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It has now emerged that 10 women died while under the care of maternity units in Ireland last year, following the release for the first time by the HSE of annual national figures on the number of maternal deaths in Ireland.

The statistics, released to irishhealth.com under Freedom of Information, also show that there were 12 maternal deaths in Ireland in 2011.

The rate for last year was 10 times the 'official' number reported by the Central Statistics Office, which only recorded one maternity death for 2012, believed to be that of Savita Halappanavar.

The HSE told irishhealth.com that it cannot give any further breakdown of the hospital location and medical causes of the 10 maternal deaths last year, due to the fact that the annual mortality figures were small and if the figures were to be disaggregated, 'there is a possibility that individual women could be identified and this would amount to the release of personal information.'

However, eight of the 10 deaths have already been publicly reported from various sources: three maternal deaths occurred at Cork University Maternity Hospital (CUMH) last year, two took place at the Rotunda Hospital in Dublin, and two are reported to have taken place at Dublin's Coombe Hospital. In addition, there was the well-publicised death of Savita Halappanavar at University Hospital Galway (UHG).

The HSE said it did not collate annual national figures for maternal deaths prior to 2011. It said the 2012 and 2011 figures for maternal deaths were based on information it recently supplied to the health safety body HIQA.

The 12 deaths revealed by the HSE for 2011 include six known to have taken place at the Dublin maternity hospitals.

Under criteria used by the HSE, maternity units and the recently established Maternal Death Enquiry (MDE Ireland) system, both 'direct' and 'indirect' maternal deaths are included in the definition of maternal mortality, whereas the CSO uses narrower criteria.

As the HSE has not provided more detailed information, at this stage it is not known where all the maternal deaths occurred last year or what the precise medical causes were in every case.

CUMH recently reported that two of its three maternal deaths last year were in women with pre-existing conditions while one occurred unexpectedly after the women had a normal delivery.

Both the deaths at the Rotunda last year were classified as indirect, in women with existing conditions, the hospital Master, Dr Sam Coulter Smith recently told irishhealth.com  A third death of a mother who booked at the Rotunda was not included in its 2012 figures as she died in the UK following complications after an abortion carried out there.

The two deaths reported in the media as occurring at the Coombe last year occurred shortly after the women concerned had had caesarean sections, and Savita Halappanavar's death in Galway was due to direct obstetric causes, with major deficits in her care highlighted in reviews of the case.

At this stage it is not known where the remaining two deaths confirmed by the HSE occurred or the causes involved.

Four maternity units have so far released their 2012 clinical reports irishhealth.com - CUMH and UHG have published annual clinical reports with details of their 2012 maternal deaths, and Kerry General Hospital and Portiuncula Hospital, Ballinasloe, where there were no maternal deaths last year, have also released their 2012 statistics.

Further reports, including the Dublin maternity hospital reports, are due to be published in the coming weeks, and these may shed more light on the location and precise causes of all reported maternal deaths last year.

However, some maternity units do not publish any annual reports with clinical details of their service record, so a full picture may not become available.

MDE Ireland's latest published national statistics showed that 25 mothers who attended maternity units around the country with their pregnancies between 2009 and 2011 died. However, these statistics do not give a yearly breakdown of the number of deaths or the location.

'Direct' maternal deaths are defined as being due to obstetric complications before, during or after labour or from interventions, omissions, or incorrect treatment during this period.

'Indirect' maternal deaths include where women have pre-existing medical conditions or conditions developing during pregnancy not related to direct obstetric causes but which were aggravated by the physiological effects of the pregnancy. 'Coincidental' deaths, eg from serious conditions not aggravated by the pregnancy or for example, from substance abuse, can also be included in the wider criteria for defining maternal deaths.

The CSO classifies maternal deaths as those occurring due to 'complications of pregnancy, childbirth and puerperium' and relies on the cause of death as recorded on a coroner's death certificate, which many believe has until recently led to an under-reporting of the true maternal mortality rate in Ireland.

MDE Ireland says six of the 25 deaths it recorded from 2009-11 were classified as direct maternal deaths.

Despite the number of deaths being in double figures in each of the past two years, Ireland's maternal mortality rate is still regarded as quite low by international standards, and is lower than that of the UK and the United States.