Since the first report of the UK Confidential Enquiry into Maternal Deaths in 1952, there has been a dramatic reduction in the maternal death rate. This has partly been achieved through better understanding of obstetric complications and advances in medical therapies and also due to the development of and adherence to evidence-based guidelines developed by national bodies such as NICE and RCOG as well as locally such as those developed by the Patient Safety Collaborative. However, in recent years, MBRRACE-UK reports1 show a stalling of this fall and show that indirect causes of death consistently outnumber direct causes of death. Population health tells us that the prevalence of medical conditions in the pregnant population is increasing2 and this fact is implicated in the findings from MBRRACE-UK. Worryingly in the US, maternal mortality has been rising since the mid ‘80’s and again indirect causes outnumber direct causes of death3. In tackling the UK government’s target to reduce maternal and neonatal deaths by 50% by 20254, it has been proposed that better provision of joined up care for women with, or presenting with, medical problems in pregnancy be achieved with: (i) the training of more obstetric physicians, to ensure regional representation, and (ii) the development of networked maternal medicine services centred around a designated centre with an obstetric physician.
The Thames Valley have set up one of the first Networked Maternal Medicine Services in the country. The network covers Buckinghamshire Healthcare NHS Trust, Royal Berkshire NHS Foundation Trust, Great Western Hospitals NHS Foundation Trust, Frimley Health NHS Foundation Trust including Wexham Park Hospital, Northampton General Hospital NHS Trust, Milton Keynes University Hospital NHS Foundation Trust, Oxford University Hospitals NHS Foundation Trust; with the John Radcliffe Hospital, Oxford, nominated as the Network Maternal Medicine Centre.
The network meets bi-annually and has endorsed the ratified Maternal Medicine Network Guideline –
- MBRRACE-UK, Saving Lives, Improving Mothers’ Care. Nov 2018
- Prevalence of maternal chronic diseases during pregnancy – a nationwide population based study, 2016
- CDC’s Pregnancy Mortality Surveillance System.
- NHS Long Term Plan, Jan 2019