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. MDE Ireland aims to promote safer pregnancy by conducting confidential reviews into maternal deaths, identifying learning points, and using its findings to formulate and disseminate recommendations.
The HSE's National Clinical Care Programme for Obstetrics and Gynaecology, which was put in place subsequent to the instigation of the work on this report, will be collaborating with health professionals to ensure that all learning from enquiries into tragic events related to pregnancy will be incorporated into service delivery to continue to ensure that care for mother and babies is as safe as possible. The Programme has been working on the development of national clinical guidelines in order to improve standardisation and to drive service quality. To date, 20 guidelines have been developed and six are under peer review.