Research Article Women's experience of maternity high-dependency care following a complicated birth: A cross-sectional study.

OBJECTIVE: There is limited evidence around childbearing women's experience following a complicated birth requiring maternity high-dependency care. Our objective was to explore women's experience and wellbeing following a complicated birth within this context. RESEARCH METHODOLOGY/DESIGN: A cross-sectional study captured women's experience through a postal survey four weeks post birth. SETTING: A convenience sample of 112 women who received care in the first 24 hours of their stay in a Western Australian maternity high dependency unit. MAIN OUTCOME MEASURES: A validated tool designed to explore patients' intensive care experience was modified and six items were added based upon the literature and in consultation with clinicians. RESULTS: Women felt they were given choice (78%; n = 86); were not glad to be transferred to a ward (62%; n = 68) and were in pain during the first 24 hours of their admission (70%; n = 78). Women who did not feel scared were more likely than those who felt scared to have a clinician explain what had happened (95% vs 78%, P = 0.007); were more likely to feel in control (94% vs 75%, P = 0.006); and were less likely to feel helpless (27% vs 62%, P = <0.001). CONCLUSION: The transfer experience to a postpartum ward requires further investigation as does the management of pain for these childbearing women regardless of their birth mode.

Maternity high-dependency care and the Australian midwife: A review of the literature.

BACKGROUND: Maternity high-dependency care has emerged throughout the 21st century in Australian maternity hospitals as a distinct sub-speciality of maternity care. However, what the care involves, how and why it should be provided, and the role of midwives in the provision of such care remains highly variable. INTRODUCTION: Rising levels of maternal morbidity from non-obstetric causes have led midwives to work with women who require highly complex care, beyond the standard customary midwifery role. Whilst the nursing profession has developed and refined its expertise as a specialty in the field of high-dependency care, the midwifery profession has been less likely to pursue this as a specific area of practice. DISCUSSION: This paper explores the literature surrounding maternity high-dependency care. From the articles reviewed, four key themes emerge which include; the need for maternity high-dependency care, maternal morbidity and maternity high-dependency care, the role of the midwife and maternity high-dependency care and midwifery education and preparation for practice. It highlights the challenges that health services are faced with in order to provide maternity high-dependency care to women. Some of these challenges include resourcing and budgeting limitations, availability of educators with the expertise to train staff, and the availability of suitably trained staff to care for the women when required. CONCLUSION: In order to provide maternity high-dependency care, midwives need to be suitably equipped with the knowledge and skills required to do so.