Avoid delaying hospital visits during labour, gynaecologists tell pregnant women

Maternal health specialists have told pregnant women to seek medical attention at the first signs of labour as against waiting for contractions to become severe, stating that delay in getting to accredited health facilities for assessment could lead to uterine rupture, foetal distress, umbilical cord prolapse, severe bleeding or death.

The seasoned specialists explained that while labour progresses differently from one woman to another, pregnant women experiencing one or two contractions every 10 minutes, leaking amniotic fluid or blood-stained mucus should go to the hospital for proper assessment by a qualified health professional.

In exclusive interviews with PUNCH Healthwise, the gynaecologists noted that every woman has a different pain threshold, therefore, pain intensity was an unreliable basis for deciding when to go to the hospital.

They stressed that proper monitoring was essential because complications could develop rapidly during labour and might not show in the intensity of a woman’s contractions.

The maternal health specialists also urged pregnant women to plan their deliveries in advance by attending antenatal care, identifying appropriate health facilities, arranging transportation and setting aside money and essential delivery supplies.

They advised women who needed to travel during pregnancy to do so early rather than waiting until close to their expected date of delivery, stating that the stress of the journey could trigger contractions, among other complications.

They further emphasised the importance of skilled birth attendance, warning that attempting to manage labour at home or relying on unqualified birth attendants could delay lifesaving interventions. They said women should follow the guidance of their healthcare providers and ensure they were properly assessed before being advised to return home.

Delay in getting to a hospital, categorised as “Delay 2 under the Three Delays Model, accounts for about 10 per cent to 20 per cent of global maternal deaths.

Already, Nigeria has one of the highest maternal mortality rates in the world and accounts for up to 34 per cent of global maternal deaths.

The Federal Ministry of Health and Social Welfare said that between January and September 2025, the country recorded about 20,811 maternal, neonatal, and under-five deaths.

Commenting on the matter, a renowned Professor of Obstetrics and Gynaecology, Prof Rotimi Akinola, said women should go to the hospital when they notice signs such as intermittent pains, leaking fluid or mucus sometimes mixed with blood, commonly referred to as a “show”.

Akinola, a former National President of the Society of Gynaecology and Obstetrics of Nigeria, said the decision on whether a woman was in labour and whether she needed to remain at the facility should be made by a qualified health professional.

“What we teach is the fact that there are some signs that you will see. We say, for example, if you see water, if you see mucus, sometimes mucus mixed with blood, some people call that show. So, if you begin to have intermittent pains, you should go to the hospital. Let the hospital look at you and say you are not in labour. Then they can decide whether you will rest or you should come back. That is the safest option rather than waiting at home,” he said.

The maternal health expert cautioned against waiting until contractions became severe before seeking care, noting that women had different thresholds for pain.

“People have different thresholds for pain. You cannot say that it is when the pain is very severe you go to the hospital. I don’t think that’s right. So, let the health worker look at you,” Akinola said.

He warned that labour could advance while a woman remained at home, potentially leaving her to deliver in an inappropriate place or without the assistance needed to manage complications.

He explained that labour progresses through different stages, with the active phase of the first stage requiring particular attention because cervical dilation can advance relatively quickly.

He explained that the first stage runs from the onset of contractions until the cervix is fully dilated, the second stage extends from full cervical dilation until the baby is delivered, while the period following delivery is regarded as the third stage.

Akinola said that although the duration of labour could vary, women in the active phase should be in a suitable facility where complications could be managed promptly.

The seasoned gynaecologist said complications could arise quickly during labour and delivery, especially when a woman was not being attended to by trained personnel.

The former SOGON president stressed that labour management should be guided by appropriate monitoring rather than assumptions about how quickly a woman ought to progress.

Akinola said antenatal care provided an opportunity to educate pregnant women about warning signs, prepare them for delivery and help them recognise when they needed to seek emergency care.

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He urged women to listen to the advice of their healthcare providers and avoid making independent decisions about when to go to the hospital.

He cautioned pregnant women against waiting until the last minute before travelling and advised those who needed to relocate for delivery to make arrangements well ahead of their expected dates.

Akinola also said women receiving antenatal care should be educated about birth preparedness and complication readiness, including the warning signs that should prompt them to seek medical attention.

A Professor of Obstetrics and Gynaecology at Obafemi Awolowo University, Ile-Ife, Osun State, Prof Ernest Orji, also warned against delaying hospital visits until labour pains become severe.

Orji, a former Head of the Department of Obstetrics and Gynaecology at OAU, Ile-Ife, said women who experienced contractions at intervals of about 10 minutes, noticed fluid leaking from the vagina or observed blood-stained mucus should seek medical assessment.

He said these signs could indicate that labour was starting and that women should not wait for the pains to become unbearable before going to a health facility.

“Contractions, at least one every ten minutes, are a sign that labour has started. One or two every ten minutes is a sign of labour. Or you see the water coming out from the vagina,” he said.

Orji advised women to go to a health facility even when they were not experiencing labour pains if their waters had broken, so that a doctor or midwife could assess them and determine the appropriate next steps.

The reproductive health advocate and fertility physician said women who were sent home after an inadequate assessment could remain at home while labour progressed or an underlying complication went unnoticed.

He explained that some women could eventually deliver at home or inside vehicles while trying to return to a health facility.

Orji said women should be properly assessed before being discharged, including checks to determine whether the baby was in distress, rather than relying only on the severity of contractions or cervical dilation.

“That’s why it is good to be properly assessed. Because it’s not just for the baby; sometimes there are other issues that can be a warning sign. The medical professional will properly assess before telling the woman, okay, go, there’s no problem,” he said.

He added that lack of bed space, overworked healthcare personnel and financial difficulties could contribute to women being sent home or delaying care, but maintained that women experiencing labour symptoms should not assume they were safe simply because their pains were not severe.

Orji said delays in reaching a health facility could result in foetal death, foetal distress, umbilical cord prolapse, a baby being born weak and dying after delivery, maternal bleeding and uterine rupture and in worst cases, both mother and baby could die.

Orji therefore urged women not to rely on their experiences from previous pregnancies when deciding when to seek care.

“What happens in one pregnancy may not be the same in the next pregnancy. So we always advise people to be very, very careful,” he said.

The gynaecologist advised pregnant women to prepare the supplies they need for delivery instead of waiting until labour began to look for essential items.

He said families should arrange transportation that would be available at any time of the day or night, ensure that fuel was available where necessary, make plans for the care of other children and set aside money to meet unexpected expenses.

Orji said such arrangements could prevent avoidable delays, particularly when a woman needed urgent attention.

He urged families to ensure that a pregnant woman had someone who could take her to the hospital whenever labour began, regardless of the time, and that arrangements were in place for other children who might otherwise prevent her from seeking care promptly.

“Pregnancy is nine months. It’s not one day. So there’s no excuse. Even if it’s eight months, they have enough time to prepare,” he said.