-patient care to women experiencing severe mental health difficulties during and before pregnancy. In addition, mental health services are available for women who have pre-existing mental health needs, as well as for those who experience challenges because of their pregnancy or labour. The GP check-up six to eight weeks after birth is absolutely crucial.

My Lords, something is happening. In the last decade or so, I have been watching the extraordinary increase in the number of healthy young mothers having C-sections. Why is this phenomenon—if I might call it that, though that is probably the wrong word to use—happening? Is this something that is part of the inquiry? Are people trying to understand whether it is because those in the midwifery world are afraid that natural births lead to more deaths?

This may be something that my noble friend Lady Amos looks at. She is very much focused on maternity services, which will include mortality and looking at the range of options. The noble Baroness will understand that there is an important balance to be struck between the voice and choice of patients, which we respect, and safety, which must be paramount.