Although midwives usually work with healthy women, sadly there are still occasions where medical intervention is necessary. In order to minimise the danger to mothers, it is vital that midwives can recognise deterioration and are aware of what action to take. Taking into account recommendations made by successive CEMACE reports on maternal deaths, 'High Risk Maternity Care' examines relevant pathophysiology and pharmacology, highlighting appropriate interventions and how to interpret indications of clinical deterioration.