This discussion paper considers how to detect maternal deterioration during both the antenatal and peripartum periods. It discusses the use and validity of early warning scores, the challenges of altered physiological parameters in pregnancy and the extension of the Sepsis Six care bundle used in non-maternity settings to the Sepsis Six Plus Two which can be applied in maternity care.

Key take home messages for clinicians working in primary care include always “thinking sepsis” and enquiring about whether maternity patients feel unwell at each contact. For secondary care, awareness of tachypnoea as a trigger sign and locally agreed and owned guidance on which thresholds should always trigger concern and clear, formalised escalation policies for any concerns are seen as fundamental to safe maternity services.