Saving Mothers' Lives: - Public Health Agency for Northern Ireland

Table 1.26
Characteristics of the antenatal care sought by pregnant or recently delivered women who were known substance
misusers and whose pregnancy exceeded 12 weeks’ gestation; United Kingdom: 2003-05.
Type of death Late or non attenders for antenatal
care (ANC)
Booked after 22 weeks
or missed more than
four visits
No ANC Subtotal
Total number of deaths of
substance misusers after 12
or more weeks of gestation
n n n (%) n (%)
Direct 3 2 5 (100) 5 (100)
Indirect 13 3 16 (73) 22 (100)
All 16 5 21 (78) 27 (100)
Coincidental 1 3 4 (33) 12 (100)
Late deaths 27 2 29 (62) 47 (100)
Total 44 10 54 (63) 86 (100)
Six women with substance abuse problems died early in pregnancy from Direct or Indirect causes, and
there was one other Coincidental death. However, as shown in Table 1.26, 21 of the other 27 women
whose pregnancies were advanced enough to require care, accessed maternity services less than
optimally, or not at all. None of the women who died from Direct causes regularly attended care, and only
22% of those women who suffered an Indirect death attended for optimal antenatal care. By comparison,
two thirds of the twelve women who died from Coincidental causes regularly attended for care.
Risk factors and barriers to care
Many of the women who died found it diffi cult to seek, or to maintain contact with, maternity and/or other
health services. The many possible reasons for this have been discussed throughout this Chapter and
the main characteristics of the women who found it diffi cult to attend are summarised in Table 1.27.
Understanding what the barriers were that prevented these women from feeling able to access maternity
care will help future services to develop in response to these needs. One of the key issues addressed in
“Maternity Matters”, the modernisation agenda for maternity services in England 3 , is developing services
that encourage and support all women, but particularly the most vulnerable, to access care early and stay
in touch with it thereafter.
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