NHS England rolls out specialist pregnancy centres to lower maternal mortality

Pregnant women with serious medical problems will be able to access treatment across 17 new specialist pregnancy centres in England, as part of the NHS commitment to halve the maternal mortality rate by 2025.

The 17 new centres of excellence will help women with pre-existing medical conditions or conditions that arise during pregnancy to get the extra care they need and avoid pregnancy complications.

As part of the NHS commitment to halve the maternal mortality rate by 2025, a medical team will be on hand to provide specialist advice before during and after pregnancy, bringing together expert physicians, obstetricians, midwives, nurses and other clinicians in one place.

There will be at least one centre in every region of the country, including at Guy’s and St Thomas’ and St Georges in London, Oxford University Hospitals and across Liverpool, Manchester and Newcastle.

NHS bosses say networks linked to the centres would ensure that access to expert maternal medicine care would be available to all women, making sure that all maternity services and emergency departments are aware of key “red flag” symptoms in pregnancy and have measures in place so that women can be appropriately assessed.

Though maternal mortality in England is rare, the majority of maternal deaths are caused by medical conditions that pre-date or develop during pregnancy such as cardiac disease, blood clots, epilepsy and stroke that can be missed or misattributed to pregnancy.

Black women in the UK are four times more likely to die in pregnancy and childbirth than white women, according to a report published by MBRRACE-UK  while Asian women are twice as likely to die in pregnancy or childbirth.

Professor Jacqueline Dunkley-Bent, England’s chief midwifery officer, said: “We know that pre-existing medical problems are a significant factor in the variation in rates of mortality for Black and Asian women.

“The establishment of these maternal medical networks will improve every woman’s access to specialist care for medical problems in pregnancy and will play an important part in our wider efforts to improve care for women and babies right across our maternity services.”

Figures show one in five women will have a medical issue during pregnancy.  However, most conditions can be safely managed locally.

Some women may be sent for an initial assessment at one of the centres, where they will be set up with a personalised management plan that they can continue at home, with support from their local maternity team.

The most serious cases will be treated at these 17 centres, where they will be closely monitored and provided with specialist treatment throughout their pregnancy.

Dr Matthew Jolly, national clinical director for maternity and women’s health, said: “For a number of years too often we have seen symptoms of serious medical problems being missed or misattributed to pregnancy.

“Maternal Medical Networks and their specialist centres are a vital step in improving the identification and management of potentially fatal medical conditions in pregnancy, wherever a woman receives care, and to ensure England continues to improve in its position as one of the safest countries in the world to give birth.”

While maternity providers already offer services ranging from midwife-led diabetes clinics, to joint clinics with physicians from particular specialties, the new Maternal Medicine Networks will work with local GPs, emergency departments, and community midwifery services to ensure all pregnant woman can access the services.

Lucy MacKillop, consultant obstetric physician at Oxford University Hospitals and regional obstetric medicine lead and chair for the Thames Valley Maternal Medicine Network, said: “I am very proud to chair the Thames Valley Maternal Medicine Network, a group of dedicated health professionals helping to ensure that women and families get the personalised care and support they need at such a special time in their lives.

“We serve a population of around three million people, with around 40,000 births a year in our geographical footprint, and it is vital that we support everyone with significant medical conditions that pre-date or arise in pregnancy so they have equal access to timely specialist care and advice.

“We support people with complex medical needs before, during, and after their pregnancy, and our aim is to give them and their babies the best care and safest experience possible.

“As president of the MacDonald Obstetric Medicine Society, we welcome the recognition of the vital role Obstetric Physicians can play in these networks, and the recent investment in training these specialists to care for pregnant people with the highest risks of complications during or soon after pregnancy.”

Minister for Mental Health and Women’s Health Strategy, Maria Caulfield, said: “We’re working hard to make sure giving birth in the UK is as safe as possible, including for anyone with pre-existing medical conditions.

“Specialist treatment centres provide access to medical care for conditions that exist before, or arise during pregnancy.

“Working with other health professionals, the centres will ensure maternity and medical staff can provide the right support as soon as its needed.”

She added: “We are improving the quality of NHS care for mothers and babies and have invested £127m to grow the workforce and improve neonatal care.”