Birth Companions Institute responds to 2026 MBRRACE-UK maternal mortality report

Today, we are once again saddened to be responding to evidence of increasing rates of maternal mortality in this country, and of stark inequities remaining deeply entrenched.

The overall maternal mortality rate

While the absolute number of maternal deaths during pregnancy or the year after remains low, MBRRACE-UK figures released today tell us that the maternal mortality rate is now 20% higher than in 2010 – the year the Government set a target to halve maternal deaths in England by 2025. This failure raises serious questions about the care, focus and resources that have been dedicated to keeping women safe during pregnancy, birth, and the postnatal period.

This is a failure of ambition and delivery, and it is one that affects some women more than others. Inequities in this year’s MBRRACE-UK data are stark, long-standing, and in most cases widening, adding to an already significant weight of evidence, including recent reviews led by Donna Ockenden and Baroness Amos.

The women who die, and the causes of their deaths

This year’s MBRRACE-UK figures paint a picture of the roles that social complexity, inequity and disadvantage play in maternal mortality. Black women remain nearly three times more likely to die compared to white women, and Asian women's risk of maternal death is also elevated.

20% of the women who died in pregnancy or the six weeks following the end of pregnancy were known to social services. Our own recent research with Kings College London and Oxford University explored MBRRACE-UK’s social care data in depth, and found higher numbers of women dying while in contact with children’s social care in the later postnatal period, up to a year after birth, amounting to almost a third (29%).

Nearly half of those who died (47%) had known mental health issues; 18% were known to be using substances; and 21% were known to have been experiencing domestic abuse either prior to, or during, pregnancy.

Mental health conditions accounted for a third of maternal deaths in this period, with suicide remaining the leading cause between six weeks and one year after the end of pregnancy.

Data on social factors remains poorly collected and recorded across our maternity system, and so these numbers are likely to be an underestimate of the true levels of need. More also needs to be done to explore the needs and experiences of the women who die in the later postnatal period – between six weeks and a year after the end of pregnancy – so we can understand how poverty, abuse, poor housing, racism and other complex factors impact women’s health and safety.

What needs to happen now?

Reviewers found that improvements to care may have made a difference to the outcome in 61% of deaths reviewed, with only 16% thought to have received good care. There are things that can be done to change these figures, and we are pleased to see, once again, MBRRACE-UK’s explicit recognition that these numbers represent systemic issues:

“There is an urgent need for better systems, clearer guidelines and improved policies that support personalised care, which responds to women's individual needs.”

As we have heard time and again in many recent maternity investigations, listening to women and families is essential. Their voices must be embedded in the design and review of services, and be centred by every professional they come into contact with during their individual maternity journey.

But the burden of ensuring safe maternity care must not rest on the woman or her family. Self-advocacy can be exhausting, and may not always be possible; responsibility for change must sit with services and systems, not with women having to fight to be heard.

1. ‍The Action Plan created by the National Maternity and Neonatal Taskforce must include a strong focus on addressing the social factors at play in maternal mortality, near-misses, and other poor outcomes for women and their families during pregnancy and early motherhood, with an emphasis on physical and psychological safety for those in most deprived areas, and those who experience domestic abuse, racism, and mental health issues.‍
2. More must be done to understand and mitigate these social factors. Maternity records should be redesigned so deprivation, insecure housing, financial need, abuse, social care involvement and other key factors are captured systematically. In particular, the persistently high numbers of women who die while known to social services must become a priority for action across health and social care services. These deaths show us, in the starkest terms, how disadvantage can compound and repeat across a lifetime and across generations, as well as the consequences of fragmented, poorly-coordinated care. ‍
3. We must establish continuity of care for women facing high social risk and other complex conditions, led by specialist midwives and supported by specialist voluntary sector navigator/advocacy services.‍
4. Maternal mental health provision must be improved, with appropriate and sustained support for women at every level of need. As called for by the Maternal Mental Health Alliance, specialist perinatal mental health teams must take a leading role in risk assessment and joint care planning – including for women who are not accepted onto a caseload or do not take up a referral – so that no woman is left to fall through the gaps. ‍
5. Care must ensure that focus on the baby, or other clinical priorities, does not overshadow the woman’s own health and wellbeing – both physical and psychological.
6. In addition to this, we need clearer guidelines across the board. The existing NICE Guideline CG110 on pregnancy and complex social factors is too narrow and, created in 2010, now hugely outdated. Birth Companions and many others have long called for NICE CG110 to be updated, and last year’s Maternal Mortality report from MBRRACE-UK specifically included a national recommendation for “guidelines on the care of women with complex social factors to include clear guidance for a standardised assessment and documentation of social risk factors at booking appointments and at least once more later in pregnancy". This must be taken forward with urgency.

We’ve known for a long time now that women in the most deprived areas; those who have involvement from children’s social care; those who experience domestic abuse; those who face racism and discrimination, are significantly more likely to die in pregnancy or in the year after birth than other women. And yet despite commitments to halve the rate of maternal mortality, the overall rates have risen, and inequities remain.

We need concerted action and system-wide reform. We need investment in the midwives and other professionals who can and do make a difference to these numbers. And we need to do this work in partnership with the women who know what it’s like to navigate the maternity system while worrying about money, housing, violence, racism, and the prospect of losing the care of their baby.  

Read the report in full:
2026 MBRRACE-UK Saving Lives, Improving Mothers' Care annual report ‍

‍To discuss anything mentioned in this statement further, please get in touch.