Care of the mother in the hospital

After a normal delivery

The patient is made comfortable and transported to the post-natal ward on her own bed. The I.V. therapy remains in place and the patient’s condition is monitored until her uterus is well contracted, the vaginal bleeding is within normal limits and urine has been passed.

After epidural / spinal anaesthesia, the spinal catheter will be removed within 2 to 6 hours as directed by the doctor. If a urinary catheter has been inserted, this will also be removed.

The patient will be required to stay in bed for + 6 hours until the epidural anaesthetic has worn off completely. Because of the danger of falling, the patient is warned not to get up without assistance from the staff.

If excessive bleeding is experienced after a normal delivery, a urinary catheter will be inserted as it is extremely important that the bladder remain empty, in order for the patient’s uterus to stay well contracted and for the bleeding to subside.

Perineal Care

Sometimes the doctor has to make an incision called an episiotomy in the perineal area to prevent tears and to assist with the delivery.

This is sutured after the delivery.

An episiotomy can sometimes be very uncomfortable. If this is the case, the patient is advised to take a sitz bath three times a day.

Tips on how to take a sitz bath

  • Add half a container of coarse salt to + 5cm of water in lukewarm bath
  • Get into the bath and soak the perineal area in the solution.
  • Do not add bath oils etc to the water.
Tips on the use of the infrared lamp

The infrared lamp is used after a sitz bath. The heat reduces the swelling and relieves the discomfort. The staff will demonstrate the use of the infrared lamp to the patient.

  • Always place the lamp + 1 meter away from you to prevent burning yourself.
  • Do not use lamp for longer than 10 minutes at a time.
  • Place a linen saver under your buttocks to prevent soiling of the bedding.
  • To ensure privacy, face the wall and cover your legs with a towel.

After a caesarean section

The patient is transported back to the maternity ward on her own bed. Her vital data (blood pressure, pulse, bleeding, etc) will be monitored ½ - 1 hourly for 4 hours. Analgesics will be given as prescribed by the patient’s doctor. Patients are requested to inform their allocated staff member if medication is not effective so that she the doctor can be contacted to discuss alternatives.

The I.V. therapy will be kept in place for + 24 hours. Some type of drain might also be inserted into the wound if necessary.

As soon as the patient’s condition allows it, she will be swabbed and made comfortable. The baby will be brought to her as soon as possible and the mother will be assisted with preliminary breast feeding techniques as well as with helping the baby to latch. The mother may decide if she would like the baby to stay with her or to go back to the baby-room until the next feed.

At + 17:00 the patient is swabbed, made comfortable and, if this has not already been done, dressed in her own nightclothes.

For the first two nights, after visiting time, babies are fed again and taken back to the baby-room. If she feels up to is, the mother can request that the baby be brought back for breast-feeds during the night. Alternatively the baby can be bottle-fed at + 02:00 and the mother can breast-feed again at 06:00.

The mother will be swabbed, given analgesics, a sleeping tablet and made comfortable for the night.

The staff and the night super will do rounds regularly to monitor the condition of the patients.

At + 04:00 the patient is given analgesics to ensure that she is relatively pain-free when the staff help her to mobilise from 05:00 onwards. Her catheter will be removed. The I.V. therapy will be discontinued (usually mid-morning) with the doctor’s permission.

The drain is usually removed on the 3rd day as directed by the doctor.

Other Information

Doctors rounds

The patient’s doctor will visit her daily.

Most doctors do their rounds in the mornings from 07:00 – 08:30, so patients are requested to be in their rooms during these times and to switch off their cell phones during the doctor’s visit.

Bathrooms and Toilets

The bathrooms and toilets are cleaned several times a day. Patients can help to keep these as hygienic as possible by:

  • Discarding maternity pads in the bins provided in the bathrooms and toilets (under no circumstances should pads and hand towels be flushed down the toilet, as this causes blockages)
  • Reporting blood spills etc to the staff so that they can be cleaned
  • Not smoking in the toilets and bathrooms (private rooms included)
  • Reporting shortages of hand towels and toilet paper to staff
  • Leaving the bathroom as they would like to find it

Meals

Unless the patient’s doctor has given special instructions, meals are as fullows.

  • Patient in labour - I.V. therapy only. Patient may suck ice. Patient may suck Super C
  • After delivery - Patient may eat full meal, which is selected from set menu (Menus will be given out by the ward hostess)
  • After caesarean section - Ice will be provided. A warm drink may be taken after + 2 hours unless nauseous. Soup, jelly and other liquids will be served at mealtime.
  • After 24 hours, the next 3 meals will be light meals. The light meals are fullowed by a full diet.

Patients can indicate special requests on their menus.

Patients are requested to inform a member of staff should they, for any reason, not receive a meal or not be satisfied with any of the meals.

Pain Medication

  • Prescribed medicine will be administered at regular intervals.
  • Patients are requested to inform their allocated staff member if medication is not effective so that the doctor can be contacted to discuss alternatives, as there is no need for a patient to suffer if the pain can be alleviated.

NB: Patients afraid of injections should discuss this with the anaesthetist or gynaeculogist as alternative analgesics are available.

Wound Care

  • If the patient has a Portovac drain in situ, it will be emptied twice daily.
  • Drains are normally removed on the 3rd day.
  • A patient may shower or bath before the drain is removed and a new dressing is applied.
  • A waterproof dressing will be applied before the patient is discharged.