NHS England has set out new clinical standards that every maternity service in England will need to meet to reduce maternal deaths during or after pregnancy. Announced on 23 April 2026, the measures focus on clinical areas linked to the leading causes of maternal mortality, including blood clots, strokes, cardiac disease, psychiatric causes, sepsis, obstetric haemorrhage and pre-eclampsia. Full rollout is expected by March 2027. Maternal mortality in England remains rare, but many deaths are associated with medical conditions that pre-date pregnancy or develop during pregnancy and can be missed or misattributed. The standards form part of a maternal care bundle developed with frontline clinicians, women and families, Royal Colleges, regulatory bodies, professional societies and charities.
Earlier Assessment for Major Clinical Risks
All pregnant women will be offered an early risk assessment for venous thromboembolism before their first antenatal appointment. Venous thromboembolism involves blood clots that form in deep veins and is now the leading cause of maternal mortality. Pregnant women identified as high risk will be offered thromboprophylaxis within 72 hours. This earlier intervention aims to address one of the medical risks that can affect women during pregnancy and may otherwise be missed before symptoms become more serious.
The standards also give specific attention to epilepsy in pregnancy. Every woman with epilepsy will have access to a local specialist team for managing epilepsy during pregnancy and will be offered a tailored plan to help control seizures. These plans include timely access to medicines that are safe to use in pregnancy. The approach places specialist input earlier in the care pathway and supports consistent management for women with a known neurological condition.
Medical conditions remain central to the maternal mortality picture in England. The majority of maternal deaths are caused by conditions that pre-date or develop during pregnancy, including blood clots and strokes and cardiac disease. Symptoms of serious medical problems can still be missed, especially for black and Asian women. The new standards are intended to strengthen earlier recognition, escalation and accountability across maternity services.
Mental Health and Emergency Escalation
Pregnant women will be routinely assessed for their mental health using a consistent set of questions. A report will be provided at the antenatal appointment, and women will be referred to specialist NHS perinatal mental health services where needed. The aim is to ensure that women receive appropriate support when mental health needs are identified during pregnancy care.
Between 2022 and 2024, maternal suicides remained the leading cause of maternal death occurring between six weeks and one year after the end of pregnancy. Deaths from psychiatric causes accounted for 33% of maternal deaths in this period. The new standards therefore place mental health assessment alongside other clinical safety measures rather than treating it as separate from maternity risk management.
Emergency care for significant bleeding after birth will also change. Women experiencing haemorrhage or significant bleeding will receive care from specialist obstetricians and anaesthetists sooner. New guidelines and thresholds for significant blood loss are designed to trigger earlier escalation. These measures form part of the wider focus on deaths linked to obstetric haemorrhage and pre-eclampsia. Full rollout of the national measures is expected to reduce deaths caused by the clinical areas that together account for 52% of maternal deaths.
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Accountability, Data and Specialist Support
Progress against each clinical standard must be presented to NHS trust boards. Local delivery that does not meet expected plans will be escalated to regional and national level. This governance route makes implementation a board-level issue and links local maternity performance to wider oversight.
The clinical standards strengthen the role of 17 maternal medicine centres established across England. These centres of excellence support women with pre-existing medical conditions or conditions that arise during pregnancy. Each specialist hub is led by a multidisciplinary team and includes at least one obstetric physician, with expertise in medical problems and treatments during pregnancy. Networks linked to these centres help ensure that expert maternal care is available to all women and that maternity departments recognise key red flag symptoms.
Maternity service facilities will also be upgraded. Direct telephone lines to maternity staff will help ambulance crews transfer pregnant women to labour wards quickly. New monitoring for pregnant women will support faster action when deterioration occurs. Up to £5 million has been allocated to NHS trusts this year to buy equipment and implement the maternal care bundle. The measures follow the rollout of the Maternal Outcomes Signal System, a digital tool that rapidly analyses data routinely recorded by maternity teams to detect emerging safety concerns that may need urgent attention. Findings from the system will be published every six months.
The new standards bring together earlier clinical assessment, mental health screening, faster escalation, stronger specialist networks and board-level accountability. They focus on risks that already account for a substantial share of maternal deaths and on conditions that may be missed or attributed to pregnancy. The March 2027 rollout will require maternity services to apply consistent measures across England, with escalation when local delivery does not meet expected plans. The overall direction is towards earlier recognition, clearer responsibility and more consistent access to specialist maternity care.
Source: NHS England
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