HSE Cannot Say How Women Experiencing Miscarriage Are Being Treated, Deputy O’Flynn Warns
28.08.2026
Independent Ireland TD Ken O’Flynn has criticised serious gaps in the HSE’s national data on early pregnancy loss, after Parliamentary Questions revealed that the health service cannot provide a national breakdown of how women experiencing miscarriage are being cared for.
Deputy O’Flynn asked the Minister for Health for figures covering 2021 to 2026 showing the numbers of women receiving expectant, medical or surgical management following early pregnancy loss, alongside information on Early Pregnancy Assessment Units and consistency of care across the country.
The HSE acknowledged that it “does not currently have a national dataset” capable of providing the requested breakdown.
“Every year, thousands of women in Ireland go through the loss of an early pregnancy,” O’Flynn said. “The very least they are entitled to expect is that our health service knows how they are being cared for.”
While the HSE says all 19 maternity hospitals now provide an Early Pregnancy Assessment Unit or equivalent service, National Minimum Standards for those services remain in development. It also failed to provide O’Flynn with the requested hospital-group breakdown of expectant, medical and surgical management, including the availability of pharmacological treatment such as misoprostol.
O’Flynn argues that without comprehensive comparative data, the HSE cannot adequately demonstrate that women are receiving consistent care throughout the country.
“I am not interested in statements from the HSE about being committed to compassionate care,” he said. “I am interested in data, standards and answers.”
The Cork North-Central TD has pledged to continue pursuing the issue, including seeking access to the HSE’s national audit of early pregnancy services.
“I will keep pushing this, for the women of Cork and for women right across the country,” O’Flynn said. “They have been through enough. They deserve nothing less than a health service that knows how it is treating them.”
Parliamentary Questions and HSE Response
PQ 36004/26: To ask the Minister for Health the number and location of early pregnancy units or equivalent dedicated early pregnancy assessment services within the HSE maternity hospital system in each of the past five years, if she will outline any hospitals without access to a dedicated early pregnancy assessment service; and if she will make a statement on the matter.
PQ 36002/26: To ask the Minister for Health if she will confirm whether service provision for early pregnancy loss is standardised across HSE hospital groups; and if she will provide any available comparative information on access to Early Pregnancy Units, diagnostic services, and medical management pathways between hospital groups.
PQ 36003/26: To ask the Minister for Health the clinical pathways in place in each HSE maternity hospital and hospital group for the management of early pregnancy loss; whether medical management using pharmacological treatment including Misoprostol is available within each hospital group; and if she will provide a breakdown of the models of care in operation (including expectant, medical and surgical management) by hospital group.
PQ 36005/26: To ask the Minister for Health the number of recorded cases of early pregnancy loss managed within HSE maternity hospitals; and the number of cases managed by expectant management, medical management including pharmacological treatment such as Misoprostol, and surgical intervention; and if she will provide a breakdown by hospital group, in each of the years 2021 to 2025 and to date in 2026, in tabular form; and if she will make a statement on the matter.
HSE Response — 24 August 2026
Dear Deputy O’Flynn,
The Health Service Executive has been requested to reply directly to you in the context of the above Parliamentary Question, which you submitted to the National Women’s and Infants Health Programme (NWIHP) for response. I have examined the matter and the following outlines the position.
The HSE’s National Women and Infants Health Programme (NWIHP) is leading work to support a nationally consistent approach to the provision of Early Pregnancy Assessment Unit (EPAU) services.
As part of this work, a national audit of EPAU services was undertaken across the maternity system to establish a baseline of current provision. The audit confirmed that all 19 maternity hospitals provide an EPAU or an equivalent dedicated early pregnancy assessment service.
The majority of services operate from dedicated EPAU clinical infrastructure. All audited services provide specialist assessment and management for women experiencing early pregnancy complications and early pregnancy loss. EPAU services generally provide access to specialist ultrasound assessment, pregnancy hormone blood testing where clinically indicated, assessment of pain and bleeding in early pregnancy, diagnosis of miscarriage and ectopic pregnancy, and appropriate follow-up care. Referral pathways are established from sources including general practitioners, emergency departments and maternity services and, where clinically appropriate, from private ultrasound providers. The findings of the audit are informing the development of National Minimum Standards for EPAUs.
Regarding care pathways and clinical guidance, in 2025, the HSE and the Institute of Obstetricians and Gynaecologists published the National Clinical Practice Guideline: First Trimester Miscarriage. This guideline provides comprehensive, evidence-based recommendations for the assessment, diagnosis and management of first trimester miscarriage and promotes a nationally consistent approach to clinical care.
It emphasises person-centred, trauma-informed care, shared decision-making, timely access to ultrasound assessment and appropriate follow-up, while recognising that management should be guided by the woman’s clinical presentation, informed choice and individual circumstances. The guideline supports the use of expectant, medical and surgical management, where clinically appropriate, and sets out recommendations to support safe and consistent care across all maternity services.
The National Standards for Bereavement Care Following Pregnancy Loss and Perinatal Death, first published in 2016 and revised in 2022, provide a national framework for bereavement care and the assessment and management of women experiencing all forms of pregnancy loss, including early pregnancy loss. The clinical management of early pregnancy loss is determined by a woman’s clinical presentation, informed choice and individual circumstances. Depending on the clinical situation, management may include expectant, medical or surgical management, as clinically appropriate.
The HSE does not currently have a national dataset that can provide the requested breakdown of early pregnancy loss cases by hospital group, year and management pathway. The Hospital In-Patient Enquiry (HIPE) system records episodes of hospital care using ICD-10-AM diagnosis codes. However, it does not routinely support national reporting of miscarriage and early pregnancy loss in the level of detail requested.
There are also broader limitations in accurately capturing the overall incidence of early pregnancy loss in Ireland. Early pregnancy loss can occur at a very early gestational stage, including before a pregnancy has been clinically confirmed, and may therefore never come to the attention of a healthcare service. Where a loss does come to medical attention, care may be provided in a number of settings, including general practice, emergency departments, EPAUs, maternity hospitals and community-based services. These services do not currently feed into a single national reporting system for early pregnancy loss. As a result, the available administrative data cannot provide a complete national count of early pregnancy losses.
National estimates of miscarriage incidence are therefore generally informed by epidemiological evidence rather than a single comprehensive administrative dataset. The HSE is continuing work to improve data capture, standardise clinical coding and strengthen the integration of relevant information systems. This work is important in supporting better understanding of the incidence, management and outcomes of pregnancy loss.
The HSE remains committed to supporting high-quality, compassionate and person-centred care for women and families experiencing pregnancy loss. The findings of the national audit, together with the implementation of National Clinical Practice Guidelines, the National Standards for Bereavement Care Following Pregnancy Loss and Perinatal Death and the forthcoming Minimum Standards for EPAUs, will continue to support greater consistency in service delivery while ensuring women have access to evidence-based assessment and a range of clinically appropriate management options for early pregnancy loss. Information resources covering miscarriage, recurrent miscarriage and ectopic pregnancy have also been developed and are publicly accessible on the national pregnancy and infant loss website.
I trust this clarifies the matter.