Conditions that threaten women’s lives in childbirth & pregnancy

Transfer from critical care

Women who experience obstetric emergencies during childbirth often need to stay in intensive care or high dependency care units (ICU and HDUs) for several hours or days until their condition has stabilised. But once clinical staff decide they are ready, women are transferred to postnatal or general wards. Here they can be with their baby (if the baby/he or she is well enough) but there are fewer staff per patient. While women welcomed what they regarded as a significant step towards recovery and going home, these transfers were not always easy. As Julie said, “When you go up to the post-natal ward, it is a completely different ball game.”
Although women may be well enough to leave the intensive care department, it is often difficult to know which is the most appropriate ward to send them to, especially if their baby is in special care and can’t be with them. Some were sent to the delivery suites where they could be more closely monitored than on a ward. Others were transferred to the maternity wards. But these could be upsetting as they were surrounded by women who had given birth with few or no complications, who had their babies with them and were going home soon.
Some women were given their own rooms, and were grateful for the quiet and privacy.
Karen who had had a haemorrhage (heavy uncontrolled bleeding) and hysterectomy said she could not have faced being in a ward with other women. “I just didn’t want anybody asking me why are in you in here… that would have been just too traumatic to go into detail with people I didn’t know.” Natalie said that having a private room, was “important to allow me the space to recover” from her traumatic birth experience. But having their own room wasn’t the best option for all women. Mandy felt very lonely being in a room on her own.
 
Positive experiences
Some women had a positive experience of their transfer to another part of the hospital. Alison T was in intensive care after she had amniotic fluid embolism (AFE) is a very rare complication of pregnancy in which amniotic fluid, fetal skin or other cells enter the woman’s blood stream and trigger an allergic reaction. She was transferred to her own room where felt the care she received was very good.
Difficult transfers
But some women found their transfer very difficult. In some cases, it was a question of coping with how weak they were after the emergency. For those whose baby wasn’t in intensive care, they also had a newborn baby to look after. They might still be in a lot of pain and not able to move about easily. Others felt there was a lack of understanding from staff about what they had been through and what physical shape they were in.
Some felt that staff expected them to be able to do more than they were able, especially in terms of looking after their newborn. Women still felt weak and overwhelmed by what they had been through.
Cara described intensive care as ‘a very cosy place to be’; moving from a place which feels so safe with lots of staff and constant monitoring to a postnatal ward could leave some women feeling unsupported and overlooked, and a bit frightened they would not be able to cope, after all the close attention they had been receiving before.


Last reviewed April 2016.

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