Women are dying needlessly in childbirth from treatable medical conditions because of \"substandard care\" in hospitals, a group of doctors said Wednesday. The article in the British Medical Journal (BMJ) by six obstetricians pointed to a \"worrying trend\" in the causes of maternal deaths and said more specialist doctors were needed to spot warning signs.A rise in the number of \"high risk\" pregnancies, including older and obese mothers, means women can face complex health problems, it said. However most deaths are caused by preventable or treatable medical conditions, such as asthma, epilepsy, diabetes and heart problems, it added.While the maternal death rate has decreased since the 1950s, the number of women dying from conditions not directly linked to pregnancy has risen, according to the latest review of Britain\'s maternity services.The main cause of maternal death is heart disease while the second is neurological disease, with most deaths occurring among women with pre-existing conditions. \"Most worryingly, the number of maternal deaths due to indirect causes has significantly increased over the past 20 years,\" the BMJ article said. \"Furthermore, most of these deaths are associated with substandard care, and in one third of cases this is classified as major substandard care, where different care might have prevented death of the mother.\"Catherine Nelson-Piercy, professor of obstetric medicine at King\'s College London, and her colleagues said the failings required \"urgent attention\", urging an increase in the number of obstetric physicians and better training for GPs.In March, a report from the Centre for Maternal and Child Enquiries (CMACE) said that 261 women in the UK died from conditions directly or indirectly related to pregnancy from 2006 to 2008.Of those, 107 died of conditions that could only have arisen if they had been pregnant, while 154 died of indirect causes, including infections and underlying health problems. The overall maternal death rate in Britain dropped from 13.95 per 100,000 maternities in 2003-05 to 11.39 in 2006-08. Royal College of Obstetricians and Gynaecologists (RCOG) president Dr Tony Falconer said an \"increased senior presence on the labour ward\" was required for patients needing urgent care.A Department of Health spokeswoman said: \"There has been a significant reduction in the number of women dying during pregnancy in the UK, but every death is one too many. \"We are committed to ensuring that every woman gets safe and quality maternity services. \"Over the last decade we have seen a 46.6 percent increase in the number of doctors in obstetrics and gynaecology and a 64.4 percent increase in consultants.\"