Dáil Éireann Debate, Tuesday - 24 October 2017
281. Deputy Róisín Shortall asked the Minister for Health further to Parliamentary Question No. 429 of 10 October 2017, the procedures in place to record and review maternal deaths; the reason age and nation of origin are not recorded (details supplied); and if he will make a statement on the matter. [45063/17]
View answer282. Deputy Róisín Shortall asked the Minister for Health the steps he and his predecessors have taken on foot of a report (details supplied) regarding investigating and addressing the disproportionate number of reported deaths of women born outside the State; and if he will make a statement on the matter. [45064/17]
View answerI propose to take Questions Nos. 281 and 282 together.
I can assure the Deputy that there are procedures in place to record and review maternal deaths and to ensure that any learning is disseminated and applied to help improve our maternity services.
A maternal death is classified as a Serious Reportable Event and, as such, must be reported through the National Incident Management System within 24 hours. Investigations must be commenced within 48 hours of the organisation becoming aware of the incident and completed within four months of commencement. In addition, from now on, all maternal deaths will be subject to a review which is external to the Maternity Network/Hospital Group. I understand that maternal deaths are also reported to the Coroner as a 'rule of practice'.
It is recognised that it can be difficult to make international comparisons in relation to maternal mortality because data collection systems vary. However, in an effort to improve the accuracy of our information on maternal deaths in Ireland, a Confidential Maternal Death Enquiry (MDE) system was established in 2009, linking Ireland to the United Kingdom's Confidential MDE which is considered the gold standard for maternal death enquiries.
With regard to MDE Ireland, the information it collects includes maternal age and ethnicity/nationality, body mass index and smoking status. The Deputy will be aware that the statistics reported to MDE Ireland require anonymisation due to the small number of such incidents occurring across the country's maternity hospitals/units. Thus, naming the hospitals/units where such events have occurred would not meet the data protection standards required for protection of otherwise identifiable patient information (Data Protection Acts 1988 and 2003, Section 5(h)); such statistics are not, therefore, publicly available. Submitting information to MBRRACE-UK allows Ireland to participate in reporting on maternal deaths while keeping anonymity in place.
According to MDE Ireland, 38.7% of maternal deaths 2009-2012 (including direct and indirect causes) occurred in women born outside Ireland, who represented 24.2% of all maternities in Ireland for that time period. This finding reflects those from successive UK MBRRACE reports which have found an increased risk of maternal deaths among migrant ethnic minorities.
In conclusion, I would like to reiterate the Government's commitment to the progressive development of maternity services in Ireland. 2016 saw the publication of Ireland’s first National Maternity Strategy, the HSE’s National Standards for Bereavement Care following Pregnancy Loss and Perinatal Death and HIQA’s National Standards for Safer Better Maternity Services. In addition, each of our maternity hospitals/units is now publishing monthly Maternity Patient Safety Statements. In January 2017, the National Women & Infants Health Programme was established to lead the management, organisation and delivery of maternity, gynaecological and neonatal services with the HSE, which includes ensuring that learning is disseminated to all hospitals/units. I have recently launched the Programme's Implementation Plan for the Strategy. All these developments represent key building blocks to facilitate the provision of a consistently safe and high quality maternity service, including for women born outside of the State.
