High c-section rate at Portlaoise hospital, where births fall after Covid-19 boom

A decade after being at the centre of a national controversy, Portlaoise hospital births have fallen following what seems like a Covid-19 baby boom while the rate of C-sections at the Laois hospital has risen to 40% annually, according to official figures.

HSE data in Maternity Patient Safety Statements (MPSS) reports from 2021 to 2025 for the Midland Regional Hospital Portlaoise also shows a rise in birth incidents at the hospital. 

The December report for 2024 shows that 1,361 women presented for delivery at Laois hospital last year. This resulted in 1,371 births. Some 40% of births last year were via C-section, which reflected an increase in surgical deliveries at the hospital.

The busiest 12 months at the hospital's maternity unit in recent years was 2021 - the second year of the Covid-19 pandemic. From January to December, 1,530 pregnant women presented to the Laois hospital, resulting in  1,541 births. The C-section rate was lower in 2021 at 35%. 

The national C-Section rate in Ireland is about 41% which is regarded as among the highest in Europe.

Reports to the end of April 2025 show the C-section rate at Portlaoise rising to over 43% of the 456 women delivering at the hospital in the first quarter. 

The reports also show a rising number of reportable maternity incidents at the hospital. There 210 noted in 2021, 252 in 2022, 281 in 2023, and 311 in 2024. MORE BELOW PHOTO.

Midlands Regional Hospital Portlaoise. Pic: Leinster Express / Laois Live

Pulmonary embolism (blood clot) has been the main type of major incident reported during deliveries. Eclampsia has also been recorded in small numbers. It occurs when a pregnant woman with preeclampsia (a condition marked by high blood pressure and protein in the urine) begins having seizures. 

The reports say that 82 women were transferred out of the hospital during the four years from 2021 to 2024.

The Statements have their origin in the controversy which engulfed Portlaoise hospital in 2014 when RTÉ revealed the avoidable deaths of babies at the Portlaoise unit.

The public campaigned against a subsequent downgrade that included the removal of maternity services that was planned and agreed at senior levels in the HSE to conclude in 2022.

Public support for the hospital ultimately led to an overhaul of services locally in Portlaoise. The controversy also led to some national changes. Among these was the requirement on units to publish safety statements.

The reports for Portlaoise also revealed that the hospital continues to operate under the oversight of the Coombe Hospital in Dublin. The final report for 2024 is signed off by the Clinical Lead for Obstetrics and Gynaecology Prof Michael O’ Connell. The Coombe Hospital-based doctor was centrally involved in the overhaul of services after the revelations of 2024. 

The HSE says the statements are used to inform local hospital and hospital group management in carrying out their role in safety and quality improvement. The objective in publishing the Statement each month is to provide public assurance that maternity services are delivered in an environment that promotes open disclosure.

The HSE adds that it is not intended that the monthly statement be used as a comparator with other units or that statements would be aggregated at hospital Group or national level.

"It assists in an early warning mechanism for issues that require local action and/ or escalation.

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"It is important to note tertiary and referral maternity centres will care for a higher complexity of patients (mothers and babies), therefore clinical activity in these centres will be higher and therefore no comparisons should be drawn with units that do not look after complex cases," it says.

The HSE adds that Maternity Safety Statements form part of the suite of key performance indicators for the maternity services. Hospitals must populate and publish on a monthly basis (2 months in arrears). Additionally, the statements are discussed at the Hospital Group Maternity Network meetings with the National Women and Infants Health Programme as part of the quality and safety agenda.   

A recent review by the Irish Patients Association of the reports from Ireland's 19 public maternity units has uncovered some significant gaps in the reporting of key information by hospitals.