Maternal Sepsis: Causes, Symptoms, and Support

Maternal sepsis is a significant cause of pregnancy and childbirth-related deaths worldwide, with a 10% mortality rate in the UK. Early detection and treatment are crucial for improving patient outcomes. This page raises awareness about the signs of maternal sepsis and signposts to resources for affected mothers and families.

What is maternal sepsis?

Maternal sepsis is sepsis – a life-threatening condition – that develops during pregnancy, childbirth, or in the months following childbirth. It can also complicate abortions and miscarriages. While maternal sepsis mortality is high in low-to-middle income countries (around 400 per 100,000 live births), the UK has a much lower rate of approximately one per hundred thousand.

What are the symptoms of maternal sepsis?

Symptoms of sepsis are the same as for the general adult population*:

How to spot sepsis in adults

Seek medical help urgently if you (or another adult) develop any of these signs:
  • Slurred speech or confusion
  • Extreme shivering or muscle pain
  • Passing no urine (in a day)
  • Severe breathlessness
  • It feels like you’re going to die
  • Skin mottled or discoloured

Additional symptoms which might affect people during or after pregnancy due to the possibility of infection include:

  • Fever and chills
  • Dizziness
  • Lower abdominal pain
  • Foul-smelling vaginal discharge
  • Vaginal bleeding
  • Increased heart rate
  • Discomfort or illness

If you suspect an infection, call 111 or your GP. If you suspect someone might have sepsis, call 999 or go to A&E.

How does maternal sepsis develop?

Pregnant women face a slightly higher risk of sepsis due to naturally occurring immunological changes, the need for procedures or surgery, and risks due to complications, such as premature rupture of membranes or gestational diabetes. 

The most common cause is a severe bacterial infection of the uterus during pregnancy or immediately after childbirth. Maternal sepsis could also be caused by a urinary infection, or pneumonia. 

Pregnant women who have a chronic condition impacting one of their organs are the most at risk from maternal sepsis. 

Is maternal sepsis preventable?

Like any form of sepsis, maternal sepsis can’t be prevented but we can reduce the risk of developing infection by practising good hygiene, such as washing hands before and after changing a sanitary pad or touching the perineum.  

Since pregnant women are also at a heightened risk of developing sepsis from other sources, including influenza, the ‘flu’ vaccine is recommended for pregnant women.

Support for maternal sepsis survivors

Recovery after sepsis can be physically and mentally challenging for anyone, even more so if they have a new-born. Sepsis can mean an extensive hospital stay and a long recovery period at home. All of this can impact a mother’s ability to bond with her baby. 

Around 40% of people report suffering from physical, cognitive, and/or psychological after-effects when they recover from sepsis. The most important thing is to not suffer alone. 

UKST provides a range of free support services for anyone recovering from sepsis and their families. You can contact our Support Nurses on our help and information line 0808 800 0029, or reach out online. 

A variety of written recovery resources are available here and many people find support in our Facebook peer support group, which is moderated by our Support Nurses. 

FAQs

Can maternal sepsis affect breastfeeding?  Open

Maternal sepsis can hinder milk production and your ability to breastfeed your baby.

It can impact the body’s ability to produce milk and it may take months before it is healthy enough to do so again. 

Some medications, particularly antimicrobials, can also be a risk to the child if passed to them through breastfeeding. Doctors should consider this and offer advice at the time of prescribing such medicines. 

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Can sepsis impact your fertility?  Open

If sepsis develops in the pelvic area, it may affect fertility. 

According to the World Health Organization, tubal disorders such as blocked fallopian tubes, which can be caused by maternal sepsis, can make a woman infertile. 

This is especially true if invasive surgery into the region is necessary. 

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How can clinicians spot maternal sepsis early?  Open

Detecting sepsis in pregnant women can be challenging since the natural adaptations to the body during pregnancy may mask the signs and symptoms of infection until the woman deteriorates. 

Due to the physiological changes in pregnancy, the National Early Warning Score (NEWS) is not designed for use in pregnant patients. Use of a Modified Obstetric Early Warning Score (MEOWS) alongside the Maternal Sepsis screening tool is recommended to facilitate the early recognition and escalation of deteriorating maternal patients.  

Learn more about our clinical tools and resources here.

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*For the signs of sepsis in children, click here.

Legal Advice

If you or your relative/friend has become critically ill very quickly, you may feel like you haven’t received enough information. Often people haven’t understood what’s happening or why it has happened. If this is how you feel, click here to learn more about your options.