HSE publishes the Irish Maternity Indicator System 2024 National Report

Today, the HSE has published the 2024 National Report for the Irish Maternity Indicator System (IMIS). The IMIS is designed to capture and measure clinical activities and trends in each of the 19 maternity units.

Dr Cliona Murphy, Clinical Director, HSE National Women’s and Infants Programme (NWIHP) said: “The National Women and Infants Health Programme welcome the publication of the comprehensive IMIS report today. The data helps us to improve the quality and safety of maternity care by tracking performance metrics across all hospitals.

“The metrics include obstetric emergencies and complications, neonatal care, hospital activities, infant feeding, and demographics.  It is important to consider the metrics as a suite of interlinked activities, for example, the association between rates of Caesarean section and peripartum hysterectomy, or the links between neonatal metrics for encephalopathy and therapeutic hypothermia treatment.  It is also important to bear in mind the variations in numbers of births at the 19 maternity hospitals/units, where the smallest units manage below 1,000 births per annum, while the largest tertiary hospital has over 8,000 births per annum.”

Longitudinal trends identified in the report

Demographics

• The IMIS data show continuing declining numbers of births and women giving birth over the past 11 years, a drop of over 20% or an annual rate of decline of 2.1%. 
• About 1 in every 61 deliveries results in a multiple birth in Ireland. The average rate has dropped in recent years, from 1.9% in 2014 to 1.6% in 2024. 

Obstetric risks/complications

• The rate of ectopic pregnancies has increased from 11.9 per 1,000 women to 18.9 over the past 11 years, ectopic pregnancy ruptures are a leading cause of maternal mortality within the first trimester of pregnancy.
• Eclampsia is a serious pregnancy complication, IMIS data show an overall declining trend in eclampsia rates since 2014, with fluctuations from a low of 0.11 per 1,000 women in 2020 to 0.35 in 2018. 
• A slight decline in severe third/fourth degree perineal tears since 2014 (down from 1.92% of all vaginal deliveries in 2014 to 1.89% in 2024) may be indication of improvements in obstetric care, increased use of procedures such as episiotomies.

Deliveries and Anaesthesia

• There has been a small drop in the rate of assisted vaginal deliveries (AVD) nationally, from 15.5% of all women giving birth in 2014 to 13.8% in 2024. 
• There have been increases in rates of inductions of labour (from 29.6% of all women in 2014 to 38.5% in 2024) and Caesarean sections (from 29.6% of all women in 2014 to 40.6% in 2024).

Neonatal care

• There has been a decline in the rates of neonatal encephalopathy (NE), down from 1.49 per 1,000 babies born in 2015 to 1.37 in 2024. 
• The rate of therapeutic hypothermia (TH) has fluctuated over the years but has remained static overall.

“Moving forward, maintaining a sustained focus and regular reporting of the IMIS metrics, fostering continued collaboration across maternity services, ensuring the effective use of clinical guidelines, and integration of the service user voice will all play important roles in building trust, ensuring transparency, and sustaining improvements in maternal and neonatal outcomes,” concluded Dr Murphy.