Across the European landscape, a troubling reality persists beneath the veneer of advanced healthcare systems: approximately 1,000 women lost their lives to pregnancy and childbirth complications in the WHO European Region during 2020 alone. Even more concerning, progress in reducing maternal mortality has slowed or stopped entirely in some European countries between 2016 and 2020, signaling an urgent need for renewed commitment to maternal health.
Despite advanced healthcare systems, maternal mortality progress has stalled across Europe, with approximately 1,000 preventable deaths occurring in 2020 alone.
The data reveals stark contrasts across the region. While Belarus, Poland, and Norway report fewer than two maternal deaths per 100,000 live births, other nations lag notably behind. Experts emphasize that most maternal deaths remain preventable with timely, evidence-based interventions delivered by skilled professionals. Direct causes of maternal deaths prevail over indirect ones, indicating poor-quality medical care rather than unavoidable complications. Preterm birth leads as the primary cause of neonatal deaths, while intrapartum-related complications, infections, and birth defects constitute other leading causes. Centralized systems for document management can support standardized guidelines and timely access to patient records, improving care coordination.
The United Kingdom has taken decisive action following a 21% rise in maternal deaths since 2009-11. The Maternal Care Bundle, published by NHS England, responds to findings that 45% of maternal deaths contained potentially preventable elements. This all-encompassing framework targets five high-risk areas: venous thromboembolism, pre-hospital care, epilepsy in pregnancy, mental health, and obstetric haemorrhage. NHS Trusts and Integrated Care Boards must implement these standards by March 2027.
Specific protocols include mandatory Modified Early Warning Systems for pregnant women or those within four weeks postpartum, standardized pre-alert systems between ambulance services and labour wards, and clear labour ward signage. For obstetric haemorrhage, standardized escalation protocols require consultant involvement at 500 mL, 1,000 mL, and 1,500 mL blood loss, with mandatory multidisciplinary team case reviews. Cumulative measured blood loss becomes mandatory for all births to enable earlier identification of potentially life-threatening haemorrhage.
These developments occur against a backdrop of declining fertility rates, with the WHO European Region recording 1.7 live births per woman in 2021 and the European Union just 1.53. As Europeans have fewer children, ensuring each pregnancy receives substantially better care becomes paramount. Quality maternal and newborn health care is integral to the right to health, equity, and preservation of dignity for women and babies. The path forward demands systematic implementation of proven interventions and unwavering commitment to maternal safety.
