Maternal data collection

This page contains information about how women's deaths, occurring during pregnancy or in the year after the end of pregnancy, are identified, and how MBRRACE-UK collects these data.

Identification of maternal deaths

MBRRACE-UK records and collects information on all women who die in the UK (or the Republic of Ireland) during pregnancy or up to one year after the end of pregnancy regardless of how the pregnancy ends and the place and circumstances of the death.

The majority of women's deaths are notified directly to the MBRRACE-UK office at the University of Oxford by the trust/health board where the woman gave birth or where the death occurred. Each trust/health board in the UK that provides maternity care should have nominated staff members who are responsible for reporting maternal deaths. The MBRRACE-UK office at the University of Oxford should be notified within one week of the death occurring, or of becoming aware of the death.

Please note that anyone can report a maternal death. In some instances, the responsibility may not be on the trust/health board where the woman gave birth or died, but instead on whomever is first to become aware of the death. In some instances deaths may be identified through other sources including coroners or procurator fiscals, pathologists, Local Supervising Authority Midwifery Officers and members of the public or media.

To ensure that all relevant deaths are captured by MBRRACE-UK, data linkages are performed using national death registries and birth records for any deaths of women of reproductive age that occurred over the following year. Using these data linkages MBRRACE-UK is able to a) confirm that a woman has died and b) identify women who died that may have been missed through standard reporting procedures.

Collecting surveillance information in England, Scotland and Wales

For each death that is reported, MBRRACE-UK collects surveillance data. For women who die during pregnancy or up to a year after pregnancy, this includes basic demographic and clinical information about the woman, her death and her infant.

This information is entered into a secure, bespoke database and entries are double checked by a member of the MBRRACE-UK team. Any queries about missing or unclear data entries are sent back to the units or taken from the woman's records to ensure that the data are of high quality.

These data are used to conduct analyses and identify any common characteristics of the women who died.

Collecting information for confidential enquiries

For all women who die during pregnancy or up to a year after pregnancy in the UK and Ireland, MBRRACE-UK collects:

• A copy of the woman's postmortem report if one has been undertaken. These help ensure that the woman's cause of death is accurate.
• Local clinician reports (LCRs) completed by key individuals involved in the woman's care. These confidential reports describe local factors impacting on women's deaths and any lessons to be learned.
• Copies of any relevant local hospital reviews and investigations including those conducted by the Maternity and Newborn Safety Investigations (MNSI) programme.
• Medical records from all units or health care providers that were involved in the woman's care during and after pregnancy. These records are also requested for women who are included in topic-specific confidential enquiries into women who experienced severe morbidity during pregnancy.

All information collected by MBRRACE-UK is fully anonymised before it is uploaded to a secure online platform. These documents are then reviewed by MBRRACE-UK assessors as part of the confidential enquiry process.

Identifying and collecting information about maternal deaths in Northern Ireland

All maternal deaths occurring in Northern Ireland are reported to MBRRACE-UK, however, privacy issues in Northern Ireland restrict identifiable information from being transferred out of the province. As such, all maternal deaths are reported to staff at the Northern Ireland Maternal and Child Health (NIMACH) office of the Public Health Agency of Northern Ireland. Surveillance data and case notes are then fully anonymised before being securely transferred to the MBRRACE-UK office at the University of Oxford.

Identifying and collecting information about maternal deaths in the Republic of Ireland

MBRRACE-UK also collects information on the deaths of all women during or up to a year after the end of pregnancy that occur in the Republic of Ireland. These deaths are not included in MBRRACE-UK's routine surveillance data and do not contribute to the UK's maternal mortality rates but they are included in MBRRACE-UK's confidential enquiries. As there are very few maternal deaths in Ireland, reviewing them alongside UK deaths helps maintain confidentiality and anonymity.

As with Northern Ireland, maternal deaths occurring in the Republic of Ireland are not reported directly to MBRRACE-UK. Instead, these deaths are identified by The Maternal Death Enquiry (MDE) Ireland and all information is fully anonymised before being sent to the MBRRACE-UK office.

The data collection and review (flow diagram)