HSE report shows continued fall in births and rise in key obstetric risks

The number of births in Ireland has fallen by more than 20 per cent over the past 11 years, according to the HSE’s 2024 National Report for the Irish Maternity Indicator System (IMIS). The data also highlights increases in ectopic pregnancies and Caesarean sections, alongside declines in neonatal encephalopathy and assisted vaginal deliveries.

The IMIS report tracks clinical activity and trends across all 19 maternity units.

Key demographic findings show an annual decline of 2.1 per cent in births since 2014, while the rate of multiple births has also fallen, from 1.9 per cent to 1.6 per cent—meaning roughly one in every 61 deliveries now involves twins or higher-order multiples.

On obstetric risks and complications, the rate of ectopic pregnancies has risen from 11.9 per 1,000 women to 18.9 over the past decade. Eclampsia, however, shows an overall downward trend, with annual fluctuations. Severe third- and fourth-degree perineal tears have seen a slight decline, from 1.92 per cent of vaginal births in 2014 to 1.89 per cent in 2024.

Delivery trends show a reduction in assisted vaginal deliveries—from 15.5 per cent to 13.8 per cent—paired with notable increases in inductions of labour (from 29.6 to 38.5 per cent) and Caesarean sections (from 29.6 to 40.6 per cent).

Neonatal data indicates a drop in neonatal encephalopathy, down from 1.49 per 1,000 babies in 2015 to 1.37 in 2024. Rates of therapeutic hypothermia have varied year to year but remain broadly static.

Dr Cliona Murphy, Clinical Director of the HSE National Women’s and Infants Programme, 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.”

The report notes that sustained monitoring of these indicators will be essential in supporting improvements in maternal and neonatal outcomes.

“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,” Dr Murphy said.