How MBRRACE-UK Shines a Light on Maternal Mortality and Saves Mothers' Lives
Imagine a woman in her sixth month of pregnancy, excitedly preparing for her baby's arrival. Suddenly, she experiences severe headaches and vision problems. Dismissed as normal pregnancy discomforts during a rushed prenatal visit, her symptoms worsen. Within days, she suffers a catastrophic seizure linked to undiagnosed pre-eclampsia. Tragically, both mother and baby are lost. For decades, such devastating outcomes in the UK were often shrouded in silence, with lessons from individual tragedies lost in fragmented systems. This changed with the arrival of MBRRACE-UK (Mothers and Babies: Reducing Risk through Audits and Confidential Enquiries across the UK), a groundbreaking initiative that transformed how the UK understands and prevents maternal deaths 1 2 .
Launched in 2015, taking over from the Confidential Enquiries into Maternal Deaths
Conduct robust national surveillance of every maternal death in the UK, investigate them confidentially, and translate findings into actionable recommendations
Funded by the Healthcare Quality Improvement Partnership (HQIP), MBRRACE-UK operates as a unique collaboration split between two academic powerhouses: the Maternal Programme based at the National Perinatal Epidemiology Unit (NPEU) at the University of Oxford, and the Perinatal Programme led by the Infant Mortality and Morbidity Studies (TIMMS) group at the University of Leicester 2 .
Meticulously tracking every maternal death (during pregnancy or within one year postpartum) and all eligible stillbirths and neonatal deaths across the UK.
| Measure | 2015-2017 | 2020-2022 | 2021-2023 | Key Disparities (2021-2023) |
|---|---|---|---|---|
| Number of Maternal Deaths | 209 | 275 (Peak) | 254 | |
| Mortality Rate (per 100,000) | 9.16 | 13.56 (Peak) | 12.67 | |
| Trend | Baseline | Significant Increase | Slight decrease, but still elevated | |
| Leading Causes (Late Deaths >6 weeks) | Mental Health: Leading cause (34% of late deaths), primarily suicide and substance misuse 4 8 . | |||
A prime example, published in BMJ Medicine in 2025, focused on a critically vulnerable yet often overlooked population: women with involvement from Children's Social Care (CSC) during their pregnancy 6 .
| Cause of Death | Timing (Highest Risk Period) | Key Insights & Trends | Vulnerable Groups |
|---|---|---|---|
| Cardiovascular Disease | During pregnancy & up to 6 weeks | Remains a leading cause of direct maternal death | Black women, older mothers (>35) |
| Mental Health | 6 weeks to 1 year postpartum | Leading cause of late maternal deaths (34%) | Women with CSC involvement, history of trauma |
| COVID-19 | 2020-2022 Peak | Significant contributor during pandemic peak | Black, Asian, Hispanic women |
MBRRACE-UK's impact transcends academic journals. Its annual "Saving Lives, Improving Mothers' Care" reports are catalysts for national change 3 8 . By consistently highlighting disparities – like the persistently 2-3 times higher mortality risk for Black women and the near-doubling of risk for women in the most deprived areas – MBRRACE-UK forces health inequalities onto the policy agenda 4 5 7 .
Centralized repository for all reported maternal/perinatal deaths across UK
Structured methodology for anonymised case record review
Trained experts from diverse clinical and social perspectives
While MBRRACE-UK represents a world-leading surveillance system, challenges remain. Rising maternal mortality rates, even excluding the COVID-19 peak, signal deep-seated problems in service provision, workforce capacity, and addressing the social determinants of health 4 9 .