Maternal mortality 2019-2021

October 2023

Main points

• There was a statistically non-significant increase in the overall maternal death rate in the UK between 2018-20 and 2019-21. A statistically non-significant decrease occurred when deaths due to COVID-19 were excluded.
• COVID-19 was the leading cause of maternal death in the UK in 2019-2021 during or up to six weeks after the end of pregnancy. Cardiac disease was the second most frequent cause of maternal death followed by thrombosis and thromboembolism and mental health-related causes.
• There remains an almost four-fold difference in maternal mortality rates amongst women from Black ethnic backgrounds and an almost two-fold difference amongst women from Asian ethnic backgrounds compared to white women. These disparities are statistically unchanged from 2018-2020.
• Women living in the most deprived areas have a maternal mortality rate more than twice as high as women living in the least deprived areas. This disparity is statistically unchanged from 2018-2020.

Maternal mortality rates UK 2019-2021

1. Overall, 261 women died in 2019-21 during or within 42 days of the end of pregnancy in the UK. The deaths of 20 women were classified as coincidental. Thus in this triennium 241 women died from direct and indirect causes, classified using ICD-MM (World Health Organisation 2012), among 2,066,997 maternities, a maternal death rate of 11.66 per 100,000 maternities (95% CI 10.23 – 13.23). This compares to the rate of 10.90 per 100,000 maternities (95% CI 9.53 – 12.40) in 2018-20 (rate ratio (RR) 1.07, 95% CI 0.89-1.29, p=0.4631 (Figure 1).
2. Thirty-three of the women who died between March 2020 and December 2021 during or within 42 days of the end of pregnancy died from complications of COVID-19 infection. If these women's deaths attributable to COVID-19 are excluded, the maternal mortality rate for 2019-21 would be 10.06 (95% CI 8.74 – 11.53) lower than the corresponding rate for 2018-20 (10.47 (95% CI 9.13-11.95) but not statistically significantly so (RR 0.96 (95%CI 0.79 – 1.17), p=0.684) (Figure 1).

Download data for Figure 1

Causes of maternal deaths UK 2019-2021

1. COVID-19 was the leading cause of maternal death in the UK in 2019-2021. This figure includes only women who died from complications of COVID-19 and excludes women who were known to have COVID-19 at the time of their deaths but died from other causes (Figure 2).
2. Cardiac disease is the next most frequent indirect cause of maternal death (Figure 2).
3. Thrombosis and thromboembolism (VTE) continues to be the leading cause of direct deaths occurring within 42 days of the end of pregnancy (Figure 2).
4. Deaths due to mental health-related causes (including suicide) and sepsis are the next most frequent causes of maternal death (Figure 2).

Download data for Figure 2

Maternal mortality amongst different population groups in England 2019-2021

1. The risk of maternal death in 2019-21 was statistically significantly almost four times higher among women from Black ethnic minority backgrounds compared with White women (RR 3.84; 95% CI 2.48 to 5.78); this disparity is higher, but not statistically significantly so, than the disparity in 2018-20 (Figure 3).
2. Women from Asian backgrounds also continued to be at higher risk than White women (RR 1.82, 95% CI 1.21 to 2.67); this disparity is higher, but not statistically significantly so, than the disparity in 2018-20 (Figure 3).

Download data for Figure 3

3. Women living in the 20% most deprived areas continue to have the highest maternal mortality rates, more than twice as high as the maternal mortality rate of women living in the 20% least deprived areas (RR 2.03, 95% CI 1.25-3.43); this disparity is lower, but not statistically significantly so, than the disparity in 2018-20 (Figure 4).

Download data for Figure 4