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In 1847, the obstetrician James Young Simpson reported the use of diethyl ether to provide peripartum pain relief in a woman with a deformed pelvis. From this beginning, an evolution in the agents and techniques used to provide obstetric analgesia and anesthesia has occurred.
This chapter summarizes standards and recommendations relevant to the care of the pregnant or recently pregnant critically ill woman for maternity and critical care. The acute care competencies required focus primarily on the clinical and technical aspects of care and the delivery of effective patient management. They assume the possession and application at every level of complementary generic competencies such as recordkeeping, team working, interpersonal skills, and clinical decision making. Maternity services should define which of their staff take on each one of the acute care responder roles and ensure that they have suitable training and assessment of the competencies they require. Lead professionals in maternity services have a responsibility to ensure that staff are deemed competent in the early recognition of acutely ill and deteriorating patients and are able to perform the initial resuscitation and management.