Suicide accounted for a third of all maternal deaths in Ireland over a three-year period, according to a new report.
There were no deaths attributed to Covid-19 between 2019 to 2021, it found.
Twelve women died while pregnant or within six weeks of the pregnancy ending, and half of these deaths were classified as direct maternal deaths, due to obstetric causes.
Five were indirect maternal deaths, due to pre-existing disease aggravated by pregnancy, and one was classified as coincidental.
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There was no evidence of clustering in any one maternity unit, according to the report.
There were a further 12 deaths of women in the first year after pregnancy, known as late deaths
The figures are contained in the Confidential Maternal Death Enquiry in Ireland Report for 2019–2021, published by the Maternal Death Enquiry at Cork University Maternity Hospital.
Of the 24 deaths investigated, eight were due to suicide – three during the antenatal period and five late deaths. This compared with nine suicides in the previous three-year period.
The report says the fact that seven of the eight suicides occurred during the Covid-19 pandemic is of particular concern, as is the fact that five of these seven deaths were late.
Rates of suicide in maternal death are up on a decade previously, with the report citing as factors international evidence of a decline in the mental health of women and a significant decline in maternal mental health during the pandemic.
While there is an increased risk of maternal death with increasing age and non-Irish ethnicity, this is not statistically significant. No obesity-related trend was identified.
However, the risk of maternal death increased among mothers of two or more children, compared with earlier pregnancies.
The maternal mortality rate for Ireland during the period was 6.3 per 100,000 maternities, which does not differ significantly from previous reports. The Irish figure is lower than the UK rate of 11.56 but the difference is not statistically significant when the rate is corrected for Covid-19 deaths.
Over the 2009 to 2021 period, cardiac disease was the largest single cause of all maternal deaths, at 25 per cent. Suicide was the leading direct cause of maternal death and the leading cause of late deaths.
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