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Resuscitation equipment, including an automated defibrillator, should be available on the delivery suite and should be checked regularly.⁵⁵ A perimortem caesarean section pack containing a scalpel, surgical gloves and cord clamp should be available on all resuscitation trolleys in the Maternity Unit and areas admitting pregnant women e.g. emergency departments.⁵⁶ A range of various sizes of tracheal tubes...

NICE guidance on the recognition of and response to acute illness in adults in hospitals should be implemented.⁷⁰

Agreed internal referral pathways to other specialties should be in place for the minority of cases in which this may be required to expedite further investigation and patient optimisation. This should be done in close collaboration between the preoperative assessment lead and nominated representatives from appropriate specialties, e.g. cardiology, diabetes, renal, respiratory and geriatric medicine.

An early warning score system, modified for use in obstetrics, with a graded response system should be used for all obstetric patients to aid early recognition and treatment of the acutely ill woman.^71,72

All units should be able to escalate care to an appropriate level, and critical care support should be provided as soon as required, regardless of location.⁵⁷

Whenever possible, escalation in care should not lead to the separation of mother and baby.^4,16

When midwives provide a level of care beyond their routine scope of practice, they should be appropriately trained.

There should be a named consultant anaesthetist and obstetrician responsible 24/7 for all women requiring a higher level of care.¹⁶

Women requiring critical care in a non-obstetric facility should be reviewed daily by a maternity team including an anaesthetist^{. 4}