Concern over rise in maternal deaths

  • Niall Hunter, Editor

The Association for Improvements in Maternity Services Ireland (AIMS) has called for an investigation into why the number of pregnancy-related maternal deaths in Ireland appears to be on the rise.

AIMS was commenting in the wake of the controversy following the death of Savita Halappanavar in University Hospital Galway last month after a miscarriage. Her husband said his wife, who was 17 weeks pregnant, sought but was refused a termination after being told her baby would not survive.

The organisation stressed that it was not taking a stance on the abortion issue related to the Galway tragedy, but it was concerned at the apparent rise in maternal deaths.

Krysia Lynch of AIMS told that it had calculated that there had been around 11 maternal deaths in Dublin maternity hospitals and Our Lady of Lourdes Hospital in Drogheda since 2010. This included two recent maternal deaths at the Coombe Hospital in Dublin.

She said since 2010, hospital records had documented three deaths at the Coombe, three at the Rotunda, two at Holles Street and one in Drogheda. Ms Lynch said AIMS knew of two further deaths that had not yet been confirmed or reported in the media.

"We are told that these deaths are rare events, and that Ireland is one of the safest places in the world to give birth. However, we would be concerned that maternal deaths seem to be becoming more frequent."

"Our view would be that no woman in Ireland should die from a maternity-related complication", Ms Lynch said.

She said there was a need for clarification and more information on the number of maternal deaths and why they were occurring.

"Factors behind the increase could be that maternity units are busier nowadays and that that there are now fewer midwives and obstetricians per woman giving birth, but we need to look into why the mortality rate is rising."

Ms Lynch said there was also an issue with the definition of maternal death and how the statistics on these deaths were calculated.

She pointed to recent research which indicated that official Central Statistics Office (CSO) figures significantly under-reported maternal death rates, and that there are discrepancies between the CSO figures and maternity hospital mortality statistics.

Ms Lynch said among the maternal death cases over the past three years was that of a 32-year-old Nigerian woman, Bimbo Onanuga, at the Rotunda Hospital in March 2010.

Ms Onanuga attended the Rotunda on Monday, March 1, 2010 when seven months pregnant and it is understood that she was told her child had died in utero.

She was treated and advised to return for further treatment the following Thursday, but is understood to have been admitted to the Rotunda in severe pain on the Wednesday. Ms Onanuga's condition deteriorated, she was transferred to the Mater Hospital and was subsequently pronounced dead later that day.

Ms Lynch said while recommendations were made for system improvements following a probe into this death, the full findings of the investigation into factors contributing to the death had were never released.

The HSE was reported in 2011 to also be investigating the death of another patient at the Rotunda, believed to be from Poland, in March of that year. The woman was reported to have collapsed in the Rotunda and transferred to the Mater, where she died.

The HSE in 2011 apologised and admitted negligence in settling a legal case with the family of Tanya McCabe, who died at Our Lady of Lourdes Hospital in Drogheda in 2007 along with one of her twin sons. The other twin survived.

In April 2011, a woman from Monaghan died at the same hospital after giving birth. Her baby was delivered safely.

According to the Central Statistics Office, the maternal mortality rate was three per 100,000 live and stillbirths in 2007, four per 100,000 in 2008 and four per 100,000 in 2009. The rate was 20 per 100,000 in Northern Ireland in 2009.

However, some experts believe the true maternal death rate is under-reported here due to the criteria currently used, and the real rate could be around 10 per 100,000 if the criteria were changed.

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