Maternal death rate in the UK

[ArabellaScott]

https://www.npeu.ox.ac.uk/news/2486-maternal-death-rates-in-the-uk-have-increased-to-levels-not-seen-for-almost-20-years

Alarming news about maternal death rates, the highest they've been for 20 years.

Death rates for Black women are three times as high as for white women. Asian women are twice as likely to die in childbirth or shortly afterwards as white women.

Thrombosis was the most common reason for death.

You are completely missing the point. I have said it’s both a poorly functioning government and a poorly functioning NHS, the latter of which is a result of the former of course.

Australia had fewer deaths per capita from Covid because it handled the first year of the pandemic better. Australia is no different to the UK when it comes to Covid itself. Everyone in Australia has had it. You seem to think Australia hasn’t had Covid?! Of course it has.

33 pregnant women died of Covid in 2020 in the UK. Who knows how many since. Pregnant women got infected at a vulnerable time because of poor government management. And then why did they die? Because the NHS failed them. No pregnant woman has died of Covid in Australia despite all of the population having Covid at some stage. You’d expect at least one if the UK’s increase in MMR during Covid was due to Covid itself. But no one has, because Australia has a functioning health system.

Fewer pregnant women got infected at the worst possible time because the government acted, and of those that did - and there were definitely cases, including in intensive care - none of them did.

What Australia has demonstrated that pregnant women shouldn’t be dying of Covid. Any death, even at the height of the pandemic, was entirely avoidable if healthcare was adequate.

Presumably you do not blame the NHS for the UK's failure to lock down early in 2020?

No, the NHS was let down. It is a poorly functioning service that wasn’t in a position to deal with anything extra.

So how has the high number of Covid cases in the UK in 2020 proved your point that the NHS is shit?

They haven’t. You used the high number of Covid cases in 2020 to excuse the fact that it’s understandable that pregnant women died of Covid. Just because Australia had fewer cases, it demonstrates that proportionally fewer - zero - women died at the height of the pandemic in Australia because they were looked after properly.

Aiming for the “middle of the pack” in Europe for Covid deaths is not exactly aspirational.

But what does that prove for MMR?

Australia has improved its MMR in its indigenous population despite Covid and despite being considered institutionally racist towards that population. And it’s better than the UK’s.

It never fails to shock me when people defend the NHS. Women didn’t need to die of Covid (even if the numbers were high in the population) but they did. The UK’s MMR did not need to rise during Covid for non-Covid death and reasons but it did.

It’s the NHS. It’s poorly staffed, underfunded, there’s no proper antenatal care, there are midwives looking after multiple labouring women on any given shift, there are high risk pregnancies being suboptimally managed. Read any of the news reports of pregnant/birthing women dying and you inevitably think how did they let that happen? But no one ever truly “learns from their mistakes” at a senior or management level. That’s why Donna Ockenden is linked on the thread lamenting it all that nothing gets done.

I know no one wants to hear it but maybe they should at least investigate links to the covid vaccine. Countries with a higher uptake have got higher excess death rates and higher maternal death rates alongside higher infant mortality rates. Why is no one at least asking the question.

One thing we need to be careful of when interpreting data between different countries is there is not a shared consensus on how data is recorded.

For UK Covid mortality data, a person who died WITH covid, but may have died for another reason (cancer, for example), is recorded the same as a person who actually died FROM Covid. They are all part of the same dataset.

Many other countries did not record it this way and therefore have lower incidence.

Australia struggled with the same issue trying to make this clear.

But this doesn’t help the UK’s cause. Because if those 33 deaths of pregnant women were not because of Covid, but were with Covid, that means the MMR went up entirely independent of Covid, because they actually died from other causes. Which again, can only be attributed to poor care.

But it can’t be argued that that’s the reason why Australia hasn’t had any deaths at all of course. Any death of a pregnant woman from Covid would have been all over the news at least.

Australia benefitted from delaying infection until information was available from other countries on how to treat it - much of that information and the first effective drug coming from the much maligned NHS! They also benefitted from the delay be being able to vaccinate pregnant women. Vaccination substantially decreased death rates. Very misinformed to suggest it was the standard of clinical care that was at fault.

Yes, very good point.

Possibly because the first vaccine given wasn't until December 2020, so antivaxxing bullshit blaming a vaccine that didn't exist for pregnant women dying in 2020 and was only made available after the end of April 2021 in accordance with the schedule for age groups would be idiocy in the highest degree?

Very misinformed to suggest it was the standard of clinical care that was at fault.

