A report by the Nuffield Trust shows that around one in five mothers attend A&E in the year after they give birth, while 6% have an emergency hospital admission. Black women, those from the most deprived areas, and those with mental health conditions are among more likely to receive emergency care.
The Nuffield Trust report takes a detailed look to date at the period after women give birth and which groups are most likely to face health complications. The researchers looked at almost all women and people who gave birth in England over a three-year period (April 2021 to March 2024). This included around 1.6 million births, belonging to 1.5 million people, as some gave birth more than once.
It found that around one in five mothers (21%) attend A&E in the year after they give birth, while 6% have an emergency hospital admission. But there is huge variation across different groups, with Black women, those from the most deprived areas, and those with mental health conditions among those far more likely to receive emergency care than average. In two-thirds of births, the mother had at least one diagnosed health condition.
Many of these emergency hospital trips happened in the very early stages of motherhood and recovery from birth. One in 10 post-birth emergency care visits (including A&E and being admitted in an emergency) occurred in the first two weeks after birth, and almost a quarter within the first six weeks.
The three most recorded reasons for an A&E visit were abdominal pain (12%), chest pain (6%), and bleeding from the vagina (5%), but a concerning 21% of mothers did not have a reason for their visit recorded. The authors argue that many of these attendances could be avoided with stronger support for women’s health across the life course: before, during and after pregnancy.
Key findings on inequalities in use of emergency services:
- Women of all Black ethnicities were more likely than average to go to hospital in an emergency when their babies were less than a year old. For example, 27% of Black Caribbean, 26% of Black African and 28% of mothers of ‘any other’ Black ethnicity had an emergency care visit. That’s compared with 23% of White British, 22% of White Irish and 19% of mothers with ‘other’ White ethnicities.
- Needing an emergency hospital visit was more common for women living in the most deprived areas, regardless of ethnic group. Emergency care visits followed 27% of deliveries in the most deprived areas, and it became less frequent as deprivation fell - 17% of deliveries of those who lived in the least deprived areas went to hospital for an emergency.[1] But these differences cannot be explained by deprivation alone, pointing to wider inequalities in health and access to care.
- In two-thirds of deliveries (67%), mothers had at least one pre-existing health condition. Many of these – obesity, diabetes and hypertension – are potentially preventable and were linked to a higher risk of emergency hospital care after birth. Risks were greatest when conditions were diagnosed pre-conception and during pregnancy and delivery, showing that many complications after birth are rooted in women’s health long beforehand.
- Nearly without exception, having a hospital record of any health condition was associated with an increased risk of needing emergency hospital care post-birth. Especially notable was the relationship with mental ill health diagnoses. 30% of mothers with a mental ill health diagnosis had an emergency care visit, compared with 19% of those without a mental health condition.
- The youngest mothers – those aged under 20 – had the highest risk of needing to go to hospital in an emergency of any age group.
- Most A&E visits (around 70%) did not result in an admission, suggesting some could potentially be avoided with better support in the community, particularly in the days and weeks immediately after birth.
Variation across different groups may reflect patterns of people being sent home more quickly after birth, inadequate health care support, and barriers to accessing primary care and community support, in addition to the complex effects of structural racism on health and how mothers interact with health services.
The authors argue that, while improving maternity care is essential, it will not be enough on its own. Many of the risks that drive emergency hospital use are often already in place before pregnancy and are closely linked to wider inequalities in health.
The report shows that meaningful progress will require action beyond maternity services, including tackling the social determinants of health, strengthening prevention, and targeting support towards women at greatest risk. This means both earlier intervention across women’s lives and better care in the critical period after birth. Improving data, including recording the ethnicity of mothers needing emergency care, should also be a clear goal for policymakers.
Nuffield Trust Deputy Director of Research and report lead Sarah Scobie said: “Mothers going to A&E soon after birth are almost certainly bringing their tiny baby with them, or worse, being separated from them at a crucial time. In the early weeks and months, mums will want to focus on the joy their new baby brings, instead of fearing an emergency hospital trip while at their most vulnerable.
“Policymakers and NHS leaders must get a handle on whether many post-birth emergency care visits could have been avoided with better community care – or indeed with improved preventive care well before birth. The worrying variation we have uncovered indicates that some mothers need much more targeted support from NHS and other community services.
“Many recent reports, including from the Amos Review of maternity services, have brought into stark relief the inequalities faced by women during pregnancy and birth, particularly for Black women. We now have the evidence to show that health inequalities follow women into the next phase of motherhood.
“It’s appalling that for one in five A&E visits in the year after birth, the reason for the visit was not even recorded. This is a clear area for improvement if the NHS is to better understand and support the health needs of mothers during the profoundly life-altering post-birth period.”
Report co-author Veena Raleigh, who is a Senior Fellow at the King’s Fund, said: “Addressing the failings in maternity care identified in recent reviews must be a priority for the NHS. Alongside this, strategies to improve the health of girls and women are a vital complement for improving maternal outcomes and reducing inequalities.
“Adverse maternal outcomes are strongly associated with potentially preventable conditions such as obesity, diabetes, hypertension, poor mental health – conditions that are more common among deprived and some ethnic minority communities, driving deep inequalities in population health overall. So, girls and women from these communities are at risk even before they embark on a pregnancy.
“Two of the three “radical shifts” in the government’s 10 Year Plan are from “hospital to community” and from “sickness to prevention”. One year on, there is scant evidence that the demand for hospital services is falling and population health is improving.
“Improving maternal outcomes and reducing inequalities should not be an issue only for maternity services – it needs to become a core, routine aim of public health strategies for improving the health of girls and women.”
