What to expect at a government hospital

If you’re facing the choice of breaking open your piggy bank to pay for private care or go to a government hospital, research your options. You may be pleasantly surprised.

Why government hospitals get a bad name

Norma Bustard, registered nurse/midwife who is also the nurse manager of the Obstetric and Gynae block at the Charlotte Maxeke Johannesburg Academic Hospital in Parktown, explains why government hospitals get a bad name:

“People just don’t understand hospital protocol – especially when it comes to obstetrics,” she says. “The maternity unit has to cope with women who come to admissions in advanced labour who have not been for any antenatal care. This means that they have no medical records, and where there’s an additional language problem, it’s almost impossible to get an accurate obstetrical history. There is no time to run tests or do investigations that would otherwise improve the outcome for mother and baby. We simply have to do the best with what we have. When things go wrong, the press is quick to publish the story, often with incorrect details.”

Your first stop after confirming pregnancy

Local municipal health department

On confirming pregnancy, your first stop is your local municipal health department. Bigger centres have independent MOUs (Midwives Obstetric Units) where women are cared for during pregnancy until after the birth of baby.

When there are no anticipated (or previous) complications (and the woman is 16 years and older) her baby will be delivered at the MOU. These units are often within walking distance and are open 24 hours a day.

Antenatal clinic

Most municipal health departments have an antenatal clinic where all pregnant women can go for ante- and postnatal care.

Healthcare cards

According to Moira Van Heerden, community health nurse/midwife for Bedfordview Baby Clinic in the Ekurhuleni municipality, standard healthcare cards are issued to all women who attend these clinics.

These are filled in with every visit and become the woman’s “passport” to hospital care should there be a problem or when she goes into labour.

What you need to do to register for antenatal care

Phone your local municipality for details about the clinic, times and dates for antenatal care.

Take with you:

• A referral letter from your doctor (this is not essential)
• Your barcoded ID 
• Most recent light and water account to verify your address
• A small notebook to record any instructions and appointments

All women with uncomplicated pregnancies may go to these clinics.

Admittance to hospital, antenatal care units and academic hospitals

Hospital and antenatal care

Teenagers 15 years and younger, women having their first babies at 35 or older, multiple pregnancies or any other complications are referred directly to the hospital for antenatal care.

Academic hospital

Should there be a serious problem the woman is then further referred to an academic hospital. These hospitals are attached to universities which may imply frequent appointments, tests and monitoring, but it also means that all women have access to the best possible healthcare.

Difference between an uncomplicated pregnancy and a "high risk" pregnancy

Registered nurse/midwife Elaine Hennessy who is the clinical assistant manager at the Johannesburg Academic Hospital antenatal clinic, explains the difference between an uncomplicated pregnancy where babies can be delivered by private midwives at home or at a MOU, and “high risk” pregnancies.

“Academic hospitals have the equipment for specialised tests and procedures and bed space is kept for problem pregnancies,” she explains.

Uncomplicated pregnancy

“Women with no medical or surgical problems or detected complications during the pregnancy, who do not need scans or other specialised tests, can give birth at the local hospital. She must go to the hospital within her residential area which may limit her options.

Moderate risk pregnancy

Moderate risks include problems with previous pregnancies or moderate problems that may occur during the pregnancy.

High risk pregnancy

High risk includes hypertension (high blood pressure), diabetes, multiple pregnancy, more than three miscarriages and congenital abnormalities”.

Booking your hospital bed

Book your hospital bed early – preferably at about 8 weeks into your pregnancy. Take your antenatal card (or referral letter from your doctor), ID, proof of residence, an employment certificate or other proof of income. If you are not working you need 3 consecutive current bank statements.

You will then receive a hospital appointment card along with your registration number and payment classification.

Go to page 2 to find out what you can expect at a government hospital