Maternal deaths have surged to a 20-year high, forcing the NHS to introduce sweeping new clinical standards in a bid to reverse a decade of rising fatalities. Between 2021 and 2023, 257 women died during pregnancy, childbirth or within six weeks of delivery — a figure nearly identical to the 252 deaths recorded between 2022 and 2024, confirming that the crisis is not an isolated spike but a persistent trend.
New standards aim to prevent avoidable deaths
Under the measures announced this week, every pregnant woman will receive a blood-clot risk assessment before her first midwife appointment. Those deemed high risk — for example, because of severe morning sickness or other conditions that increase the likelihood of venous thromboembolism — must be prescribed blood-thinning medication within 72 hours. Blood clots are now the leading cause of maternal death in the UK, a risk that is four to five times higher during pregnancy than for non-pregnant women of the same age, and which extends for six weeks after birth.
Mental health assessments will become a routine part of midwife appointments throughout pregnancy and the postnatal period. This reflects the fact that psychiatric causes account for a third of maternal deaths in the year after childbirth, with suicide remaining a leading cause in the period from six weeks to one year postpartum. Perinatal mental health services are being strengthened to provide specialist treatment for women during pregnancy and up to a year after birth.
Women with pre-existing medical conditions or complications that arise during pregnancy will be referred to one of 17 newly established maternal medicine centres of excellence, each led by a multidisciplinary team including obstetric physicians. The NHS estimates that one in five pregnant women experiences a medical complication, yet many cases are not picked up until dangerously late.
Hospitals that fail to implement these standards by March 2027 will face intervention from national leadership. Every trust must report progress to its board, and up to £5 million has been allocated to support the changes. The new clinical standards form part of the NHS’s Maternal Care Bundle, which sets best practice across five key areas linked to the leading causes of maternal death.
What is killing mothers?
Nearly half of all maternal deaths during the period are considered avoidable. Blood clots are the primary cause, followed by cardiac problems, suicide, stroke, sepsis and severe haemorrhaging. Obstetric haemorrhage — heavy bleeding after delivery — ranks eighth among causes but leads to hundreds of emergency hysterectomies and intensive care admissions each year. Under revised protocols, women who suffer significant blood loss will now receive faster attention from senior obstetricians and anaesthetists, with lower thresholds for escalation.
The maternal death rate has risen by approximately 50 per cent over the past decade, from 8.54 deaths per 100,000 pregnancies in 2013 to 12.80 per 100,000 in 2023. In 2020–22 the rate hit 13.41 per 100,000 maternities — a level not seen since 2003–05. Even when deaths from Covid-19 are excluded, the 2020–22 rate of 11.54 per 100,000 was still higher than in 2017–19. Covid-19 itself has receded as a direct threat: only six deaths were attributed to it in 2022–24, down from being the second most common cause in 2020–22.
Investigations and reports over the past decade have issued 748 recommendations across 59 official reports, many repeating the same warnings about failures to implement guidance. That pattern is now being addressed through mandatory standards and accountability measures.
Racial disparities: a persistent and widening gap
The most glaring failure highlighted by the data is the stark inequality in maternal outcomes. Black women are three to four times more likely to die during or shortly after pregnancy compared with their white counterparts. Women from Asian ethnic backgrounds face roughly twice the risk. These disparities are not explained by income, education or other socioeconomic factors alone.
Kate Brintworth, chief midwifery officer for England, acknowledged the problem directly: “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.”
The NHS has admitted that serious medical conditions are more frequently overlooked among ethnic minority patients. Research into the systemic causes points to failures in accountability, leadership, unconscious bias, stereotyping and racism within the healthcare system. The disparity is compounded by socioeconomic deprivation: women living in the most deprived areas have a maternal mortality rate more than twice that of those in the least deprived areas. Age also plays a role, with women aged 35 or older nearly twice as likely to die as those aged 25–29.
A significant proportion of maternal deaths are linked to pre-existing medical conditions that are exacerbated by pregnancy rather than directly caused by it. Many of these conditions — such as cardiac disease, which is consistently the second most common cause of death — may have been missed, misattributed or undertreated in the past, particularly for women from ethnic minorities.
Brintworth added: “By setting out these clinical standards and holding hospitals to account, we can significantly reduce avoidable deaths and prevent future tragedies.” The new standards specifically mandate that maternal medicine centres provide specialist oversight for women with complex pre-existing conditions, with the aim of closing the gap in detection and care that has disproportionately harmed Black and Asian women.
Accountability and the path forward
Every NHS trust is now required to report its progress on implementing the new standards to its board. Hospitals that fail to meet the March 2027 deadline will be referred to national leadership for corrective action. The NHS has allocated up to £5 million to support trusts in making the necessary changes, which include improved haemorrhage management protocols, routine mental health screening and early blood-clot risk assessments.
The new measures are the most comprehensive response yet to a crisis that has drawn repeated warnings from official inquiries. With nearly half of all maternal deaths deemed avoidable, and with disparities that have persisted for years despite dozens of reports and hundreds of recommendations, the NHS is now attempting to move from guidance to enforceable standards — and from acknowledgment to accountability.