England plans maternal overhaul

England’s National Health Service said every maternity service will have to meet new clinical standards after maternal deaths stayed above pre-2010 levels. (england.nhs.uk) The new rules require an early blood-clot risk check before the first antenatal appointment, with high-risk patients offered preventive blood thinners within 72 hours. Women with epilepsy must get access to specialist teams, and maternity services must use standard mental-health questions and refer patients for perinatal support when needed. (england.nhs.uk) The overhaul also sets earlier escalation thresholds for severe bleeding after birth and tighter oversight from hospital trust boards, with national rollout due by March 2027. NHS England said the package targets blood clots, strokes, heart disease, suicide, sepsis, obstetric haemorrhage and pre-eclampsia, which together account for 52% of maternal deaths. (england.nhs.uk) The trigger for the redesign was new MBRRACE-UK data showing 252 women died from direct or indirect maternal causes across 1,969,321 maternities in the UK in 2022-24, a rate of 12.8 deaths per 100,000 maternities. That rate was 20% higher than in 2009-11, when ministers set an ambition to halve maternal mortality in England. (npeu.ox.ac.uk) The data did not show a statistically significant change from 2021-23 to 2022-24, but it did show that the post-pandemic improvement has stalled above the last complete pre-pandemic triennium. MBRRACE-UK said removing COVID-19 deaths made little difference to the long-run increase. (npeu.ox.ac.uk) The biggest immediate clinical risk remains thrombosis and thromboembolism, or dangerous blood clots, which MBRRACE-UK said was the leading cause of maternal death during pregnancy and up to six weeks after it ended. After six weeks, maternal suicide remained the leading cause of death, and psychiatric causes made up 33% of deaths between six weeks and one year after pregnancy. (npeu.ox.ac.uk) NHS England’s Maternal Care Bundle, published in January, said maternal mortality in 2021-23 was 21% higher than in 2009-11 and linked the rise to older maternal age, obesity and more pre-existing medical conditions. The bundle set five priority areas: venous thromboembolism, pre-hospital and acute care, epilepsy in pregnancy, maternal mental health and obstetric haemorrhage. (england.nhs.uk) The burden is not evenly shared. NHS England said Black women in 2021-23 died at more than twice the rate of white women, and women in the most deprived areas died at almost twice the rate of those in the least deprived areas; the January 2026 MBRRACE-UK brief put the Black-white gap at nearly three-fold across the UK in 2022-24. (england.nhs.uk) Parliament’s Health and Social Care Committee said in September 2025 that Black women in England faced poorer maternity outcomes because of failures in leadership, training, data collection and accountability. The committee also said the National Health Service had faced an estimated £27.4 billion maternity negligence bill in England since 2019. (publications.parliament.uk) The clinical overhaul lands alongside a wider government push. The Department of Health and Social Care said on March 17, 2026 that a new Maternity and Neonatal Taskforce would act on Baroness Amos’s review, backed by £25 million for trusts to tackle causes of maternal death, improve bereavement facilities and strengthen triage. (gov.uk) NHS England said nearly half of the women who died in 2021-23 might have had a different outcome with better care. The new standards now turn that finding into a deadline: every maternity service in England is expected to implement them by March 2027. (england.nhs.uk)