Frequently Asked Questions
Meternal is the public-facing name of The Maternal Critical Care Alliance, a new UK wide alliance focused on women who become critically ill during pregnancy or after giving birth. Meternal’s application for charitable status is currently pending.
We bring together expertise from maternity, critical care and the many other healthcare professionals involved in caring for critically unwell women alongside the experiences of women and families.
Our work focuses on guidance and education, multidisciplinary training, sharing proven models of care, improving information and signposting, and strengthening support following maternal critical illness.
Meternal does not replace NHS maternity or critical care services. Our role is to help improve how professionals, services and organisations work together to care for critically unwell pregnant and recently pregnant women.
The number of women dying during or after pregnancy in the UK is increasing. Maternal death remains rare in the UK, but mortality figures represent only the most visible part of a much larger issue. Many more women experience severe illness and complications during pregnancy, childbirth or after giving birth.
Research suggests that for every maternal death, around 70–90 women become seriously unwell. Most of these women require enhanced care, and some will require admission to an intensive care unit.
Maternal critical illness usually requires expertise from several different specialties at the same time. Ensuring those services recognise deterioration and work effectively together is therefore an important part of improving maternal care.
Pregnancy and childbirth in the UK are generally very safe, and maternal death remains rare.
However, there remain important concerns about maternal mortality, serious maternal illness, variations in care and inequalities in outcomes between different groups of women.
Meternal believes reassurance and improvement can go together: women should feel confident in maternity care while healthcare services continue to learn from cases where women have died or become seriously unwell and work collaboratively to make care safer for everyone.
EMC is a higher level of observation, monitoring and treatment than routine maternity ward care for women who are unwell or at increased risk of deterioration.
It can often be provided within a maternity unit, with additional expertise from anaesthesia, critical care and other specialist teams. Depending on the care they need, some women may require admission to an intensive care unit (ICU).
Research across 17 NHS maternity units in Yorkshire and Humber found that, while nearly 1 in 10 of all pregnant women required EMC within maternity units, 1 in 300 required admission to an ICU.
Pregnancy causes significant changes to the body, including changes to normal physiology. This can make serious illness more difficult to recognise, and standard adult warning systems are not appropriate for use in pregnancy.
Using an evidence-based maternity-specific Early Warning Score, such as the national MEWS in England, helps staff to identify deterioration but further training and education are required to enable staff to understand why a woman is deteriorating, respond in a systematic fashion and escalate to other multidisciplinary team members to provide timely support and collaborative treatment.
A critically ill pregnant or recently pregnant woman may need care from several specialist teams at the same time. This often includes maternity, anaesthesia and intensive care and neonatal teams but multiple other teams may also be involved depending on the situation and the woman’s location.
Women don’t just become unwell in maternity units, they may be in the community, in primary care or in other areas of the hospital. For this reason all healthcare providers who may be involved in caring for a pregnant or recently pregnant woman need to be able to recognise when a woman is unwell, know how to look after her and escalate care appropriately.
Effective maternal critical care means bringing the appropriate expertise to the woman with a shared plan, clear triggers for escalation and rapid senior decision-making. When a woman becomes critically ill, the care and expertise she needs should be provided without delay. This may initially mean bringing the appropriate staff to the woman, before moving her to the most appropriate place for her ongoing care.
No single healthcare profession can provide every aspect of care that may be required when a pregnant or recently pregnant woman becomes critically ill.
Effective multidisciplinary care means creating a shared plan around the woman, establishing common triggers for escalation, providing clear contact routes and enabling rapid senior decision-making.
It also involves cross-training between maternity, critical care and wider teams involved in caring for a sick woman as well as coordinated transfer, step-down and follow-up care. The aim is for the woman and her family to experience one joined-up team, even when many different professionals and services are involved.
Recovery from maternal critical illness does not end when a woman leaves intensive care or is discharged from hospital.
Women may be recovering from severe infection, surgery, organ failure or other serious complications while simultaneously caring for a new baby. They may also be processing an unexpected or traumatic birth, separation from their baby or disruption to early bonding. Some women may also be processing bereavement or other profound losses, including loss of fertility.
This is why appropriate follow-up, rehabilitation, mental health support, information and signposting following maternal critical illness are important parts of the care pathway.
Meternal aims to improve care at the point where maternity, critical care and other clinical specialties meet.
Our work will focus on education and training for those involved in caring for sick women, sharing effective models of care, improving information and signposting, supporting better coordination between services and advocating for improvements in maternal critical care.
We will work alongside the NHS, professional bodies, networks, women and families. Our aim is not to duplicate existing work, but to help connect expertise, share good practice and address genuine gaps in maternal critical care.
No. Meternal provides information and signposting but does not provide individual medical advice or emergency clinical care.
Anyone concerned that they, or a pregnant or recently pregnant person, may be becoming seriously unwell should contact their maternity service or the appropriate urgent or emergency healthcare service.
Meternal’s role is to make trustworthy information easier to find and to help improve the systems surrounding women and families, rather than operate as a parallel clinical service.