Australian midwives’ recognition of and response to maternal deterioration: A literature review

Dwyer, TA ORCiD: 0000-0001-8408-7956; Flenady, TM ORCiD: 0000-0002-5286-4789BACKGROUND:Confidential enquiries into maternal deaths have reported that recognition and timely interventions can reduce maternal morbidity and mortality. Although research has been undertaken that examines factors impacting registered nurses recognition of and response to the deteriorating patient, there is less literature identifying the factors impacting midwives’ recognition of and response to the deteriorating maternal patient in the clinical context. OBJECTIVE:To identify, summarize, and critically evaluate peer-reviewed studies that explored factors impacting clinical practice of Australian midwives in relation to maternal deterioration. DESIGN: Reviewers searched Maternity and Infant Care, EBSCOhost, Medline, CINAHL, SCOPUS, EMCARE, and EMBASE for published literature reporting on factors impacting Australian registered midwives’ ability to recognize and respond to maternal deterioration. FINDINGS: Of the articles identified and screened (n = 2,412), no studies met the inclusion criteria. This review revealed a lack of published research examining factors impacting Australian midwives’ capability to recognize and respond to the deteriorating maternal patient. CONCLUSION AND IMPLICATIONS FOR PRACTICE: While research shows, for registered nurses, that high workloads and poor skill mix can negatively impact capability to respond to the deteriorating patient, little is known of registered midwives’ capability during similar health events. This review highlights a major gap in current knowledge regarding Australian registered midwives’ experiences surrounding the recognition of and response to the deteriorating maternal patient. Increasing understanding in this area can inform and support the Australian midwifery education, practice, and National health policies to improve health outcomes for childbearing women. Further research in this area is therefore required