Friday, 23 November 2012

More on Irish Maternal Mortality

[Update 25th November 2012: corrected a couple of errors.]

It's always good to follow the example of the masters, so I'll start this post in the style of Cosma Shalizi, who regularly leads off with an Attention Conservation Notice, telling his readers what return they can expect for the time invested in reading further. That's especially appropriate in this case, because Ireland's low maternal mortality figures are being cited frequently in the course of arguments against abortion liberalisation. But that's not what this post is about. To my mind abortion law has to do with rights, not numbers. I want to know more about the numbers, but even if I knew them with certainty I don't believe that would settle any moral questions.

Another issue that I'm not proposing to tackle is the underlying causes of variations in maternal mortality from one country to another. There is quite a bit of literature on that but I haven't read it. When I do, I will share whatever I learn here, so please drop by again. That's what blogging is all about: sharing one's scraps of newfound knowledge (and frequently getting told one is full of shit, usually by people who know even less).

If you're still reading I take it that you want a few numbers. So far, the best primary source I have found is the clinical reports of the Coombe Hospital, which are available online. The table below combines two tables from page 34 of the report for 2010 (click to enlarge).

We could add one more column, for 2003, by looking at the corresponding tables from the 2009 report, which tells us that 8,288 mothers attended the hospital in 2003 and there were no maternal deaths in that year. So over an 8-year period, 71,229 mothers attended the hospital and there were just three maternal deaths. That's a reasonably good outcome, with mortality averaging 4.2 per 100,000 mothers (or slightly better worse if the number is expressed as a proportion of live births). From press reports I know that there were two deaths in 2001-2002. If we include those, assuming that the number of mothers wasn't much different from 2003, we get a mortality figure of about 5.6.

Does what goes for the Coombe Hospital, go for the country as a whole? Well, maybe. The pessimist's reading is that the Coombe is an unusually well-equipped hospital so others are unlikely to do as well. The optimist's reading is that the Coombe probably handles more difficult cases -- see the footnotes to the table. The truth is that we can't safely make inferences for the country as a whole from the figures for a major hospital or even a few of them.

So we're back to the need for better data. When I wrote my previous post, I hadn't read this recent article by Niall Hunter which mentions recent research highlighting the inadequacies of CSO data. I haven't seen that research but I doubt that it would surprise me greatly.

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