Why is the UK at risk of maternal and neonatal deaths? | | Health Issues

Two new inquiries have found that poor care in at least two hospitals has contributed to rising maternal and neonatal deaths in England, UK.

An investigation into maternity care in Nottingham found that more than 500 mothers and babies were injured or died as a result of poor care.

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The report released last week, led by obstetrician and midwife Donna Ockenden, found that at the Queen’s Medical Center and Nottingham City Hospital, “many” women experienced “harassment” and poor or “brutal” care while the minor problems continued.

In addition, it found that 444 women and 76 newborns suffered “preventable consequences” from poor care over 13 years at Nottingham University Hospitals Trust (NUH).

A similar comment, the Amos report, named after Baroness Valerie Amos, in British medical institutions has also found similar results: women and babies are failing because hospitals ignore the needs of patients.

According to research published in January by Oxford University, the UK maternal mortality rate for 2022-2024 was 12.8 deaths per 100,000 women.

This was 20 per cent more than 2009-2011, “meaning the UK government has missed its target of reducing maternal deaths,” the Oxford report concluded.

Here’s what we know about the problem of women in British hospitals.

What did the UK maternal and infant mortality survey show?

The Ockenden report, which carried out a three-year study of the deaths of 27 women in the Nottingham area between 2006 and 2024, found “failures in care that may have caused or significantly affected the outcome of six deaths”.

In another shocking case, the investigation found that a baby who died during pregnancy was “inadvertently disposed of as medical waste by laboratory staff after the examination,” much to the dismay of her parents.

Overall, the report found deficiencies in the following areas:

• Listening to mothers and families and taking proactive steps to address issues.
• Continuity of care, especially for those with other social or medical problems.
• Standardized clinical governance to ensure timely information sharing across organizations.
• Rapid access to imaging for women with neurological disorders.

The study also found that newborn deaths could have been prevented if they had been better cared for in hospitals. It also highlighted an “oppressive and dangerous culture” that persisted at NUH, with senior management failing to act after repeated warnings of specific problems. Expectant mothers were often turned away from two maternity clinics and told to return home – often when they should not have come – the question was raised.

It found that all maternity units were small and lacked the equipment to manage the number of births and critical cases they had.

Ockenden also found that “when complaints were made, the instinct of the trust was to cover up rather than investigate failures”.

It was noted that several doctors refused to answer questions from the survey.

Nottingham Maternity Families, which represents 600 injured and bereaved families, said it was “horrendous” and called for senior managers who refused to give evidence to be sacked. The group called on the government to launch a government-sanctioned inquiry into maternal infertility across England.

Following the publication of the Ockenden report, Kath Abrahams, chief executive of Tommy’s Missing Babies, said: “This is a very sad report. It is inexcusable that pregnant women seeking help at Nottingham University Hospitals NHS Trust have sometimes been treated poorly – sometimes with devastating results – and that medical staff and families are at risk of neglecting what to do.

Both the Ockenden and Amos reports found similar causes of death in the UK, which highlighted failings within the NHS and maternity and hospital care.

Amos’s commentary also shows racism and discrimination to be “persistent throughout the system”.

According to the report, the women and families who were interviewed said that they were treated unfairly or unjustly, they were treated with violence, racism, Islamophobia and antisemitism.

The hospital staff also shared the same feelings about being discriminated against while working.

Have similar findings been reported in other UK hospitals?

Yes. In the northern city of Leeds, an independent inquiry was launched following a BBC investigation last year which revealed that 56 child deaths and two maternal deaths between 2019 and 2024 could have been avoided at Leeds Teaching Hospitals.

At the same time, the Care Quality Commission described Leeds Teaching Hospitals as “inadequate” and found that hospitals were understaffed and under-staffed.

In March, Ockenden was appointed to oversee another review in Leeds Teaching Hospitals which is expected to cover hypoxic injuries and maternal deaths from 2011 to 2025.

What measures has the government announced?

On Tuesday, Health Secretary James Murray called Amos’ assessment a “watershed moment”.

“We will get rid of bad things, strengthen the morale of the workers and support good cooperation between midwives, doctors and other practitioners,” he told the members of parliament.

“We need the right policies, procedures and policies to be put in place and the necessary reform in the culture of work that often puts the desire to protect ourselves above the work of protecting women and babies,” he added.

Murray also said that a new director of maternity and newborn care, who has not been appointed, will be appointed to replace the maternity services. This will be an official function and the commissioner will be accountable to the parliament.

The Commissioner will lead the National Maternity and Neonatal Taskforce together with the Secretary of State for Health and Social Care, “giving them direct guidance on policy, safety policies, and the distribution of NHS resources”, the government said.

The health secretary also announced an extra 41 million pounds ($54.75m) to improve safety in maternity and newborn centers and will create 1,000 temporary midwifery places and publish new national standards for maternity care.

What other factors are contributing to the high maternal and infant mortality rate in the UK?

According to MBRRACE (Mothers and Children: Reducing Risk Through Audits and Confidential Interviews in the UK), in 2022-2024, 252 women died of “direct or indirect causes during pregnancy or immediately after childbirth among 1,969,321 women”.

“Anemia continued to be the leading cause of death for women in the UK during pregnancy or up to six weeks after pregnancy. Heart disease was the second leading cause of death, followed by mental health-related causes (suicide and drug use),” it found.

At the same time, class and race also played a role in mortality risk, with the study finding that the death rate among black women in 2022-2024 was “nearly three times that of white women”.

“Women living in the most disadvantaged areas continued to have a maternal mortality rate almost twice that of women living in the poorest areas.”

Are health insurance systems better than national health systems?

Despite the failure of the NHS, the United States, which is unusual among Western countries with insurance-based insurance, has a high rate of maternal and infant mortality, mainly due to lack of medical care, experts say.

According to a Johns Hopkins University study, for example, black patients on the government-sponsored insurance plan, Medicare, were hospitalized in inferior hospitals, even though they lived near better facilities.

As a result of the US health care system, many people have declared bankruptcy due to medical expenses, with the Consumer Financial Protection Bureau reporting in 2024 that nearly 100 million US citizens will have more than $220bn in medical debt.

The Commonwealth Fund also reported that the US ranked last among 16 high-income countries in terms of deaths that could have been prevented with timely medical care.

It also said that, at the end of the decade, “the number of people who could be prevented in the US was almost twice that of France”, which had a much lower number – 55 per 100,000 and used the universal health system.

According to the Centers for Disease Control, in 2024, there will be 649 maternal deaths in the US compared to 669 the year before.