The Invisible 10%

You can’t improve what you can’t see.

Ten years ago, Yorkshire and Humber had this exactly problem: women were becoming critically unwell during pregnancy, but there was no systematic data on why, how many, or what could be done about it. Staff knew it was happening, but knowing it happens and understanding the patterns are two entirely different things.

That’s when MEaCC decided to create the evidence base that didn’t exist and use data to find the patterns and fix the problems.

What is MEaCC?

Maternal Enhanced and Critical Care (MEaCC) is a regional initiative across Yorkshire and Humber supporting the one in ten women who become critically unwell during or after pregnancy. Through coordinated data collection, multidisciplinary training, and shared policies across 17 maternity units, MEaCC helps staff recognise deterioration early and deliver care at the right time.

As of now, they have over 7,000 cases on the MEaCC database and counting.

The Gap Nobody Was Filling

“This data around those women who became sick and were cared for in maternity – there was no one capturing that data nationally anywhere,” Dr. Deborah Horner explains.

At one of the most critical points in someone’s life, they were becoming unwell without anyone knowing why.

National data existed for women requiring intensive care (the most severely unwell), but what about the much larger group needing enhanced care on delivery suites?

They were invisible in the data. Which meant:

• No one knew how many women this affected
• No one understood the patterns of why women deteriorated
• No one could identify which conditions were most common
• No one could prove the case for additional resources or training
• No one had baseline data to measure improvements against

For staff on the ground trying to care for these women, this gap was frustrating, and for leaders trying to secure funding or justify new approaches, it was incredibly damaging to progress.

Building the Evidence Base

MEaCC’s solution was straightforward but ambitious: if the data doesn’t exist, we’ve got to create it.

Starting with 17 maternity units across Yorkshire and Humber, a team of midwives built a database designed to capture every case of enhanced maternal care – and not just the numbers, but the context, such as:

• Why did the woman need enhanced care?
• What were her observations and early warning scores?
• Did she have pre-existing health conditions?
• What time of day did deterioration occur?
• What interventions were needed?
• How long did she require enhanced care?
• What was the impact on her baby?

“Once we started to collect the data in each of the individual units, we were then able to start to understand a bit more about why those women become unwell and how many do,” Dr. Horner notes.

What the Data Revealed

With 7,000 cases now in the database, MEaCC has transformed understanding of maternal enhanced care:

This data fundamentally changed the conversation. “When you’re working in trust, there’s lots of different specialities competing for funding,” Viv Dolby, Lead Midwife for MEaCC, points out. “Collect the data. Then you would have evidence behind you.” Leaders require evidence, and data empowers you with that evidence to challenge assumptions and prove priorities. 

The Postpartum Haemorrhage Project

Perhaps the most powerful demonstration of data’s value is what MEaCC is doing as a result of the data’s picture; blood loss following birth emerged as the leading cause of enhanced maternal care needs in Yorkshire and Humber. So MEaCC is launching a targeted quality improvement project focused specifically on postpartum haemorrhage.

“We’ve got really rich baseline data,” Dr. Horner explains. “Once we implement the care bundle, we’ll really be able to see whether that is helping to improve outcomes because we’ve got that before and after data.”

This is the ultimate value of systematic data collection: the ability to measure whether your interventions actually work.

Without baseline data, you can implement a new care bundle and hope it helps. With baseline data, you can implement it and prove it helps—or prove it doesn’t and try something else.

The data enables:

• Targeted intervention: Focusing resources where they’ll have the biggest impact
• Rigorous evaluation: Measuring outcomes before and after changes
• Continuous improvement: Using evidence to refine approaches over time
• Shared learning: Demonstrating what works so other regions can adopt proven solutions

None of this came easy. 7,000 cases, manually entered by staff across 17 trusts. Hours and hours of clinical time, taken from already-demanding days.

The Technology Behind the Data: Athera Insights

Building a database that 17 trusts would consistently use, especially during such a challenging time such as COVID, required technology purpose-built for clinical conditions.

MEaCC uses Athera Insights, a platform designed for clinical audits and healthcare registries. The system allows users to:

• Capture tailored data through customised forms that ask only what’s needed
• Access data from any device for flexible, real-time entry
• View local, regional, and national trends to benchmark and compare
• Track performance over time

An Open Invitation to Other Regions