Information for Pregnant Women
The guidelines recommend management of common obstetric conditions at primary and referral level, based on local experience and evidence-based practice. They are not intended as strict protocols nor as standard operating procedures, but rather as a guide to safe effective management of common obstetric problems. The guidelines should be most useful to interns, medical officers and registrars.
Future pregnancies and contraception
Certain essential information must be provided to all pregnant women, verbally or in the form of written or illustrated cards or pamphlets. Midwives provide much of this information, but doctors may need to emphasize some of these points.
Five danger signs and symptoms of pregnancy
- Severe headache
- Abdominal pain (not discomfort)
- Drainage of amniotic fluid (liquor) from the vagina
- Vaginal bleeding
- Reduced fetal movements
A woman that experiences any of these symptoms should report immediately to her clinic or hospital with her antenatal card.
Self-care in pregnancy
- Diet, exercise, sexual intercourse & safe sex, travel, work, etc.
- Personal hygiene & breast care
- Use of medications
- Avoidance of alcohol, tobacco & recreational drugs
- Avoidance of traditional medicines such as isihlambezo (a uterotonic)
A delivery plan
At the end of their first visit, all pregnant women should be given a provisional delivery plan:
- The expected date of delivery, based on the best estimate of gestational age
- The expected place of delivery, whether community health centre or hospital
- The expected mode of delivery, whether vaginal or caesarean section
- Who will deliver the baby, whether midwife or doctor
Newborn and infant care
- Plans for infant feeding & techniques, whether breast or formula
- Details of follow up care: immunization & where this can be obtained
Future pregnancies and contraception
- Contraception that will be used after the pregnancy
- Return to normal activities e.g. work, sexual intercourse