Maternal death is an 'every day risk' - Mahony
National Maternity Hospital master Dr Rhona Mahony has acknowledged the tragic death of Malak Thawley, saying "every day we deliver women of their babies this awful potential is a possibility".
Dr Mahony, writing in the hospital's annual report, did not refer to Ms Thawley by name but said it is "hard to imagine a more difficult outcome in medicine". Ms Thawley (35) died in Holles Street in May 2016 after a blood vessel was cut during emergency surgery for ectopic pregnancy.
It was the first maternal death at the hospital in more than four years.
Dr Mahony said the hospital delivered 9,037 babies last year - a drop of 3.6pc on 2015. But it was still one of the busiest years in the hospital's history - delivering 25 babies a day.
"On our busiest day, July 26, we delivered 43 babies," she said.
The largest baby weighed 5.7kg (12lbs 9oz) and the lightest just 490g (1lb 3oz). That baby spent nearly six months in the neonatal unit.
She said more than four in 10 women attending the hospital are overweight and nearly half are over the age of 35.
Thirty years ago, the over-35s accounted for just 10pc of mothers.
Older motherhood is associated with a range of adverse outcomes, including miscarriage and complications.
The caesarean section rate remained stable at 26pc.
The major contributor to the rise in recent years has been the number of women presenting who had a previous caesarean section.
There has been a striking increase in pre-labour caesarean sections, which accounts for almost 16pc of deliveries.
Dr Mahony referred to advances in scans, which can identify genetic and other abnormalities in the womb.
"Our patients face very difficult choices and it is impossible not to be moved by the impossibly difficult situations we see every day here," she said.
"In Ireland we are ill-equipped to deal with the rapid development of complex genetic testing that requires sophisticated interpretation."
The hospital ended the year with a surplus of €1.4m, but it laboured under unnecessary cash flow pressures due to the HSE.
The hospital prioritised patient safety over spending cuts, she added.
Dr Mahony said it is unacceptable we have such low numbers of obstetricians.
A total of 30pc of deliveries happen between midnight and 8am.
There should be a consultant on-site during this time.