NEW data from a UK-wide study highlights a stark inequality in maternal mortality among women with children’s social care (CSC) involvement, stressing the urgent need for trauma-informed, personalised maternity services.
The national cohort study, conducted by MBRRACE-UK, analysed data from 1,451 women who died during pregnancy or up to a year postpartum in the UK between 2014–2022. Researchers also performed a confidential enquiry into a sample of 47 of these cases to assess quality of care. The study aimed to examine maternal death rates in the context of CSC involvement and identify gaps in care delivery.
The study found that nearly a third of women who died during or in the year after pregnancy (29%) had involvement with CSC for their (unborn) baby. Women with CSC involvement who died were more likely to be aged ≤20 years (rate ratio: 1.85, 95% CI: 1.27–2.63, compared with those aged 21-29 years), reside in the most deprived areas (rate ratio: 2.19, 1.42–3.50), and were less likely to be from Black (rate ratio: 0.56, 0.35–0.84) or Asian backgrounds (rate ratio: 0.26, 0.14–0.44) compared to White women with no CSC involvement. Notably, 75% of deaths occurred in the late postpartum period (6 weeks–1 year). Psychiatric causes, including suicide, substance overdose, and homicide, were more prevalent among this group. The confidential enquiry highlighted significant failings in risk recognition, medication management, care coordination, and staff training. Systemic and individual barriers further restricted healthcare access and engagement.
This research points to an urgent need for restructured maternity care that accounts for both medical and social complexity. Women with CSC involvement face unique risks that demand responsive, coordinated, and equitable care strategies.
Reference
De Backer K et al. Characteristics, outcomes, and maternity care experiences of women with children’s social care involvement who subsequently died: national cohort study and confidential enquiry. BMJ Medicine. 2025;4:e001464.
