Summary
Pregnancy and the weeks after birth are often portrayed as exciting and joyful. While that is true for many families, it's also a time when serious health complications can occur. One of the most dangerous—but least talked about—is maternal sepsis.
Although maternal sepsis is a leading cause of maternal death worldwide, many people have never heard of it.
Amy Breslin is a Manchester-based midwife and Maternity Consultant for the UK Sepsis Trust. In this interview, she explains what maternal sepsis is, the huge impact it has both globally and for the individuals affected, and how we can improve outcomes.
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Amy, can you tell us a bit about yourself and how you became interested in maternal sepsis?
My own interest in maternal sepsis began during a secondment with an Acute Care Team, where I was responsible for auditing cases of maternal sepsis and educating healthcare professionals. It quickly became clear that maternal sepsis wasn't receiving the attention it deserved, so I began working with the UK Sepsis Trust to help change that.
Since then, I've contributed to updating maternity sepsis screening tools and developing educational resources to support professionals caring for pregnant and recently pregnant people.
What is maternal sepsis?
Many people think ‘sepsis’ and ‘infection’ are the same thing, but they aren't.
Sepsis is the body's overwhelming and life-threatening response to an infection. Instead of fighting the infection in a controlled way, the immune system reacts abnormally, which can damage organs throughout the body. Without prompt treatment, sepsis can become life-threatening very quickly.
Maternal sepsis refers to sepsis affecting anyone who is pregnant or has recently been pregnant, including people in early pregnancy or those who have recently experienced a miscarriage or termination. The risk extends until around six weeks after the end of a pregnancy, when the body is still adapting and recovering
What is the impact?
In the UK, maternal sepsis remains one of the leading direct causes of maternal death, accounting for around 9% of maternal deaths (approximately 1.3 deaths per 100,000 maternities).
Globally, the picture is even more concerning. In many low- and middle-income countries, maternal sepsis causes around 400 deaths per 100,000 maternities.
For every person who dies from maternal sepsis, around 50 more experience a "near miss"—developing sepsis or septic shock but surviving.
Survival is, of course, the priority, but recovery can be long and difficult. Some people require intensive care and are separated from their baby during treatment, which can be incredibly distressing for the whole family. Many survivors also experience ongoing physical, psychological and cognitive problems, sometimes referred to as Post-Sepsis Syndrome (PSS).
What are the main symptoms?
The symptoms can vary depending on the stage of pregnancy.
During pregnancy, warning signs may include:
Feeling unusually unwell
A racing heartbeat
Abdominal pain or discomfort
Foul-smelling vaginal discharge
After birth, miscarriage or termination, symptoms may include:
Foul-smelling vaginal discharge or lochia (post-birth bleeding)
Lower abdominal pain
Feeling generally very unwell
Healthcare professionals also look for signs such as:
Rapid breathing
A fast heart rate
Passing very little urine
Mottled, pale or discoloured skin
One thing many sepsis survivors describe is simply "feeling like you're going to die." While that may sound dramatic, it is a symptom that should never be ignored. Most importantly, trust your instincts. You know your own body better than anyone else. If something doesn't feel right during pregnancy or in the weeks afterwards, seek medical advice promptly.
If you or someone you love has symptoms of a severe infection or is becoming increasingly unwell, contact your local maternity triage service or emergency gynaecology unit, depending on the stage of pregnancy. Healthcare professionals would always rather assess someone who turns out to be well than miss someone who is becoming seriously ill.
How can outcomes be improved?
Sepsis itself can't always be prevented, but recognising and treating infections early can reduce the risk of developing sepsis.
Three key ways we can improve outcomes are:
Raise awareness so pregnant and recently pregnant people know the warning signs and seek help early.
Improve education so healthcare professionals recognise maternal sepsis quickly and start treatment without delay.
Reduce the risk of infection through good hand hygiene, avoiding close contact with people who have infectious illnesses where possible, and keeping up to date with recommended vaccinations, such as the flu vaccine.
Who is disproportionately affected?
Maternal sepsis does not affect everyone equally.
Across maternity care, significant ethnic inequalities persist. Recent UK reports show that Black and Asian women and birthing people face a substantially higher risk of severe pregnancy complications and death, including from sepsis, compared with White women.
People with certain health conditions are also at increased risk, including those with diabetes, sickle cell disease, or weakened immune systems—for example, because of cancer treatment or long-term steroid medication.
Understanding these inequalities is essential if we are to improve outcomes for everyone.
What do you hope to see change in the future?
No one should lose their life to maternal sepsis due to a lack of awareness, timely treatment and escalation.
While eliminating maternal sepsis completely may not yet be realistic, we can make enormous progress by shining a brighter spotlight on the condition. Greater public awareness, better education for healthcare professionals, especially for generalists on maternal medicine, and consistent, rapid treatment across all healthcare settings could prevent many deaths and life-changing complications.
Every conversation about maternal sepsis helps increase awareness—and awareness saves lives.
Useful resources
The UK Sepsis Trust provides information and resources for both the public and healthcare professionals, including advice on recognising the signs of sepsis and evidence-based maternity screening tools. They also provide support for anyone affected by sepsis.
Information for patients and families: Learn the signs and symptoms of sepsis, and find advice on when and how to seek urgent medical help.
Information for healthcare professionals: Access the UK Sepsis Trust's maternity sepsis screening tools and explore educational resources to support the recognition and management of maternal sepsis.
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