This podcast contains advice and information about what to expect if you or your relative needs to be looked after in a maternity critical care area.  

The majority of women remain healthy during pregnancy and childbirth.  However, there are some people who will experience complications of pregnancy and serious illness can result. 

A Scottish (SCASMM) study showed that around 7.3 per 1,000 pregnant women will experience a serious illness around their pregnancy.  If a person becomes unwell around the time of their pregnancy, they may need critical care.

The maternity critical care area in your hospital may be within the labour ward or may be located within the general hospital intensive care or high dependency unit.  Every critical care unit in Scotland is slightly different but the information here should be used as a general guide.  

Not every patient will need to experience all of these things and remember you can always ask any member of staff looking after you, or your relative, if you have any questions

What is critical care?

Critical care is the name given to the greater support and observation for patients who are very ill.  It is often referred to as ‘high dependency’ or ‘intensive care’.  Critical care is the name given to both of these levels of care.

If you are receiving critical care, whether in a high dependency or intensive care unit, this is because one or more of your organs eg heart, lungs, kidneys require extra support with medications and/or machines such as kidney Dialysis or to support your breathing.  This may be because of planned, or emergency treatment. 

Where is critical care provided?

This may be on the labour ward, with the involvement of maternity and anaesthetic staff who have experience in this area, or within a high dependency unit within the maternity centre if where this is available. In some cases, care may be provided in the high dependency unit or intensive care department elsewhere in the hospital. Rarely, care may be provided in a specialist intensive care setting such as cardiac or neurosurgery intensive care because additional expertise in these areas needs to be immediately available. 

Throughout your stay in critical care, the healthcare team will answer any questions you or your family have.

Why do I/my loved one need critical care?

Being looked after in a maternity critical care area might be necessary for a number of reasons.  This is usually because you are unwell and need additional close monitoring or specialist treatment.  

Common reasons to require critical care around the time of pregnancy are;

-       Blood pressure problems such as pre-eclampsia

-       Sepsis (severe infection)

-       Major bleeding around the birth of your baby

-       Blood clots on the leg or lung

-       A pre-existing medical condition which means you need to be closely monitored

What are all the monitors and wires for?

Being in a critical care area allows the doctors, nurses or midwives to monitor your heart rate, blood pressure, breathing and kidney function more closely.  

This may require extra blood tests, scans, or monitoring lines to be placed.  It is common to have a tube in the bladder and drips to give medicines and fluids into the veins.  Just ask the staff caring for you or your loved one if you have any questions about the drips and wires.

Who looks after me in critical care?

Being looked after in critical care often means there are lots of different staff members helping with your care.  This usually includes midwives, physiotherapy, nursing staff and obstetric and anaesthetic doctors, but may also involve other specialist doctors who come to give specialist advice on your treatment.  You will usually have an allocated midwife or nurse who is responsible for your care and will introduce themselves to you.  

I’m worried about being separated from my baby

Once your baby has been born, every effort is made to keep you and your baby together.  Sometimes this may not be possible, for example if your baby requires additional care with the paediatric team.  If a mother is very unwell and requires to be looked after in the intensive care unit, it may not always be possible to properly care for your baby there too.  

If you have been separated from your baby, photographs or video camera links may be used to help you stay in touch with your baby and their care.  You can talk to any member of staff about any worries you may have about being separated from your baby.  You will also be given the opportunity to express breast milk for your baby if you wish.

Can family and other children come to visit?

Every unit is different so it is worth asking.  Visiting a relative in critical care can be a difficult experience but children are normally welcome to visit.  There may be unfamiliar sounds, alarms or beeps – these are there to help the staff to take care of your relative.

Visiting hours are usually flexible in critical care areas and can be arranged with the staff looking after your relative.  It is important to follow any instructions, such as hand washing, that help to limit the spread of any infections in critical care areas.  Again, staff can help advise you on this if you have any questions.

What is Intensive Care?

Intensive care units (ICUs) are specialist hospital wards that provide treatment and monitoring for people who are very ill.  They're staffed with specially trained healthcare professionals and contain advanced monitoring equipment.  ICUs are also sometimes called critical care units (CCUs) or intensive therapy units (ITUs).

Why would I need to go to Intensive Care?

Intensive care is needed if someone is seriously ill and requires intensive treatment and close monitoring.  Most people in an ICU have problems with 1 or more organs. For example, they may be unable to breathe on their own and require the help of a breathing support machine called a ventilator.

There are many different conditions and situations that can mean someone needs intensive care. 

Most intensive care units will have open visiting and your baby will be able to visit you there.

Midwives and obstetricians will see you daily as well as physiotherapists and dieticians to ensure your nutrition and strength are at their best to help you recover.

I have a long term medical condition, will I need critical care?

With pregnant or recently pregnant women, most critical care is provided after emergency treatment; however, there are some people who can expect to receive planned critical care. Pre-existing medical conditions which could lead to this extra care include;

• Heart disease
• Complications of preg...