Understanding the relationship between social determinants of health and maternal mortality (RCOG, 10 February 2022)

Summary

This report was commissioned by the Royal College of Obstetricians and Gynaecologists, with research led by Leeds Beckett University in collaboration with the University of Sheffield and the University of Oxford.

It aims to inform those involved in the care of pregnant women in the UK about the relationship between social determinants of health and the risk of maternal death.

Content

A number of recommendations have been made in the report, including:

• Understanding it is the vulnerable, minoritised and disadvantaged women in society that have an increased risk of maternal death. These women are often living in an entangled web of complex inequalities that is beyond their control, which impacts on the care they receive and the outcomes of that care.
• Strategies and care pathways need to be identified and put in place to improve their situation. These women have been let down in the way that our maternity and reproductive health services are currently delivered.
• We need to find a better way of recording social determinant data. The current way of doing this is inadequate and not fit for purpose, and it doesn’t provide us with enough information to really understand how the complex circumstances of the woman impacts on her maternal outcomes.
• The research shows current models of care are still failing pregnant women who have lived in adverse social circumstances prior to, during and after pregnancy. Maternal outcomes are particularly poor for socially disadvantaged women affected by pre-existing physical or mental health problems; those who misuse substances; those who have a lower level of education; those who are overweight, undernourished or poorly sheltered; and those who are at increased risk due to the threat of abusive and unsupportive partners, families and peers.

The recommendations are aimed at helping prevent disadvantaged and vulnerable women dying during and after pregnancy.