Transfer from critical care to postnatal or general care wards

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 postnatal ward, it is a completely different ball game.”

After being in intensive care with septicaemia (blood poisoning) for several days Anna felt that…

Age at interview 22

Gender Female

Age at diagnosis 21

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Helen had HELLP syndrome and her first son was delivered early. Leaving HDU was a step forward.

Age at interview 31

Gender Female

Age at diagnosis 31

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Although women may be well enough to leave the intensive care department, it is often difficult to know which the most appropriate ward is 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.

When Kate (who had HELLP syndrome) was moved onto a normal ward she found it very difficult. She…

Age at interview 35

Gender Female

Age at diagnosis 34

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Kerry had grade 4 placenta praevia (completely covering the cervix/birth canal) and delivered her…

Age at interview 27

Gender Female

Age at diagnosis 25

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Some women were given their own rooms and were grateful for the quiet and privacy.

Helen was initially put in a 4-bed ward, but found this upsetting as her son was in the neonatal…

Age at interview 31

Gender Female

Age at diagnosis 31

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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.

Once she came out of intensive care, Alison T was put in her own room where she was constantly…

Age at interview 44

Gender Female

Age at diagnosis 42

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Alison had a hysterectomy after her first baby was born. She was discharged from intensive care…

Age at interview 32

Gender Female

Age at diagnosis 30

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Difficult transfers

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.

After her uterine rupture (a tear opening the womb directly into the abdominal cavity), Debbie…

Age at interview 31

Gender Female

Age at diagnosis 29

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Jo’s first baby was born by emergency caesarean after she had a placental abruption (the placenta…

Age at interview 34

Gender Female

Age at diagnosis 30

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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 was in intensive care. Once she was transferred she was expected to get up and get on with…

Age at interview 37

Gender Female

Age at diagnosis 29

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After her haemorrhage, Amy was transferred to her own room, which in hindsight was a mistake. She…

Age at interview 31

Gender Female

Age at diagnosis 29

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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 the close attention they had been receiving before.

Mandy felt incredibly well supported while still in intensive care but found being transferred to…

Age at interview 35

Gender Female

Age at diagnosis 28

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Rebecca had an emergency caesarean and surgery on her leg after she developed a deep vein…

Age at interview 42

Gender Female

Age at diagnosis 40

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Farkhanda found the transfer from high dependency very difficult but soon she was able to do…

Age at interview 35

Gender Female

Age at diagnosis 34

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