Sunday 18 March 2018

Childbirth deaths rise as women delay pregnancy

Murray Wardrop

A "worrying" number of mothers are dying during pregnancy and childbirth because women are having babies later and receive substandard care in hospitals, leading doctors have warned.

Failures in identifying preventable and treatable medical problems and wrongly putting the health of babies over that of mothers has led to a rise in deaths, it is claimed.

Experts are calling for an increase in the number of obstetric physicians and better training for GPs in Britain to counter the trend.

Catherine Nelson-Piercy, professor of obstetric medicine at King's College London, said a rise in the number of "high risk" pregnancies, including older and obese mothers, has fuelled the problem.

While the overall number of deaths has decreased since the 1950s, there has been a rise in the number dying from conditions not directly caused by pregnancy – which represents a "worrying trend", she said.

The leading cause of maternal death is heart disease while the second is neurological disease.

Writing in the British Medical Journal (BMJ), Prof Nelson-Piercy and colleagues said: “Increasing numbers of women with often complex medical conditions are now becoming pregnant or seeking fertility treatment.

"Women are delaying childbearing until later in life, and the menopause is no longer a barrier to pregnancy.

"Older women are more likely to be obese, have hypertension, or be predisposed to gestational diabetes and thromboembolism."

They added: “Most worryingly, the number of maternal deaths due to indirect causes has significantly increased over the past 20 years.

“Furthermore, most of these deaths are associated with substandard care, and in one third of cases this is classified as major substandard care, where different care might have prevented death of the mother. These failings require urgent attention.

“This often arises when well-meaning clinicians prioritise the health of the foetus over that of the mother, but it can result in the death of both mother and foetus”

In March, a report from the Centre for Maternal and Child Enquiries (CMACE) revealed that 261 women in Britain died from conditions directly or indirectly related to pregnancy for the three years from 2006 to 2008.

Some 107 mothers died of conditions that could only have arisen if they had been pregnant (direct deaths), while 154 died of indirect causes, including infections and underlying health problems.

Today's research said some women die every year from treatable conditions such as epilepsy, diabetes and asthma.

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