Tania McCabe, Bimbo Onanuga, Dhara Kivlehan, Savita Halappanavar, Jennifer Crean and now Sally Rowlette – the list of women who have died in or after childbirth in controversial circumstances in Irish maternity hospitals continues to lengthen.
Every case is different, and there will always be instances where expectant mothers die in tragic circumstances. Yet the number of maternal deaths that have come to prominence in recent years surely belies our once-vaunted reputation as one of the safest countries in the world to have a baby.
Top in rankings
A decade or so ago, we were near the top of some international rankings, but the figures, though low, are beginning to move upwards. This week, the
Rotunda Hospital
in Dublin reported three maternal deaths last year, the joint highest level in a decade.
A further spotlight will be shone on maternity services when a report is published detailing the follow-up on recommendations made in the wake of the most high-profile of these deaths, that of Ms Halappanavar in University Hospital Galway in 2012.
The report from the Saolta hospital group is expected to show that most of the recommendations made in two reports and by the coroner at Ms Halappanavar’s inquest have been implemented. No doubt they have, but it will be some time before the maternity system enjoys full confidence again where complex obstetric emergencies occur.
After all, Ms Halappanavar might never have died if lessons had been properly learned about sepsis from the death of Tania McCabe some five years previously. Sally Rowlette died in Sligo Regional Hospital in February 2013 as a result of the same Hellp syndrome that was a factor in Dhara Kivlehan's death in the same hospital almost three years earlier.
The system struggles to learn from its mistakes.
The inquests into the deaths of Ms Rowlette and Ms Kivlehan unearthed a number of disturbing similarities, including delays in taking action, questions about the availability of senior staff, and issues around note-keeping.
Cuts matter
Resources are an issue, of course. A lack of critical care beds may have been a factor in the deaths of Ms Rowlette and Ms Kivlehan. The number of such beds has been cut when an official report recommended a substantial increase. Meanwhile, we have one of the lowest levels of obstetricians in the EU relative to the number of births.
With elections looming, the suspicion is that tough decisions to uphold safety standards are being delayed because of the political flak that would arise from any cuts to local services.
