New NHS clinical standards will be adopted by every maternity service in England to cut the number of women who die during or after pregnancy.
Key measures include an early venous thromboembolism (VTE) risk assessment offered before the first antenatal appointment. Women judged high risk will be offered thromboprophylaxis (blood thinners) within 72 hours. VTE is now the leading cause of maternal death, and earlier assessment aims to reduce those fatalities.
Women with epilepsy will be able to access a local specialist maternity epilepsy team and be offered individualized plans to manage seizures, including timely access to medications considered safe in pregnancy. Mental health screening will be delivered routinely using a consistent question set, with results provided at antenatal appointments and referrals to NHS perinatal mental health services when required. Between 2022 and 2024, maternal suicide was the leading cause of death between six weeks and one year after pregnancy, and psychiatric causes accounted for a third of deaths in that period.
Care for postpartum haemorrhage will be escalated sooner: women with significant bleeding will receive earlier involvement from specialist obstetricians and anaesthetists, supported by new guidance and lower thresholds for escalation.
The full national rollout is due by March 2027. The measures are expected to reduce deaths from blood clots, strokes, cardiac disease, suicide, sepsis, obstetric haemorrhage and pre-eclampsia — conditions responsible for about half of maternal deaths. Trust boards must report progress on each clinical standard, with regional and national escalation if local delivery falls short.
Although maternal deaths are relatively uncommon in England, many result from medical conditions present before or developing during pregnancy, such as blood clots and strokes (17%) and cardiac disease (15%), which can be missed or misattributed to pregnancy. Official figures show 252 maternal deaths from 2022 to 2024, compared with 257 from 2021 to 2023. Analysis of deaths from 2021 to 2023 suggests that improvements in care could have changed the outcome for almost half of the women who died.
Kate Brintworth, Chief Midwifery Officer for England, said every death during or after pregnancy is a tragedy and that differences in care may have altered outcomes. She highlighted that serious symptoms are still sometimes missed, particularly in Black and Asian women, and said earlier, more thorough risk assessments aim to ensure problems are detected and acted on. One in five women will experience a medical issue during pregnancy, and the new measures aim to leave no stone unturned.
The standards form part of an NHS maternal care bundle developed with frontline clinicians, women and families, and partner organisations including Royal Colleges, regulators, professional societies and charities. They concentrate on five areas of clinical care linked to the leading causes of maternal death identified by MBRRACE-UK.
Maternity units will also be upgraded to speed transfers and monitoring: direct telephone lines for ambulance crews will facilitate quicker transfer of pregnant women to labour wards, and new monitoring arrangements will help teams spot deterioration sooner. Up to £5 million has been allocated to NHS trusts this year to buy equipment and support implementation of the bundle.
The rollout builds on the Maternal Outcomes Signal System (MOSS), a digital tool that rapidly analyses routinely recorded maternity ward data to detect emerging safety issues. MOSS findings will be published every six months so trusts flagged for concern can take action.
The new standards strengthen the network of 17 maternal medicine centres, specialist hubs across England supporting women with pre-existing or pregnancy-onset medical conditions. Each centre is led by a multidisciplinary team that includes at least one obstetric physician. Networks linked to these centres aim to ensure expert maternal care is available to all women, that maternity departments recognise key red flag symptoms, and that appropriate assessment and escalation arrangements are in place.