Maternal sepsis is one of the most preventable, yet devastating causes of maternal death. It happens when an infection during pregnancy, birth, or the postnatal period triggers a life-threatening immune response that damages organs and, without rapid treatment, can prove fatal.
Despite modern healthcare, maternal sepsis continues to claim lives in the UK. And worldwide, it remains a leading killer of mothers and babies. For me - as Lead Midwife for Maternal Medicine in the East of England and through my work with Cambridge Global Health Partnerships - it is both a professional and personal mission to raise awareness of detecting sepsis early and rapid response.
MBRRACE-UK reports that maternal mortality between 2021-2023 was 12.67 per 100,000 maternities. While thrombosis and cardiac disease are the leading causes, sepsis remains one of the top direct killers of mothers (MBRRACE-UK, 2025). What struck me reading the reports is how avoidable many of these deaths were. Infections that begin with something as simple as a urinary tract infection (UTI), wound infection, or mastitis can spiral quickly. Delays in recognition, escalation, and treatment are the common themes.
For every woman that dies, dozens more experience a 'near miss' - requiring intensive care, surviving with long-term complications, and leaving families traumatised. The ripple effect of maternal sepsis is enormous.
Globally, sepsis accounts for 11 million deaths each year. In low and middle-income countries, barriers such as lack of antibiotics, limited staff training, and delays in reaching care make maternal sepsis far more deadly. Through my work with Cambridge Global Health Partnerships, I have seen mothers arrive at hospitals hours - or days - after symptoms begin. By then, opportunities for early intervention are lost. The contrast with the UK is stark, but the underlying challenges remain the same: recognising sepsis early and acting without delay.
Nurses and midwives are often the first to notice when something is wrong: a mother becoming feverish, tachycardic, or confused. In maternity care, these signs can be subtle - and easily misattributed to normal postpartum changes. Using the Maternity Early Warning Score (MEWS) in maternity can also help nurses and midwives identify early signs of sepsis, prompting rapid escalation before deterioration occurs. Nursing and midwifery vigilance is the difference between escalation within minutes versus dangerous delay.
Protocols such as the 'Sepsis six' saves lives, but only if they are started quickly. The six key actions are:
1. Administer high flow oxygen to improve tissue oxygenation and prevent organ damage.
2. Take blood cultures before antibiotics, so treatment can be targeted once results return.
3. Give intravenous antibiotics within one hour, the single most important intervention of survival.
4. Start intravenous fluids rapidly to restore circulation and support blood pressure.
5. Check lactate levels to assess the severity of sepsis and detect tissue hypoperfusion.
6. Monitor urine output closely, as reduced urine output can be an early sign of organ failure.
In maternity care, nurses and midwives are usually the first to initiate these steps. Timely action - often within minutes - can mean the difference between full recovery and rapid deterioration.
It's also important to note that nurses and midwives play an important role in antimicrobial stewardship. They can ensure that antibiotics are used correctly, monitoring for side effects and reinforcing infection control practices.
Sepsis does not end at discharge. Increasing numbers of maternal deaths happen weeks after birth. Community nurses, midwives and health visitors are essential in recognising signs of late infection and supporting women to seek urgent care. Red flags for sepsis in maternity care include fever or hypothermia, rapid heart rate, fast breathing, low blood pressure, new confusion, and reduced urine output - all signals that demand urgent escalation.
World Sepsis Day, on September 13th, is a chance to highlight this issue. Too often, sepsis is seem as a rare complication. But it is neither rare nor inevitable. Every maternal death from sepsis is one too many - because with timely recognition and treatment, it can almost always be prevented.
Despite modern healthcare, maternal sepsis continues to claim lives in the UK. And worldwide, it remains a leading killer of mothers and babies. For me - as Lead Midwife for Maternal Medicine in the East of England and through my work with Cambridge Global Health Partnerships - it is both a professional and personal mission to raise awareness of detecting sepsis early and rapid response.
MBRRACE-UK reports that maternal mortality between 2021-2023 was 12.67 per 100,000 maternities. While thrombosis and cardiac disease are the leading causes, sepsis remains one of the top direct killers of mothers (MBRRACE-UK, 2025). What struck me reading the reports is how avoidable many of these deaths were. Infections that begin with something as simple as a urinary tract infection (UTI), wound infection, or mastitis can spiral quickly. Delays in recognition, escalation, and treatment are the common themes.
For every woman that dies, dozens more experience a 'near miss' - requiring intensive care, surviving with long-term complications, and leaving families traumatised. The ripple effect of maternal sepsis is enormous.
Globally, sepsis accounts for 11 million deaths each year. In low and middle-income countries, barriers such as lack of antibiotics, limited staff training, and delays in reaching care make maternal sepsis far more deadly. Through my work with Cambridge Global Health Partnerships, I have seen mothers arrive at hospitals hours - or days - after symptoms begin. By then, opportunities for early intervention are lost. The contrast with the UK is stark, but the underlying challenges remain the same: recognising sepsis early and acting without delay.
Nurses and midwives are often the first to notice when something is wrong: a mother becoming feverish, tachycardic, or confused. In maternity care, these signs can be subtle - and easily misattributed to normal postpartum changes. Using the Maternity Early Warning Score (MEWS) in maternity can also help nurses and midwives identify early signs of sepsis, prompting rapid escalation before deterioration occurs. Nursing and midwifery vigilance is the difference between escalation within minutes versus dangerous delay.
Protocols such as the 'Sepsis six' saves lives, but only if they are started quickly. The six key actions are:
1. Administer high flow oxygen to improve tissue oxygenation and prevent organ damage.
2. Take blood cultures before antibiotics, so treatment can be targeted once results return.
3. Give intravenous antibiotics within one hour, the single most important intervention of survival.
4. Start intravenous fluids rapidly to restore circulation and support blood pressure.
5. Check lactate levels to assess the severity of sepsis and detect tissue hypoperfusion.
6. Monitor urine output closely, as reduced urine output can be an early sign of organ failure.
In maternity care, nurses and midwives are usually the first to initiate these steps. Timely action - often within minutes - can mean the difference between full recovery and rapid deterioration.
It's also important to note that nurses and midwives play an important role in antimicrobial stewardship. They can ensure that antibiotics are used correctly, monitoring for side effects and reinforcing infection control practices.
Sepsis does not end at discharge. Increasing numbers of maternal deaths happen weeks after birth. Community nurses, midwives and health visitors are essential in recognising signs of late infection and supporting women to seek urgent care. Red flags for sepsis in maternity care include fever or hypothermia, rapid heart rate, fast breathing, low blood pressure, new confusion, and reduced urine output - all signals that demand urgent escalation.
World Sepsis Day, on September 13th, is a chance to highlight this issue. Too often, sepsis is seem as a rare complication. But it is neither rare nor inevitable. Every maternal death from sepsis is one too many - because with timely recognition and treatment, it can almost always be prevented.
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