Midwives 'with' women in the obstetric high dependency unit: A qualitative descriptive study of midwifery care for women in an obstetric high dependency unit

Childbearing and critical illnesses are subjects rarely connected, one event brings new life, and the other threatens life. For some women their experience of childbearing is also the experience of critical illness. In an Obstetric High Dependency Unit critically ill pregnant women are able to birth their babies in a safe environment, close to neonatal care and in the care of staff who are familiar with the physiological and psychological state of pregnancy. The role of the midwife who cares for these critically ill pregnant women is the focus of this qualitative descriptive study. Two women who received midwifery care while they were in the Obstetric High Dependency Unit and two midwives with experience in this specialised area were interviewed. Data was gathered by interviews to describe the role of the midwife caring for critically ill pregnant women. Four themes were identified. They were the struggle for the natural process, ‘being with’ the woman, trust in the expertise of the midwife and expanded practice. The findings from this dissertation identified that the role of the midwife was to partner the woman through her critical illness and childbirth experience encouraging and empowering her, focusing on the needs of the new mother as she embraced motherhood. ‘Being with’ the woman assisting and supporting her through the struggle, the midwives knowledge and expertise guides her through the birthing and illness process. Expanded practice as a midwife with intensive care skills and knowledge of complex obstetrical and medical conditions enables the midwife to competently care for the woman when in the Obstetric High Dependency Unit. To give birth is an enormous event in a woman’s life, and when combined with a critical illness experience she needs the support and care of midwives in an environment where healing can take place and motherhood can be initiated