When to go to the maternity ward

Not sure when the right time is to head to the maternity ward? Read on...

Rupture of the membranes

The rupture of the amniotic sac is always a reason for admission to the maternity ward. The amniotic fluid may rupture before labour begins or during labour. Sometimes the fluid breaks all at once, sometimes in small amounts over time. If you are unsure, it is advisable to have this assessed during an examination, as prolonged leakage of amniotic fluid can lead to infectious complications. Amniotic fluid is usually a clear liquid, though it may contain a small amount of blood. Once it has broken, you should arrive at the maternity ward within 2 hours. However, if the amniotic fluid is not clear – it may be yellow, green, brown – or if you have tested positive for GBS, please come to the delivery room as soon as possible. If a small amount of amniotic fluid leaks, or if you are unsure whether your waters have broken, bring a maternity pad so we can test for the presence of amniotic fluid using a reagent. If only the mucus plug is coming out – that is, mucus with a small amount of blood – this is not yet a reason to be admitted to the delivery room; it is usually a sign that labour is approaching.

Regular uterine contractions

If you feel regular, painful tightening of the uterus at least every 5 minutes for 2 hours, head to the delivery room. Uterine contractions are usually irregular at first, gradually becoming regular, with the intervals between them shortening and their intensity increasing. They usually start at the top of the uterus and spread concentrically towards the cervix. They are triggered by the release of oxytocin and have a dilating effect on the birth canal. A few days or weeks before labour, so-called ‘Braxton Hicks contractions’ may occur – painless or only mildly painful hardening of the uterus, which, however, does not yet lead to the opening of the birth canal. These contractions are usually irregular, felt in the lower abdomen or back, and generally subside after a warm bath. 

Bleeding

Any heavy bleeding is a reason to be examined in the delivery room. It may be the start of labour, but it could also be a serious complication associated with bleeding from the placenta. Light spotting is possible when the mucus plug is discharged, at the start of labour, or after a gynaecological examination.

Change in foetal movement

If there is a significant change in the baby’s movements over an unusually long period – usually a decrease, but sometimes an increase – ensure the baby is well by having a check-up in the delivery room.

Gynaecologist’s recommendations

If your registered gynaecologist or doctor at the antenatal clinic recommends a check-up or hospital admission, please attend as agreed.