AN open verdict was returned at the inquest into the death of a pregnant woman whose body was found at the foot of a cliff.
Anna Byrne (35) from Beechdale in Dunboyne, Co Meath, and her unborn twin sons were killed in the fall at Howth summit in the early hours of March 8 this year.
The mother of two's last known contact was 11am the previous day when she spoke on the phone with her husband Terry Byrne and told him that she was going to the supermarket.
"At the end of the call, I told her to phone anytime if there was anything," he told the court, "We told each other that we loved each other and she said 'I'll see ya later'".
He first became aware she was missing at 1.30pm when she failed to pick up their son from Montessori school. Mr Byrne checked the supermarket and maternity hospitals and rang around her friends. At 3.30pm Gardaí in Dunboyne were notified. Just after midnight a friend found Mrs Byrne's car at Howth summit. Gardaí found a note in the car.
A search and rescue operation followed but was called off at 3.30am without success. At 7.49am, an object was spotted at the base of the cliff and rescue workers were lowered down to recover the body.
Death was pronounced at Howth Lifeboat Station and the attending doctor said that Mrs Byrne had been dead for eight to ten hours. The postmortem gave the cause of death as multiple injuries due to a fall from a height.
Mrs Byrne had been taking the anti-depressant Seroxat for ten years but stopped during this pregnancy.
Master of the Rotunda Hospital, Dr Sam Coulter-Smith said that Mrs Byrne did not indicate a history of depression when she registered the pregnancy with the hospital, however, this information was contained in notes related to her previous pregnancies. Mental health team notes are not contained in obstetric team notes for confidentiality reasons, he said.
She was due to deliver by C-Section on March 29, he said. In mid-February she was noted to be "anxious".
Six days before her death Mrs Byrne and her husband attended an appointment with consultant psychiatrist at the Rotunda, Dr John Sheehan. She told him that she felt "part of her life was missing" because she had no daughter.
"She said that she planned the current pregnancy hoping for a baby daughter but found out at 20 weeks she was having twins and that they were both boys, even though they were non-identical. She said that she was devastated," he said.
Her mood was low, particularly in the evening, and she described a loss of interest and not feeling "maternal". She told him she felt overwhelmed by the prospect of having four boys but did not express any intention to take her own life, he said.
Mrs Byrne's GP had started her on Sertraline - an anti-depressant regularly used during pregnancy - and Dr Sheehan doubled her dosage, prescribed an anti-histamine to help her sleep and advised her to seek a referral to a counsellor in her area. She was suffering a recurrence of depression associated with an adjustment disorder to her twin pregnancy of boys, he said. Mrs Byrne presented a low risk given that she did not indicate that she was suicidal and had made future plans, he told the court.
Speaking from the body of the court, her father John Deeney asked why she had not been admitted to hospital for observation on foot of her anxiety. Dr Sheehan said that this is only done in severe cases of mental illness and admission would be to a psychiatric hospital.
Coroner Dr Brian Farrell said the note was a farewell letter and "particularly heart rending" but it was not dated. He also noted the difficult terrain that Mrs Byrne would have traversed to get to the area where she fell and her lack of suicidal ideation.
He said that although he was not saying that Mrs Byrne did not take her own life, the evidence heard in court did not satisfy the legal test for a verdict of suicide. He returned an open verdict.
Dr Farrell will also write to the board of the Rotunda Hospital reflecting Terry Byrne's concerns about sharing of mental health notes with the obstetrics team in cases such as his wife's.