Obstetrics

Delivery of your baby is the culmination of months of work and preparation. Throughout this time, your healthcare will be carefully considered and personalised. The idea is to optimise your health to provide an ideal environment for the development and growth of your baby. Your pregnancy is precious and deserves all the protection modern obstetrics can provide.

Your Obstetrics Journey

With the help of my dedicated team, I provide compassionate care to moms on their pregnancy and birth journeys. My decades of experience have helped me deliver many healthy and happy babies, and I look forward to doing the same for you.

Weeks 8-10

Your first visit should be during the second month of pregnancy. During this visit, we'll take a short history to look for anything that might influence you or your baby later on. Then, we'll do an ultrasound to confirm gestational age and the number of fetuses.

After this, we'll have a friendly discussion about all the dos and don'ts of pregnancy. You will be given ample opportunity to ask questions at this visit and in the future. We'll also discuss your follow-up for the remainder of your pregnancy and send you for some routine blood tests.

Weeks 11-13

At this stage, I recommend you go for a first-trimester anomaly scan. This ultrasound (formerly known as the 'Down's scan') will allow you to see your baby in detail. You'll see their face and hear their heartbeat for the first time. Usually, gender is established by this time as well.

Lastly, based on the presence or absence of specific anatomical markers, we can ascertain your risk for certain common genetic abnormalities – Down's syndrome being the most common. If you have no intention of terminating an abnormal pregnancy, it's still a wonderful experience to see your baby in so much detail.

Weeks 16-18

Your next visit with me is when we will discuss your blood results and monitor your baby's growth. We can usually confirm the gender as well.

Weeks 20-22

At this stage, it's back to the ultrasound specialist for the detailed scan. Your baby will be a bit bigger now, and all the anatomy can be viewed in incredible detail. You'll get to see their precious face in 4-D, including the different structures in the heart and brain. You'll see the limbs and the little fingers and toes.

We can even predict your risk of certain conditions like preterm delivery or fetal growth restriction. Though no ultrasound can rule out any abnormalities with 100% certainty, this is the best test available at the moment to put your mind at ease. Hereafter, we will have a follow-up visit every 4 weeks until 34 weeks.

Weeks 30-40

We will discuss your delivery choice in detail at 36 weeks and then weekly until delivery (or 41 weeks). I will provide you with the information you need to help you decide what route is best for you and your family, and then go out of my way to make this as pleasant an experience as possible. This might include having a doula or birth photographer present during labour. You might also have specific requests about birthing positions or music playing while in labour. These can be discussed at length, and almost all of them can be accommodated.

Should you go over your dates, we'll discuss your options in detail. Typically, I suggest delivery no later than 41 weeks, as your chances of a caesarean section increase significantly after 41 weeks. Your risk of losing your baby also increases after 41 weeks.

Other obstetric services Dr van Zyl assists with include:

Frequently Asked Questions

How do I know if I've gone into labour?

Every woman's experience of labour is different. During the early stages of labour, you may experience the following:

Abdominal or lower back pain, with a pre-menstrual feeling and cramps.
Painful contractions that may be irregular in strength and frequency and may stop and start.
Broken water can take place long before labour, but you should still call your maternity unit to let them know.
A brownish or blood-tinged mucus discharge - labour typically begins soon after passing the mucus plug.
An upset tummy or loose bowels.
A period of feeling emotional, excited or moody - you may feel restless, anxious or impatient.

When should I leave for the hospital?

Speak to your Gynaecologist about this. If your membranes rupture, please come in so we can make sure that your baby is safe. Sometimes the water flow can cause the cord to shift and end up in a position where your baby is not getting enough oxygen. Of course, you can always go home again if everything's fine. Otherwise, come in when you're having 3 contractions in 10 minutes.

What are the best ways to time contractions and the best apps to use?What are the best ways to time contractions and the best apps to use?

There are several possible ways of doing this. You could use an everyday watch or stopwatch on your cell phone.

For those that love making life easier with an app, I recommend the following:

1. Lamaze: It's a great app that tracks your appointments, pregnancy milestones, contractions, diaper changes, and breastfeeding. Available at www.lamaze.org for iPhone and Android.
2. Full Term: This is a labour contraction timer, pregnancy reference and kick counter available on Itunes.
3. Contraction timers: They're all straightforward to use and make monitoring the frequency and duration of your contractions easier.

Braxton Hicks contractions - how do I know the difference?

This is one of the more difficult questions. Braxton Hicks contractions are not 'supposed' to be painful but can be. The most significant difference from regular contractions is that there is no fixed pattern and no increase in the frequency and duration of contractions. This is another way that an app can be helpful.

If you're having regular contractions, you'll start with one or 2 short (usually less than 30 seconds) contractions. Over time, this increases to 3 in 10 minutes - it will be even more during the later part of the active phase of labour. The duration will also slowly increase until your contractions last between 40 and 60 seconds.