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ACHIEVE – Appraise and CHange PerInatal Mortality EVEnts: Structured evaluation and implementation of a national perinatal mortality review tool for Ireland

What is this project about?

ACHIEVE – Appraise and CHange PerInatal Mortality EVEnts: Structured evaluation and implementation of a national perinatal mortality review tool for Ireland

Perinatal mortality is one of several key indicators of the quality of health care in pregnancy and childbirth. In Ireland, the perinatal mortality rate (PMR) was 6.25 per 1,000 births in 2020. While other European countries have successfully reduced their perinatal mortality rate over the last decade, the PMR in Ireland has largely remained static. There is evidence to show that a robust perinatal death review system has the potential to improve the PMR while also providing opportunities for learning and improvements to clinical care.

While local and national reviews of perinatal deaths are occurring in Ireland, the reviews lack standardisation, transparency, or adequate depth to fully elucidate the lessons for the prevention of perinatal deaths. Importantly, parents are frequently not involved in the review process and have little opportunity to offer their opinion or concerns. The PMR in Ireland could potentially be further reduced by the implementation of a validated, standardised national review process and confidential enquiry. To date, a national perinatal mortality review tool has not been introduced and there is little known about the effect this might have on perinatal mortality rates in Ireland.

What is involved?

The project aims to gather national and international evidence-based knowledge to develop and implement an adequate and efficient tool for review of perinatal deaths, which is suitable for healthcare services (and providers) while also responding to the needs of bereaved parents. With this, we are hoping to implement a new standardised tool that better promotes shared lessons learned to improve maternity care and ultimately reduce the number of perinatal deaths in Ireland. The PhD objectives are outlined below:

  1. Systematically review the literature to identify audit tools that are in use internationally to review perinatal deaths, and analyse their development, implementation, function, value and ongoing use.
  2. Examine potential barriers and facilitators to the introduction of a standardised perinatal mortality review tool in the maternity services in Ireland.
  3. Develop a review tool for objective, consistent and standardised review of perinatal deaths occurring in maternity units in Ireland.
  4. Model the implementation of the new proposed review process and tool in the hospital setting to identify the appropriate team members, resources and requirements for adequate completion of a full review. Evaluate the proposed process and tool to ensure consistency of the data generated and assess the degree and approach to inclusion of parents.
  5. Pilot, and evaluate, the new standardised review tool in at least two maternity hospitals following the initial model study.

Who is involved?

Project team

Name Affiliation Role
Dr Emily O'Connor Pregnancy Loss Research Group  PhD Student
Professor Keelin O'Donoghue Pregnancy Loss Research Group  Primary Supervisor
Professor Richard Greene National Perinatal Epidemiology Centre, UCC Co-supervisor
Dr Sara Leitao National Perinatal Epidemiology Centre, UCC; Pregnancy Loss Research Group Co-supervisor

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

Journal articles

  • O'Connor E, Greene R, O'Donoghue K, Leitao S. A protocol for a systematic review of standardised tools used in perinatal death review programmes [version 2; peer review: 2 approved]. HRB Open Research. 2023;5:52.

News items

Project status

Ongoing: January 2022 to December 2024

Further information

Please email Dr Emily O’Connor:


Pregnancy Loss Research Group

Pregnancy Loss Research Group, Department of Obstetrics & Gynaecology, University College Cork, Fifth Floor, Cork University Maternity Hospital, Wilton, Cork, T12 YE02, Ireland,