MBRRACE report: racial inequalities in maternity outcomes continue
MBRRACE report: racial inequalities in maternity outcomes continue by Megan Disley Scott and his PMH support can also be found on his instagram page. https://www.instagram.com/p_m_h_support/ On the 14th January 2021, the latest MBRRACE-UK report was released1. This annual report from the Maternal, Newborn and Infant Clinical Outcome review programme looks at data from the UK and Ireland confidential enquiries into how many women had died during childbirth, and the 12 months after, for the three years 2016 to 2018. The report provides statistics on these deaths as well as summaries on the circumstances around them; and makes suggestions on prevention and lessons to be learnt. The report can be read in full2, or an infographic is available3 Important findings from the 2020 MBRRACE report include: • The significant increase in Sudden Unexpected Death in Epilepsy. • 90% of those that died in the three year period from 2016-18 had multiple problems suggesting a constellation of biases are preventing women from receiving the care that they need. • There continue to be racial disparities in maternity care, with Black, Asian, and mixed ethnicity women significantly more likely to die than their white counterparts. • Women living in the most deprived areas were almost three times more likely to die than those who lived in the most affluent areas.
What does the report say? It is important to remember that pregnancy in the UK remains very safe. In the UK, 2,235,159 women gave birth during the three-year period from 2016-2018. Of these, 566 died from either direct causes (deaths related to obstetric complications during pregnancy and up to 12 months after birth) or indirect causes (deaths associated with a disorder which is exacerbated by pregnancy) during and up to the first year after pregnancy. 217 of these deaths occurred within pregnancy or up to six weeks after giving birth4. Cardiac disease remains the leading cause of indirect maternal death in the UK. Epilepsy and stroke together are the second most common indirect cause, and third commonest cause of death overall, due to the statistically significant increase in Sudden Unexpected death in Epilepsy (SUDEP)5. This refers to deaths in pregnant women with epilepsy that are not caused by either injury, drowning, or any other known causes6. The exact causes of these deaths are not known and there may not be any one single explanation. The report does go on to detail that, in many incidences, these deaths are related to inadequate medication 1 Editor’s note: For anyone not familiar with it, ‘Information about MBRRACE-UK for Parents and Health Service Users’ can be found here: www. npeu.ox.ac.uk/mbrrace-uk/service-users 2 MBRRACE-UK (2020) Saving Lives, Improving Mothers’ Care: Lessons learned to inform maternity care from the UK and Ireland Confidential Enquiries into Maternal Deaths and Morbidity 2016-18: www.npeu.ox.ac.uk/assets/downloads/mbrrace-uk/reports/maternal-report-2020/ MBRRACE-UK_Maternal_Report_Dec_2020_v10_ONLINE_VERSION_1404.pdf 3 MBRRACE-UK (2020) infographic and lay report. www.npeu.ox.ac.uk/assets/downloads/mbrrace-uk/reports/maternal-report-2020/MBRRACEUK_Maternal_Report_2020_-_Lay_Summary_v10.pdf 4 MBRRACE- UK (2020) Saving Lives, Improving Mothers’ Care. 5 Sudden Unexpected Death in Epilepsy (SUDEP) is when a person with epilepsy dies suddenly and prematurely and no reason for death is found. https://sudep.org/sudden-unexpected-death-epilepsy-sudep 6 Angus-Leppan H. (2019) ‘Epilepsy-related deaths and SUDEP’. Epilepsy Action. www.epilepsy.org.uk/info/sudep-sudden-unexpected-death-inepilepsy
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