Labor & Postpartum Care

When You Are In Labor


Call us if you experience:

  • 5-1-1 Contractions. Call when you are having contractions five minutes apart, lasting one minute each, for one hour.
  • Ruptured membranes with clear fluid and no labor pains, if your vaginal culture for Group B strep at 36 weeks was positive. If your membranes rupture during the day, call us. If your membranes rupture after 5:30 p.m. and your Group B strep culture was negative, you can wait for signs of labor. If you are not in active labor by 7:00 a.m., please call our office.
  • Ruptured membranes with green amniotic fluid. This may be meconium (fetal stool) which occasionally signifies fetal distress. You will be instructed to come to the hospital when fluid is this color.
  • Heavy bleeding and/or unremitting, severe pain.

How to reach us:

  • During office hours, please call us at (415) 666-1250, and choose option 2.
  • After or before office hours, please dial (415) 666-1250 and press 0. Our nurse triage service will make an assessment and give you instructions. An on call physician is available 24 hours a day and the nurses can reach us if necessary.
  • If instructed by a physician, call the CPMC hospital triage desk at (415) 600-2100.

Labor pains are typically uniform in their intensity and predictably rhythmic in their timing.

In general, when at term, there is NO need to call if:

  • You are cramping or having erratic contractions, even if some are strong.
  • You note a slight bloody discharge, pass your mucous plug or see blood-tinged mucous in the absence of regular labor pains.

 

Postpartum Instructions


Follow-up Appointment
When discharged from the hospital, please call to schedule a post-partum appointment at six weeks after a vaginal delivery or two weeks after a cesarean section.

Bleeding and Cramping
Bleeding and cramping should gradually decrease after delivery and may not completely disappear for four to six weeks. You may occasionally pass some clots or have heavy bleeding. Unless you are soaking a pad every hour for four hours, there is no need to worry. If you develop worsening abdominal pain, please call us.

Breastfeeding
Fevers are common as breast milk comes in. Occasionally, a duct or gland may get clogged and form a lactocoele. Continue breastfeeding and eventually the lactocoele will resolve and the fever will abate. If fevers over 101.5 persist and are accompanied by skin redness, this may be a sign of mastitis. Please call us. For other breastfeeding problems, the lactation center phone number is (415) 346-BABY or (415) 346-2229.

Stitches
Stitches from repair of an episiotomy will dissolve by your follow-up appointment.