Severe maternal morbidity has become an important quality indicator of obstetric care and maternal welfare in developed countries over the last decade.
The term, "maternal morbidity" encompasses a range of chronic and acute conditions which may result in obstetric complications during labour, delivery and the puerperium. However, there is an absence of international consensus on definitions of "severe maternal morbidity", which impedes comparative analysis between similarly resourced countries.
In collaboration with the multidisciplinary-specialist NPEC Maternal Morbidity Group, the NPEC has collected and analysed anonymised maternal morbidity data from Irish maternity units since 2011. The NPEC also conducts detailed assessments of pertinent morbidities and morbidity-related topics such as: critical care in obstetrics and major obstetric haemorrhage. The purpose of the audit is to provide both baseline evidence for reflective practice and action planning by public maternity health care providers, public health professionals and policy makers in Ireland.
The NPEC uses the Severe Maternal Morbidity Notification Form to collect its data. You can find the form on this page.
For further information on the Severe Maternal Morbidity Audit, please contact Edel Manning (e.manning@ucc.ie) and Jessica Keane (JKeane@ucc.ie)
Latest Recommendations
Based on findings from this and previous reports, the NPEC Severe Maternal Morbidity Group makes the following recommendations:
- Organisations have been identified to take ownership of progressing these recommendations. Robust clinical audit on adverse maternal outcomes requires the protected time of clinical staff. Funding should be provided by the Health Service Executive (HSE) to facilitate the same. Owner; Quality and Patient Safety Directorate (NQPSD)
- A public health education programme on maternal morbidity and modifiable risk factors should be developed. Owner; in discussion with the National Women and Infants Health Programme (NWIHP) to progress this
Antenatal education:
- Antenatal education/information should be provided by the multidisciplinary team to women to ensure an understanding of maternal morbidity and complication awareness. (b) When a pregnant woman is identified as high risk for significant morbidity, specific education should be available during her antenatal care and at birth preparation.
- When a pregnant woman is identified as high risk for significant morbidity, specific education should be available during her antenatal care and at birth preparation.
- The national standards on antenatal education should provide guidance on specific education for maternal morbidity awareness.
Owner; the National Women and Infants Health Programme (NWIHP) to progress these
Internationally, social inequalities have been shown to impact on risk of SMM. There is a need to establish the evidence in this regard in Ireland. This requires improved maternity data at national level and more research in order to establish this evidence.
- There is an opportunity with the Maternal Newborn Clinical Management System (MN_ CMS) data from Irish maternity units to mine data at a national level. These data could be collated to identify the influence of risk factors for SMM in Ireland including ethnicity, maternal age, body mass index (BMI), smoking, employment status and other socio-economic factors. This should overcome the current deficit in the pregnant population data at national level. Owner; the NPEC to progress this.
