What is this project about?

The ACHIEVE Project – Appraise and CHange PerInatal Mortality EVEnts

Title of PhD: Structured evaluation and implementation of a national perinatal mortality review tool for Ireland

Perinatal mortality is a major indicator of quality of healthcare in pregnancy and childbirth. In Ireland, the perinatal mortality rate for 2023 was 4.30 per 1,000 births. Other European countries have reduced their perinatal mortality rate over the last decade through several targeted initiatives. One of these initiatives is through review of perinatal deaths to identify any modifiable or preventable factors in those deaths. A robust review system has the potential to help reduce the perinatal death rate while also providing opportunities for learning and improvements to clinical care. 

Local reviews of perinatal deaths occur in each maternity unit and hospital in Ireland. However, the reviews lack standardization, transparency, or adequate depth to fully elucidate the lessons for prevention of perinatal deaths. Importantly, parents are frequently not involved in the review process and have little opportunity to offer their opinion or concerns. Implementing a standardised national review process for perinatal deaths may help to identify important learning from perinatal deaths at a national level and may contribute towards further reducing Ireland’s perinatal mortality rate.

What is involved?

The project aims to gather national and international evidence-based knowledge to develop and implement an efficient tool for review of perinatal deaths, which is suitable for healthcare services while also responding to the needs of bereaved parents. Through our research, we are working towards implementing a standardised perinatal death review process that promotes learning and education to improve maternity care and ultimately reduce the number of perinatal deaths in Ireland. Our work aims to highlight ways to improve communication between hospitals and parents and promote meaningful parent engagement in the review process. Emily works closely with the members of the Pregnancy Loss Research Group, who provide valuable oversight for this work.

The PhD objectives are:

1. Systematically review the literature to identify review tools that are in use internationally to review perinatal deaths, and analyse their development, implementation, function and ongoing use.
2. Examine potential barriers and facilitators as reported by maternity staff to the introduction of a standardised perinatal mortality review tool in the maternity services in Ireland.
3. Explore feedback and suggestions from bereaved parents to further develop the information that is provided to parents regarding perinatal death reviews and devise methods to ensure that parents are included in the review process.

Who is involved?

Project team

Steering Group

Oversight for Dr O’Connor’s PhD work is provided by a steering group, which was formed in April 2022. The steering group is chaired by Rev Dr Daniel Nuzum, PhD.

Dissemination activities

Project status

Ongoing: January 2022 to December 2026

Further information

Please email Dr Emily O’Connor: emilyoconnor@ucc.ie