Expert Witness Journal Issue 66 April 2026 - Flipbook - Page 15
What impact will the Maternal Care
Bundle have on future claims?
by Barbara Richardson, Senior Associate at Clyde & Co.
In response to a sharp increase in maternal deaths,
NHS England has published the Maternal Care
Bundle (MCB). The MCB identi昀椀es 5 areas of
maternal care where the risk of maternal mortality
is increased – what impact will it have in assessing
future clinical negligence claims?
3. Epilepsy in pregnancy
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The MCB aims to reduce maternal mortality. It
responds to MBRRACE UK data which shows a
21% rise in maternal deaths since 2009–11, and that
45% of maternal deaths had potentially preventable
elements
4. Maternal mental health
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The MCB sets national minimum standards across
昀椀ve high risk clinical areas of maternal health: venous thromboembolism (VTE), pre hospital and
acute care, epilepsy in pregnancy, maternal mental
health, and obstetric haemorrhage. The minimum
standards must be implemented by NHS Trusts and
ICBs by March 2027
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1. VTE
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Early pregnancy VTE risk assessment will be
o昀昀ered at the 昀椀rst NHS contact, not at booking.
Rapid access to LMWH within 72 hours is to be
provided for high risk women.
Standardised dosing of LMWH will be
introduced.
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There will be a mandatory implementation of
MEWS across all settings for women who are, or
have been, pregnant in the past 4-weeks.
Standardised pre alert systems between the
ambulance and labour ward will be introduced,
alongside clear labour ward signage.
Clear referral pathways for acutely unwell
women from local services to maternal medicine
centres will be implemented.
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There will be routine wellbeing screening
throughout pregnancy and women should
be invited to self-administer the Whooley
questions.
Where there are concerns, the patient will be
invited to complete the EPDS.
Where women score 13 or above in total, or 2 or
above on self-harm, there will be a conversation
to discuss care options, agree next steps and
arrange referrals.
5. Obstetric Haemorrhage
2. Pre-hospital and acute care
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There will be guaranteed access to a local
epilepsy in pregnancy team (consisting of an
obstetrician, obstetric physician and epilepsy
nurse specialist or neurologist), who will lead
care plans.
Women requiring more complex care must be
referred to a maternal medicine network MDT
to oversee the provision of care.
There will be mandatory cumulative measured
blood loss for all births
Standardised escalation steps at 500 mL, 1,000
mL, and 1,500 mL are to be introduced, with
consultant involvement for ongoing bleeding.
MDT case review will be required for all women
who su昀昀er >2 L blood loss or use 昀椀brinogen/
cryoprecipitate within a month.
The MCB establishes baseline standards in maternal
care, albeit only in the above areas of concern.
In respect of future claims, we can expect that the
MCB will be used by solicitors to evidence breach of
duty. Because the standards are speci昀椀c, time-limited
and standardised, they are likely to be treated by the
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APRIL 2026
