MBRRACE: 40% of maternal deaths in first postnatal year due to mental ill-health

Today, MBRRACE-UK published their latest Confidential Enquiry into Maternal Deaths in the UK and Ireland.

The Saving Lives Improving Mothers' Care 2022 report investigates the deaths of women during or up to one year after pregnancy between 2018 and 2020. MBRRACE examines the reasons why each of the women died, what can be learnt from these tragic deaths and urgent recommendations to improve care and save lives.

Sounding the alarm

Worryingly, this year’s report shows that the number of maternal deaths caused by mental health problems is increasing. It also finds that many of the women who died faced multiple disadvantages, including mental health problems, domestic abuse and addiction.

Key maternal mental health findings:

• Suicide remains the leading cause of direct maternal death in the first postnatal year.
• Suicide during pregnancy or up to six weeks after is increasing:
  In 2020, women were three times more likely to die by suicide during this period compared to 2017-19.
• 40% of deaths within the year after pregnancy were from mental health-related causes.
• Very few women who died by suicide in 2020 had formal mental health diagnoses, but significant numbers had a history of trauma.

Significantly, mental ill-health and heart disease are now on an equal footing as the cause of maternal deaths in the UK. 

Findings on the impact of adversity:

• 1 in 9 women who died had severe and multiple disadvantages, such as a mental health diagnosis, substance use and domestic abuse.
• Ethnic disadvantage endures; there remains a more than three-fold difference in maternal mortality rates among women from Black ethnic backgrounds, and an almost two-fold difference amongst women from Asian ethnic backgrounds, compared to white women.
• More women from deprived areas are dying.

The overall picture

The Government’s ambition is to reduce maternal mortality in England by 50% between 2010 - 2025. The MBRRACE report finds maternal mortality has increased by 3% in the last twelve years. These figures contrast starkly with the perinatal picture, where the number of baby deaths has reduced steadily over a similar period. The report calls urgently for a continued focus on the health of the mother.

In response, MMHA CEO Laura Seebohm said:

“It is tragically sad to read that maternal death due to mental health problems is increasing. This report from MBRRACE-UK and the heartbreaking loss of lives need to send an urgent rallying call for change.”

“For many years now, suicide has been the leading cause of direct maternal deaths in the year after pregnancy. Sadly that is still the case, but there is also alarming information, so powerfully exposed by the report, on inequalities, disparities and clear injustices. This adds to the sense of urgency we must all feel. There are clear recommendations of what needs to change and these need to be acted upon, to understand how services can be improved so that every mother and her family has access to essential maternal mental health care and support, when and where they need it.”

Read more of Laura’s reflections on the latest MBRRACE findings.