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The Confidential Enquiry into Maternal Deaths began in 1952 and has led to major improvements in care for pregnant and postnatal women. In 2012, the responsibility for awarding and monitoring the contract passed to the Healthcare Quality Improvement Partnership (HQIP). The maternal, newborn, and infant enquires were awarded to a collaboration called MBRRACE-UK (Mothers and Babies: Reducing Risk through Audits and Confidential Enquiries). The maternal death enquiry runs from the National Perinatal Epidemiology Unit (NPEU) in Oxford. There have been changes; there are now annual reports, with surveillance of deaths based on 3-year rolling averages and an annual topic-specific serious morbidity and mortality review.A maternal death is defined as a death during pregnancy or up to 42 days postnatal. Deaths are classified as ‘direct’ — deaths resulting from obstetric complications of the pregnant state; ‘indirect’ — deaths from a previous existing disease or a disease that develops during pregnancy, or that is aggravated by pregnancy; ‘late’ — deaths occurring between 42 days and 1 year postnatal that are due to a direct or indirect cause; and coincidental — deaths from unrelated causes that happen in pregnancy or the puerperium. The process of producing the report involves obtaining and anonymising the medical records for each case, including the GP records, and completion of a short report. There has been difficulty obtaining information from GPs, although the General Medical Council states that: ‘All doctors in clinical practice have a duty to participate in clinical audit and to contribute to National Confidential Inquiries’ .1GPs have been involved in the review process for the past 10 years. There is now a team of eight GP assessors, working in pairs; each case is assessed twice and conclusions agreed jointly. The case is also reviewed by an appropriate range of specialists. Finally, a …

Maternal health in pregnancy: messages from the 2014 UK Confidential Enquiry into Maternal Death