Frequently Asked

I think I am in labour, what should I do?

Please be aware of the fact that you will be admitted to hospital for delivery once you are in the active phase of your labour. This means that contractions are getting more and more intense and closer together, and that cervical dilation continues at a steady pace past 4 centimeters of dilation. If you observe signs of active labour, please report to your labour ward where you are booked to deliver. No need to break land speed records.

If you are assessed in-hospital as not being in active labour, do not be discouraged as this is part of a completely normal process. Also be aware that early labour can be a long process which can be a different experience for every woman. The body prepares for labour and birth with early contractions. These may not be the same as previous Braxton-Hicks contractions you have experienced, and may genuinely feel like labour. However, in early labour contractions start up and then slow down and stop after several hours. Take the time to rest when this happens so you can have adequate energy for the active labour stage. In active labour, contractions increase in intensity to the point that rest is not possible and you will definitely know that labour is in progress.

Sometimes active labour can progress very quickly, and that is why it is important for you to be aware of your body’s signals and go to hospital for an assessment as soon as you believe that your contractions are intensifying and getting closer together with no sign of being irregular or slowing down. It’s always best to come to hospital and have the progress of your labour assessed by an experienced medical professional.

You will experience regular lower abdominal or back pain increasing over time in frequency and intensity. Your water may break, releasing amniotic fluid. A mucous show is a poor sign of labour as some ladies lose theirs a week before labour. Please be aware that labour occurs in several stages and is not the same as what we see in the movies. Weeks before active labour, while your body is preparing to give birth, you may experience Braxton-Hicks contractions which are practice contractions that are not painful, Prodromal labour which is early labour that may feel very real but then slows down or stops, and then finally active labour which is when your contractions do not slow down or stop and your cervix continues dilating from 4cm to 10cm when you are ready to deliver your baby.

Sometimes the water breaks when contractions have not yet started. It is important to come in to hospital and be assessed at this stage in order to prevent infection from occurring which can be dangerous to mother and baby. You may be given antibiotics and labour will be expected to start within 24 hours. If no change occurs within 24 hours, please consult with Dr. de Gouveia regarding safe delivery options. Sometimes there may be sufficient amniotic fluid to allow you to wait past the initial 24 hours; however, these factors must be discussed with your doctor in order to ensure your safety and that of your baby’s.

Sometimes the water breaks when contractions have not yet started. It is important to come in to hospital and be assessed at this stage in order to prevent infection from occurring which can be dangerous to mother and baby. You may be given antibiotics and labour will be expected to start within 24 hours. If no change occurs within 24 hours, please consult with Dr. de Gouveia regarding safe delivery options. Sometimes there may be sufficient amniotic fluid to allow you to wait past the initial 24 hours; however, these factors must be discussed with your doctor in order to ensure your safety and that of your baby’s.

Please pack a bag for baby, including the following: Clothing for baby, including at least one extra set of clothing. Nappies. Receiving blankets and warm blankets if needed. Surgical spirits and dressing for baby’s umbilical cord. Formula, sterile water and bottles if you will be bottle-feeding. A cover or scarf for breastfeeding if needed. Please ensure to bring an appropriate car seat to safely bring your newborn home. A bag with essentials for yourself, including the following: Linen savers for the car ride to the hospital if your water has broken. At least two comfortable gowns to wear in the hospital. A change of clothing to wear after delivery, including a shirt or top that is convenient for breastfeeding. Maternity pads and 2-3 hospital panties or comfortable panties of your choosing. Personal care items such as a comb, toothbrush and toothpaste, your own comfortable pillow and extra blanket if you choose. Please be aware that depending on your delivery, you may need to stay in hospital for an extra day or longer. It is always best to pack extra items you may need such as books to read. Other essentials include your medical aid ID and the main member’s ID, your personal identification, charger for phones, camera to take photos, your printed birth plan, and snacks and drinks for you and your partner.

You will be encouraged to move around and be upright for most of the time. You may bounce, dance, walk stairs. You must eat and drink. You will not have an IV drip unless medically indicated and no catheter. You will be examined every two hours so if you wander please come back for those examinations! You may deliver in any position which is most comfortable to you. Your pain relief is individualized to your needs but we do have a wide range of options. An epidural can be given whenever your pain experience is too intense. Your baby will be placed immediately skin to skin and you should not need to be separated from your baby unless intense resuscitation is needed. Dr. de Gouveia delays the cord clamping so baby gets extra blood. Once the cord is cut, the placenta is delivered actively by pulling gently. Dr. de Gouveia will then examine you for tears which may need to be sutured. You may breastfeed and bond with baby while this happens.

You will remain in the labour ward for an hour after delivery to be observed for bleeding. Once you are stable you will be transferred to the post-natal room where you will be staying for a minimum of six hours and perhaps a day or two. Depending on your birth you may go home quite quickly.

Your life partner or husband, and/or a doula, friend or family member for support can be with you during your labour and birth. Having your own birth partner at the hospital with you to support you is encouraged. Please pack a change of clothes and snacks/drinks for your birth partner.

GYNAECOLOGICAL SERVICES
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FOR MEDICAL AND URGENT INQUIRIES, APPOINTMENTS, ADMINISTRATIVE MATTERS, AND BILLING: Email our Nurse, Dilla Bruwer Email Margaret van Kooij dillagynaes@gmail.com