Maternity mortality rates have increased, the maternity services czar has revealed.

Speaking at an HSJ conference on redesigning maternity services, national clinical lead for maternal health and maternity services Dr Gwyneth Lewis said the Why Women Die report, due out in early December, will show 'worse results than the last one, which showed that women from poor backgrounds are 20 times more likely to die as a result of pregnancy or childbirth'.

Dr Lewis said the rise could be explained by an unexpected increase in immigrants. Among the groups most likely to miss antenatal appointments were black African women, she said. 'We need to know why these women are not coming to appointments, which can stop problems with their pregnancies being picked up,' she said.

President of the Royal College of Obstetricians and Gynaecologists Professor Sabaratnam Arulkumaran said in parts of London, which accounts for around a sixth of births in England, deliveries were rising by 2.5 per cent a year and around half were to women who did not have English as a first language.

These 'extra 5,000 births a year' had to be addressed through reconfiguration, as they were equivalent to an extra hospital, he said.