Clare Daly (Dublin North, Socialist Party)
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210. To ask the Minister for Health the number of non-national maternal deaths using MDE classifications not CSO that have occured here [19524/13]

James Reilly (Dublin North, Fine Gael)
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Statistics on causes of death are based on civil registration and compiled internationally by the World Health Organisation. In the most recent World Health Statistics Annual Report (2012), Ireland had the 13th lowest rate of maternal mortality out of 178 countries reporting data. 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 MDE report shows that 75.4 per cent of maternities in Ireland in 2010 were women of Irish nationality and that 40% of all maternal deaths identified in the triennium 2009-2011 occurred in women who were not born in Ireland. There were 25 maternal deaths in the period, and 10 of these deaths were women not born in Ireland. The report draws attention to how these women engage with Irish maternity services and the importance of the availability of interpretive services. A particular concern was the issue of engagement with the services by non-national patients in receipt of alternative medical advice from outside the country.

In order to improve standardisation and to drive service quality, the HSE's National Clinical Programme in Obstetrics and Gynaecology has been working on the development of national clinical guidelines; to date, 20 guidelines have been developed, eight are under review and a further 20 have been commissioned. It is important to state that no matter what definitions are used or how case ascertainment is conducted, that Ireland continues to be a very safe country for a woman to give birth and our safety record compares favourably with other developed countries.