Pregnant women were infected with Covid in 2020 in Australia but none of them died. Why is that? Why did infected pregnant women die of Covid in the UK in 2020 but infected pregnant women in Australia did not?

Women died in the uk because there was no treatment initially that could save them. So the NHS developed such treatments that were then used to benefit women around the world who were infected later. If you compare death with covid in the uk over time you'll find they drop - because of vaccination and treatments being available.

To see why people die during pregnancy you need to look at why they died - what other conditions did they have. You would need to use matched comparisons to see if clinical care was at fault.

As I said, very ill-informed.

There were no treatments to treat women in Australia either Any. Pregnant women got sick with Covid at the start of the pandemic in Australia, the same as in the UK, you do realise that?

Australia has comparable rates of obesity. Gestational diabetes. An indigenous population with poor health outcomes. But no pregnant/recently pregnant woman has ever died of Covid. Before treatments were available. After treatments were available. Before vaccines were available. After vaccines were available. Why?

I’d also be interested in why you genuinely think the NHS isn’t an absolute shit show.

Which would you rather be right now, a pregnant woman in Australia or the UK?

A pregnant indigenous woman in Australia, who lives literally thousands of kilometres from a major hospital and is reliant on local midwifery/GP care, has a better chance of surviving pregnancy than any woman in the UK right now. In what possible world does that not indicate a poor quality health service?

Pregnant women died of covid around the world before vaccination and treatments reduced the risk. I dont actually know if it's true that none died in Australia or whether it simply was not reported there. Maybe they got lucky and no-one with severe comorbidity got pregnant because I dont believe Australian health care would have done something miraculous and not shared it with other health care systems.

I have heard of the lengths the NHS went to trying to save pregnant women and it's deeply insulting to those who worked with covid patients, putting their own lives at risk, to dismiss their efforts as a "shit show" . Where is your comparison of numbers of women getting pregnant showing how many had covid and what other problems they had? When you can show you are comparing like with like then you can claim care is better. Until then you dont know what you are talking about.

Pregnant women died of covid around the world before vaccination and treatments reduced the risk. I dont actually know if it's true that none died in Australia or whether it simply was not reported there.

I linked this on the first page.

Maybe they got lucky and no-one with severe comorbidity got pregnant because I dont believe Australian health care would have done something miraculous and not shared it with other health care systems.

They didn’t do anything miraculous that they withheld. Functioning ambulance service, functioning maternity services, functioning intensive cares etc. It’s also ridiculous to believe that the NHS led the way at the forefront of Covid treatments. A good deal of intensive care research came out of Melbourne.

I have heard of the lengths the NHS went to trying to save pregnant women and it's deeply insulting to those who worked with covid patients, putting their own lives at risk, to dismiss their efforts as a "shit show"

This always comes up when someone defends the NHS; it’s taken as a personal affront on individual healthcare workers who are doing their best. But the failures of the NHS are not (usually) due to people not doing their best. I have not said it is. It’s a systematic issue. Of course people “did their best” and of course people still do their best.

But if you’re a midwife who is the only one on shift with multiple labouring women who you physically can’t monitor properly, you’re doing your best, but it’s a shit show isn’t it? Are you saying the Ockenden Review findings are overblown? 12 women’s cases were reviewed who died and not one received appropriate care.

If pregnant women are routinely sent home when they shouldn’t be, not monitored when they should be, not screened appropriately, not taken for emergency caesareans in time, etc etc all resulting in poor outcomes, individual people might be doing their best, but they’re doing their best in amongst a shit show.

The Covid point is ultimately immaterial. It just highlights that women didn’t have to die of Covid. The MMR still went up. Covid is just one of many things women die of unnecessarily in the UK.

You seem to have very odd views of Australia, like it’s a backward country whose health system leaches off the NHS’s good work. It has a world class health system treating similar patients and as a result, its MMR is half that of the UK’s. The difference between the two health systems is the primary reason for such a difference in MMR. Australia has women with just the same complications, co-existing diseases, genetic mix, with the addition of vast distances to deal with. Fewer women die as a result.

Honestly, would you rather be a pregnant woman in the UK or Australia right now?

I also struggle to understand what is to be gained from pretending the NHS is up to scratch. Doctors are striking because of poor pay and terrible working conditions. They’re leaving in droves to go to other countries like Australia. It’s worth reading the Reddit thread r/doctorsUK to read the terrible conditions good people are having to deal with. There was this one a few weeks ago, people working in the NHS who see it for what it is. Pregnant women will continue to die unnecessarily.

https://www.reddit.com/r/doctorsUK/s/t17JlV6fdn