Failings in UK maternity care that lead to death require urgent attention, experts warned today.
Professor Catherine Nelson-Piercy of King’s College London, UK, and colleagues say on the website of the British Medical Journal that most maternal deaths are now caused by preventable or treatable medical conditions.
The March 2011 Confidential Enquiry into Maternal Deaths highlights a worrying trend, say the experts. It states that most maternal deaths in the UK now occur in women with medical and psychiatric conditions classed as "indirect causes".
"The number of maternal deaths due to indirect causes has significantly increased over the past 20 years," it states. "Furthermore, most of these deaths are associated with substandard care, and in one third of cases this is classified as major substandard care. These failings require urgent attention."
Even in the UK, women die in pregnancy or shortly after delivery from preventable and treatable medical causes such as epilepsy, diabetes, heart failure, and asthma.
Several reports have highlighted failures in the diagnosis, investigation, and treatment of women with new onset chest pain, headache, or other medical symptoms, often because "well-meaning clinicians prioritise the health of the foetus over that of the mother", the experts believe.
Due to fertility treatment and women delaying childbearing, the rate of high risk pregnancies in women with chronic medical disorders is rising. More obstetric physicians with better training are needed, and the subspecialty should be formally recognised, say the authors.
"An expansion in the number of obstetric physicians would be a positive step towards reducing deaths from medical disorders in pregnancy," they conclude.
The findings echo a study in London reported yesterday linking a sudden surge in maternal deaths to indirect causes – and calling for more obstetricians and improved supervision of junior midwives.
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