The Corporate Manslaughter and Corporate Homicide Act 2007 and maternal death: an opportunity to address systemic deficiencies in maternity services?

Maternal deaths in the UK are statistically very low: in the three years 2006-8, 261 maternal deaths were recorded, a maternal mortality rate of 11.39 per 100, 000 maternities. The maternal mortality rate has fallen since the triennium 2003-5, for which a rate of 13.95 deaths per 100, 000 maternities was recorded. While this is a welcome reduction, each death is a tragedy, impacting on family and friends, healthcare workers and the community. It is axiomatic that there will be instances where individual fault is the sole cause of a maternal death. Healthcare professionals (HCPs) - be they consultants, midwives or maternity support workers - are accountable (professionally, civilly and criminally) for their own acts and omissions. They are, however, individuals who must operate within, and are constrained by, organisational structures which can themselves be deficient. Concerns about poor systems, practices and procedures within maternity services have been raised for a number of years. The law has a role to play in making maternity services safer: to regulate the service and, where appropriate, to sanction poor practice. In cases where a maternal death (or maternal morbidity) is attributable to substandard care, the civil and/or criminal law may be engaged. It is argued, however, that where the quality of a maternity service is compromised by poor organisational systems and practices, and these systemic failings materially contribute to a maternal death, prosecution under the 2007 Corporate Manslaughter and Corporate Homicide Act (CMCH Act) should be considered both as a means to ensure the equitable apportionment of liability and as a vehicle to effect real and immediate change.