Pregnant person in the ICU

ICU care is not commonly needed in pregnancy, only 2-3 pregnant people out of 1000 babies delivered need to come to ICU.

Here are some questions you might have about being pregnant and needing ICU care.

Why would I need to go to ICU?

Some pregnant people have long term medical conditions which can get worse as the baby grows or at the time your baby is delivered. Heart and lung conditions often need support during and after delivery of baby. Your obstetrician and midwife along with your heart or lung specialist will plan the safest way to look after you and your baby during pregnancy and speak with you about the best way to deliver baby.

Some pregnant people become unwell during pregnancy unexpectedly and this requires ICU care. Sepsis and blood clots on the lung are two common conditions. If you are very unwell then you may need to be sedated (with a general anesthetic) and put on a ventilator with a tube in your windpipe. Other machines might be needed to look after you if other major organs are failing to work, kidney and ECMO machines are sometimes needed. 

Delivering any baby can be complicated by bleeding, which can be such a large amount that you require ICU care along with medical and surgical treatment by the obstetricians, obstetric anaesthetists, x-ray doctors and blood specialist. 

Is the ICU like labour ward?

No. The ICU can be very noisy, with other adult patients who are not pregnant in the beds next to yours. These patients will have tubes in their mouth, neck and groin with machines supporting their breathing, heart and kidneys. It can be distressing to see, so we try to use our side rooms, but this is not always possible. Some patients have very serious infections which need them to be cared for in a room away from other patients. 

Here is a link to a video showing the ICU bedspace and monitoring: https://youtu.be/UbOODfp67tY

There is one nurse for each patient and the curtains will be closed as much as possible. Your midwife will visit each day to assess you and your baby. 

We have psychologist that can come and talk to you if you feel this would be helpful.

Who will care for me in ICU?

The ICU team will be caring for you with support from the obstetricians, obstetric anaesthetists, obstetric medical doctors, neonatalologists (doctors that look after the baby if they are unwell after delivery) and other specialist doctors. The midwifery and nursing teams work closely together to support you while on ICU. 

Could I deliver my baby on ICU?

Yes.

If you are very unwell while pregnant then there is an increased risk of going into labour and delivering your baby. When pregnant people are sedated on breathing machines there may be no warning that labour has started and baby will be delivered. 

The neonatal and obstetric doctors will talk to you about the risk of labour and how this could affect your baby. 

There will be a machine at your bedside, called a resuscitaire, this is used to look after your baby if your baby is delivered unexpectedly on ICU. 

We tell all the doctors that would need to look after you and your baby that you are on the ICU and an emergency call would be made to get them to come to you.

Can I breastfeed on ICU?

Yes. 

If you are awake and able to cope with breatfeeding we will work with the midwives and breatfeeding team to support you breastfeed. Sometimes, breast feeding is not possible, so breast pumps are used to help express milk. There are medicines you might be given to help you get well and these may be in your breast milk. Some medicines can make a baby unwell and so the doctors will only given breast milk that is safe for your baby. 

What if my baby dies while I am on ICU? 

Sadly, some babies do not survive, because they are too premature or you have been so unwell it has affected baby during the pregnancy and critical illnes. There are bereavement midwives that will support you during this very emotional and difficult time.