Good Midwives or Bad Statisticians?

In the controversy surrounding the death of Savita Halappanavar many commentators have been quick to point out that Ireland's maternal mortality rate is really very low by international standards. I'm not disputing that, but a word of caution is in order.

According to the CSO's Report on Vital Statistics 2010, there was just one maternal death in Ireland in that year. This figure is certainly incorrect. The Rotunda Hospital recorded three maternal deaths in 2010, while the Coombe Hospital recorded one. (See this Irish Times report). I don't know what the true figure for the entire country is but obviously it can't be less than four. It is unlikely to be in double figures: maternal mortality figures are typically quoted as deaths per 100,000 live births and Ireland has about 75,000 births per year.

So the CSO's numbers are a bit dodgy. What else is new? It won't come as a huge surprise to anyone who has wrestled with CSO figures for migration and the balance of payments. As Paul Krugman remarked in the latter context, Ireland is a major importer of errors and omissions. Even so, an error of at least 300% should make us hesitate before making brash claims about the quality of medical care.

Efforts are being made to produce more meaningful figures. Until these are available, treat with scepticism anyone who refers you to numbers published by outfits like the World Health Organization, Unicef or the CIA Factbook. Their models rely in one way or another on figures supplied by national sources; garbage in, garbage out.

Once again, because I really don't want to be supporting scaremongers: I'm not suggesting that Irish maternal care is poor, even by the standards of other highly developed countries. I'm simply saying that we don't have data that entitles us to make strong claims about our relative performance. Maybe the English really are a bit worse at maternity care. Or maybe they are just a bit better at counting.