Pregnant women will be offered more routine checks for deadly complications in an NHS drive to bring down soaring maternal deaths.
The health service has set new clinical standards to combat the five leading causes of death in pregnancy and childbirth, including blood clots and severe bleeding.
Hospitals which do not follow the national measures by March 2027 will be “held to account” and face interventions to overhaul their maternity care, the NHS said.
Maternal deaths — those in pregnancy, birth or the six weeks after birth — are at the highest level for 20 years in the UK. The NHS has been accused of ignoring dozens of warnings from official reports telling hospitals to act faster on life-threatening symptoms in women.
The most recent available data shows 257 women died in the two years to 2023, and that nearly half of these deaths could have been prevented. The biggest killer was blood clots, followed by heart issues, suicide, stroke, sepsis and severe bleeding.
Black women are three times more likely to die than white women, and the NHS acknowledged that “serious medical problems” were more likely to be missed in ethnic minorities.
The new standards, developed with Royal Colleges, are aimed to ensure medical staff act more quickly to assess and treat women experiencing deadly complications.
It includes a requirement for all pregnant women to be assessed at the “earliest opportunity” for the risk of blood clots, before their first midwife appointment. Women who are at high risk owing to factors such as extreme morning sickness will be offered blood-thinning medications to reduce the risk of clots.
Women with underlying health conditions will be referred for specialist medical care in pregnancy at new maternal medicine centres of excellence. The majority of maternal deaths are caused by medical conditions that pre-date or develop during pregnancy, such as blood clots, stroke and heart disease, but these can be missed.
Kate Brintworth, chief midwifery officer for England, said: “Every death during or after pregnancy is a tragedy especially when differences in care may have changed the outcome. We still see symptoms of serious medical problems being missed, especially for Black and Asian women.
“By setting out these clinical standards and holding hospitals to account we can significantly reduce avoidable deaths and prevent future tragedies. One in five women will have a medical issue during pregnancy, yet many of these aren’t caught early enough — these measures including more risk assessment in early pregnancy will ensure no stone is left unturned.”
There is also a new focus on preventing suicides, which are the leading cause of maternal death after birth and the fourth leading cause in pregnancy.
Deaths from psychiatric causes account for one third of deaths in women in the year after pregnancy. Under the new guidelines, women will all be assessed for mental health problems at midwife apopintments before and after birth.
Women experiencing a haemorrhage or significant bleeding after birth receive care from specialist obstetricians and anaesthetists sooner. The new guidelines lower the thresholds for significant blood loss during or after birth that triggers escalation to senior medics.
Severe bleeding during birth, known as obstetric haemorrhage, is the eighth leading cause of maternal mortality and leads to hundreds of hysterectomies and intensive care admissions every year.
The NHS said the full introduction of these national measures by March 2027 was expected to reduce the number of deaths caused by blood clots, strokes, cardiac disease, suicide, sepsis, obstetric haemorrhage and pre-eclampsia, which account for 52 per cent of maternal deaths.
All hospitals will have to present their progress to NHS trust boards, and poor performance will be referred to national leaders.