Mortality by pregnancy status following death certification reform, England and Wales: 2025

• In 2025 in England and Wales, 103 deaths of females between the ages of 10 and 64 years were registered as having occurred during pregnancy, or within a year of the end of the pregnancy.

• 27 of the 103 deaths were reported as occurring during pregnancy, 30 deaths within 42 days of the pregnancy ending, and 46 deaths between 43 days and one year after the pregnancy ended.

• Pregnancy was reported to have contributed to 24 of the 103 deaths, while 46 reported that pregnancy did not contribute to the death; a total of 33 reported that it was unknown whether pregnancy contributed to the death or not.

• Of the 24 deaths that reported that pregnancy had contributed towards the death, 23 mentioned a pregnancy related cause of death (anywhere on the death certificate) consistent with being related to pregnancy, childbirth and the puerperium (as defined by the International Classification of Diseases, Version 10 (ICD-10)).

• Of the 46 deaths that reported that pregnancy did not contribute towards the death, three mentioned a cause of death consistent with being related to pregnancy, childbirth and the puerperium (as defined by ICD-10), which were not the main cause of death.

• Some information appears to be recorded in error, such as 21 death registrations to women aged 65 years and over and 11 registrations to men who were recorded as being pregnant in the previous year; the potential introduction of an electronic medical certificate cause of death (MCCD) system could improve data quality.

• For women who were identified as being pregnant in the year prior to death, recorded causes of death (as defined by ICD-10) were mostly consistent with whether the pregnancy contributed to the death or not; it is uncertain how many women died within a year of pregnancies that were unknown to the medical examiner.

Maternal deaths 

Deaths from any cause related to, or aggravated by, pregnancy or its management (excluding accidental or incidental causes) during pregnancy and childbirth or within 42 days of termination of pregnancy, irrespective of the duration and site of the pregnancy.

Late maternal deaths are the death from direct or indirect obstetric causes, occurring more than 42 days, but less than one year, after termination of pregnancy. 

Guidance

Two questions relating to maternal deaths were added to the non-neonatal medical certificate cause of death (MCCD), to align it with international standards. This subsection presents each question with its response options:

Was the deceased pregnant within the year prior to their death? 

• 0 - Not applicable 

• 1 - Pregnant at the time of death 

• 2 - Pregnant 1 to 42 days before death 

• 3 - Pregnant 43 days to a year before death 

• 4 - Not pregnant 

• 9 - Unknown

If the deceased was pregnant within the year prior to their death, did the pregnancy contribute to their death? 

• 1 - Yes 

• 2 - No 

• 9 - Unknown

The use of "0. Not applicable" in the first question covers deaths of those that the attending practitioner (AP) deems incapable of being pregnant.

The use of "4. Not pregnant", is for deaths where the AP believes the deceased was capable of being pregnant, but they were not pregnant at the time of death.

The guidance for medical practitioners completing medical certificates of cause of death in England and Wales, from the Department of Health and Social Care (DHSC), advises that the question on whether pregnancy contributed to the death should only be completed in cases where the individual was recorded as pregnant in the year prior to their death.