Multidisciplinary training in obstetric critical care.

Once identified, the critically ill obstetric patient will often fare well. Unfortunately, several recent publications show that many such patients are not identified and come to harm. Training for those caring for pregnant women has changed in recent years. Medical training has contracted with a shorter working week, reducing experience of the critically ill. Midwifery training has also changed. Previously, midwives trained in general nursing prior to entering midwifery. Now they enter training directly, meaning their experience of the critically ill, especially those with non-obstetric problems, is limited. Other medical staff (anaesthetists, intensivists) may have experience of critical care in non-pregnant patients, but may be less aware of physiological changes of pregnancy that can affect how these patients are managed. The best way to address these issues is with multidisciplinary training, as highlighted in 'Safer Childbirth' and 'Saving Mothers Lives'. Such training allows each team member to understand his/her role and that of each of the other disciplines involved.