Risk to women of severe bleeding after giving birth at five-year high in England

The risk of women in England suffering severe bleeding after giving birth has risen to its highest level for five years, prompting fresh concern about NHS maternity care.

The rate at which mothers in England experience postpartum haemorrhage has increased from 27 per 1,000 births in 2020 to 32 per 1,000 this year, a rise of 19%.

Last year had the largest number of incidents of postpartum haemorrhage in the five years since records began – 16,780 – despite the number of births falling in recent years, NHS England figures analysed by the Liberal Democrats also reveal.

In comparison 15,780 occurred in 2023 and 15,230 in 2022, the year in which almost all trusts that provide maternity services began submitting data on postpartum haemorrhage to NHS England.

The data cover incidents in which a woman has lost at least 1.5 litres (2.6 pints) of blood after giving birth. Haemorrhage is a known cause of birth-related trauma in women.

Many women bleed after delivering their baby, usually without causing concern. But the possibility of a mother losing an unusually large amount of blood is a known risk of childbirth. It is the leading cause of maternal death worldwide and causes one in 14 or 7% of maternal deaths in the UK.

“The growing risk to mothers of suffering serious and potentially fatal bleeding following childbirth is terrifying”, said Helen Morgan, the Liberal Democrats’ health spokesperson.

“We know that severe blood loss contributes to nearly one in 10 maternal deaths [in the UK]. Every birth involves risk, but rising rates of these incidents will be a source of real fear for women and families across the country.

“It’s completely heartbreaking to see just how many families experience unacceptable injuries and trauma at a time that should be full of excitement and joy.”

The findings are the latest evidence to suggest that the quality and safety of NHS maternity care are declining.

In the initial report of her government-commissioned investigation into maternity care, the inquiry chair, Valerie Amos, said last week that some mothers were receiving unacceptable care and that had led to “tragic consequences”.

Morgan said: “We already have a situation where the Care Quality Commission says that two-thirds of maternity units are not safe enough. Maternity deaths are up. The risk of women suffering a serious tear has risen.

“And now we have this shocking news that there is a growing risk of postpartum haemorrhage.”

Obstetricians and gynaecologists said the rise was the result of childbirth becoming more complicated in recent years. Experts have blamed that on obesity and more older women having babies, as both significantly increase the chances of complications and the need for medical intervention.

“The reported increase in postpartum haemorrhage is concerning”, said Prof Asma Khalil, a consultant obstetrician and maternal-foetal specialist and spokesperson for the Royal College of Obstetricians and Gynaecologists.

“But it must be understood in the context of births becoming more clinically complex. More women are entering pregnancy and birth with factors that can raise the risk of heavy bleeding, for example high blood pressure and a higher body weight, though most will not experience a haemorrhage.”

The Liberal Democrats are urging the health secretary, Wes Streeting, to draw up a “maternity rescue plan” to bring all units up to what the CQC judges to be a good standard.

The failure to implement recommendations made by an array of previous maternity inquiries is an insult to families harmed by poor care, they say in a letter signed by 60 of the party’s MPs.

Lady Amos said last week that it was “staggering” that many of the 750 recommendations made over the last decade had not been put into practice.

A Department of Health and Social Care spokesperson declined to comment directly on the Lib Dems’ findings.

They said only that: “As Baroness Amos set out this week, too many families have been let down by maternity and neonatal services, with devastating consequences.

“That’s why the secretary of state has ordered a rapid review of maternity services and will chair a new national maternity and neonatal taskforce to address deep-rooted issues.”