Leo Varadkar (Dublin West, Fine Gael) | Oireachtas source

I thank the Deputy for raising this issue. It is generally recognised internationally that official statistics can result in an underestimate of maternal deaths. In particular, indirect obstetric deaths resulting from pre-existing disease or diseases which developed during the pregnancy may not be recorded in official statistics. For this reason, Ireland established a confidential maternal death enquiry, MDE, system in 2009. In so doing, it linked itself with the United Kingdom's confidential MDE, which has been acknowledged in recent decades as a gold standard for maternal death enquiry.

The most recent MDE report, published this month, shows 38 maternal deaths during or within 42 days of pregnancy between 2009 and 2012, of which ten were classified as direct maternal deaths, 21 were classified as indirect maternal deaths due to pre-existing medical or mental disorders which were exacerbated by pregnancy, and the remaining seven were attributed to coincidental causes. There was no evidence of clustering in any one maternity hospital.

The report indicates that the maternal mortality rate for the three year period 2009-2011 was 8.6 per 100,000 maternities. This rate increased to 10.5 in the period 2010-2012. However, we must interpret this increase with caution. Ireland is a small country and, thankfully, maternal mortality cases are rare. Taking account of the relatively small number of deaths, fluctuation in our maternal mortality rates is inevitable, even where data are aggregated over several years. The experts who prepared the report note that the increase is not statistically significant. Our maternal mortality rate of 10.5 per 100,000 maternities compares with a rate of 10.01 in the UK. Again, the authors make the point that the difference in rates between the countries does not represent a statistically significant difference.

In conducting its confidential reviews into maternal deaths, MDE Ireland aims to promote safer pregnancy, identify learning points and use its findings to formulate and disseminate recommendations. It is imperative that the lessons learned from this research informs service development. Some of the issues raised by the report will be, therefore, particularly relevant in the context of service planning and delivery. Reports of incidents of maternal deaths in Ireland cause real concern to some women, their families and partners. It is important to reassure women and their families that maternal and perinatal health statistics indicate that Ireland continues to be a safe country in which to give birth and that our maternal mortality rates are on a par with the rest of the developed world. I should also point out that €2 million has been provided in the National Service Plan 2015 to further improve maternity services. Additional obstetricians, midwives and other staff will be appointed. This is against the backdrop of a falling birth rate. I hope this additional funding will drive further service improvement.

My Department, with the HSE, is currently working on the development of a new maternity strategy. The strategy will provide the direction for the optimal development of maternity services, in line with best international practice. It will be informed by a national review and evaluation of maternity services being undertaken by the HSE.

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