Managing Risk of Falls - Maternity Patients

Mothers and newborns can be at risk of falls whilst in Maternity Units. Managing falls risk in the maternal and newborn population has received minimal attention and has not been well documented. Women have an increased short term falls risk for example following a vaginal or caesarean birth, especially during initial attempts at ambulation.

Newborn falls in maternity units are associated with maternal sedation, and many falls occur when a neonate rolls from the arms of a sleeping parent.

Traditional falls risk screening tools do not address the unique characteristics experienced by women in the immediate pre and post partum period.

Pre-birth falls risk in woman can include:

• Pre-existing maternal medical conditions
• Seizure disorders
• Antepartum haemorrhage (APH)
• Mobility problems
• Developmental delay
• Mental health illness

Post-birth falls risks in woman can include:

• Tiredness following birth
• Post-caesarean section
• Ongoing effects of anaesthesia e.g. epidurals (weakness, or lack of sensation in lower extremities)
• Medications for pain or sedation (affecting level of consciousness, balance, cognition and sleep pattern)
• Blood loss from a post partum haemorrhage (PPH)
• Hypotension

Routine care post birth:

• Provide instruction to new mother/parents on how to obtain assistance when getting in/out of bed, transferring to chairs or mobilising to the toilet.
• Ensure adequate guidance and assistance is provided to the new mother and partner when moving a neonate/baby from cot to the mother/partner for cuddling or feeding purposes.

Interventions for new mothers at risk of falling:

• Remind new mothers/parents to wait for staff a asistance when walking to the bathroom
• Place call bells, bedside tables, frequently used objects within easy reach (particularly for mothers who have had an epidural, post caesarean section or PPH)
• Ensure the bed brakes are on /locked and the bed is at the right height for the women following a clinical procedure
• Encourage mothers to wear non slip foot wear when mobilising.

Parental education:

Educate new parents about how to keep their baby safe from falling:

• Address safety issues when changing nappies, bathing babies etc as these are potential falls risk situations.
• Highlight the importance of putting their baby to sleep on their back from birth in their own safe cot next to the maternal adult bed
• Provide advice about the risk of falling asleep while holding their baby
• Highlight risks associated with walking around the maternity unit with their baby in their arms - it is advised to transport their baby in a wheeled cot.

Documentation of falls risk:
Incorporate falls prevention strategies in the management plan in the care pathways.

DISCLAIMER This fact sheet provides general information only. For specific advice about your baby or your healthcare needs, you should seek advice from your health professional. Burnside Hospital does not accept any responsibility for loss or damage arising from your reliance on this fact sheet instead of seeing a health professional. If you or your baby require urgent medical attention, please contact your nearest emergency department.