Written answers

Tuesday, 18 December 2012

Department of Health

Maternal Mortality

Photo of Clare DalyClare Daly (Dublin North, Socialist Party)
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To ask the Minister for Health in relation to recent statements he has made in the press about Ireland having one of the lowest rates of maternal mortality in the world, if he will confirm that the recently published first Confidential Maternal Death Enquiry in Ireland Report for the Triennium 2009 – 2011 records that the maternal death rate in Ireland is at best average in comparison with other EU countries and that data on maternal mortality figures are incomplete due to ongoing deficiencies in data collection systems. [56899/12]

Photo of James ReillyJames Reilly (Dublin North, Fine Gael)
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Ireland had the 13th lowest rate of maternal mortality out of 178 countries reporting data. Maternal mortality is a rare occurrence in Ireland. It must be understood that since there are usually fewer than 5 such deaths per year, rates can appear to fluctuate significantly from year to year. For example, an increase in deaths from 2 to 4 in a given year would lead to an apparent 100% increase in the maternal mortality rate. Because of this, reports based on data from different years can appear to be contradictory.

It is generally recognised internationally that official vital statistics can result in an underestimate of maternal deaths. In particular, indirect obstetric deaths resulting from previous existing disease or diseases which developed during the pregnancy may be missed in the official statistics. For this reason, Ireland established a Confidential Maternal Death Enquiry (MDE) system in 2009. In doing so, it linked itself with the United Kingdom’s Confidential MDE which has been acknowledged as a gold standard for maternal death enquiry in recent decades. The recently published report of Ireland’s Confidential MDE for the period 2009 to 2011 cannot be compared with civil registration-based rates of other EU countries which do not have MDE systems. Comparison with the UK’s MDE for the period 2006 to 2008 showed Ireland with a rate about 30% lower than the UK. Again, however, caution must be exercised in interpreting this data since, even when aggregating 3 years of data (i.e. 2009 to 2011), numbers of deaths remain small and the rates will be subject to significant fluctuation.

The recent MDE report for Ireland makes a number of very valuable recommendations both with respect to clinical care and in the area of improved ascertainment of cases. A key recommendation for improving completeness of official statistics is the inclusion of a question on pregnancy status at time of death on the Coroner’s Death Certificate along the same lines as is already included on the Medical Death Notification Form.

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