Maternal experience in the intensive care unit and Post-discharge care: the third report from the MaCriCare study.

Background: Obstetric critical care patients face unique challenges during intensive care unit (ICU) admission, including separation from their newborns and psychological trauma. The ICU environment, primarily designed to support physiological recovery, may not be optimised for maternal experience. Healthcare staff caring for these patients may also experience psychological distress. This is the third report from the MaCriCare study, which examines maternal experiences, follow-up practices, and staff support provisions in ICUs managing obstetric patients across WHO Europe countries.

Methods: Between September 1 2021 and January 1 2022, a multicentre international survey was conducted and included questions on mother-baby contact, breastfeeding support, single-room availability, psychological screening and follow-up, and psychological support for staff in ICUs serving obstetric units. Data from 928 ICUs were analysed.

Results: Physical contact was facilitated in 64.9% (n=602) of centres, while breastfeeding support was available in 82.2% (n=763). Single-room accommodation was accessible in 50%. Psychological screening for obstetric patients and follow-up were conducted in 30.6% (n=284) and 33.1% (n=307) of centres, respectively. In 61.7% (n=573) of ICUs, psychological support for staff was available following poor maternal outcomes.

Conclusion: While breastfeeding support and some form of mother-baby contact were quite widely available, psychological screening, follow-up, and staff support after poor maternal outcomes remained inconsistent. National-level service mapping is needed to identify best practices and context-specific barriers. The impact of bundled interventions to improve maternal experience during critical illness, and staff support strategies after adverse maternal outcomes, should be formally evaluated in future research.