title: Maternity high-dependency care and the Australian midwife: A review of the literature.
abstract: BACKGROUND
  Maternity high-dependency care has emerged throughout the 21st century in Australian maternity hospitals as a distinct sub-speciality of maternity care. However, what the care involves, how and why it should be provided, and the role of midwives in the provision of such care remains highly variable.
  
  
  BACKGROUND
  Rising levels of maternal morbidity from non-obstetric causes have led midwives to work with women who require highly complex care, beyond the standard customary midwifery role. Whilst the nursing profession has developed and refined its expertise as a specialty in the field of high-dependency care, the midwifery profession has been less likely to pursue this as a specific area of practice.
  
  
  CONCLUSIONS
  This paper explores the literature surrounding maternity high-dependency care. From the articles reviewed, four key themes emerge which include; the need for maternity high-dependency care, maternal morbidity and maternity high-dependency care, the role of the midwife and maternity high-dependency care and midwifery education and preparation for practice. It highlights the challenges that health services are faced with in order to provide maternity high-dependency care to women. Some of these challenges include resourcing and budgeting limitations, availability of educators with the expertise to train staff, and the availability of suitably trained staff to care for the women when required.
  
  
  CONCLUSIONS
  In order to provide maternity high-dependency care, midwives need to be suitably equipped with the knowledge and skills required to do so.
authors.affiliation: King Edward Hospital for Women, Department of Nursing and Midwifery Education and Research, 374 Bagot Rd. Subiaco, 6008 Perth, Australia; Curtin University, School of Nursing, Midwifery and Paramedicine, Kent Street Bentley, 6845, Australia. Electronic address: Emma.Kingwell@health.wa.gov.au.
authors.forename: Emma L
authors.initials: EL
authors.lastname: Kingwell
authors.affiliation: King Edward Hospital for Women, Department of Nursing and Midwifery Education and Research, 374 Bagot Rd. Subiaco, 6008 Perth, Australia; Curtin University, School of Nursing, Midwifery and Paramedicine, Kent Street Bentley, 6845, Australia.
authors.forename: Janice
authors.initials: J
authors.lastname: Butt
authors.affiliation: Curtin University, School of Nursing, Midwifery and Paramedicine, Kent Street Bentley, 6845, Australia.
authors.forename: Gavin
authors.initials: G
authors.lastname: Leslie
mesh_terms: D000328:Adult; D001315:Australia; D002983:Clinical Competence / Q000592:standards*; D003422:Critical Care / Q000592:standards*; D005260:Female; D006801:Humans; D008427:Maternal Health Services / Q000592:standards*; D008880:Midwifery / Q000592:standards*; D009721:Nurse Midwives / Q000592:standards*; D024802:Nurse's Role; D017410:Practice Guidelines as Topic; D011247:Pregnancy; D018566:Pregnancy, High-Risk; D011795:Surveys and Questionnaires
keywords: Critical care; Education; High-risk; Midwifery; Pregnancy