Prenatal Care: Frequently Asked Questions

 

What is the best resource for information on pregnancy and newborn care?

 

Baby’s Best Chance, published by the BC government, is an excellent publication for pregnancy and newborn care. The most recent edition can be downloaded from this website: http://www.healthyfamiliesbc.ca/parenting.

 

A paper copy can be obtained from your care provider or local public health office at no cost to you.

 

 

Which pregnancy care provider is right for me?

 

The answer to this is based on your medical history and personal preferences. There are three major groups of maternity care providers: family practice obstetrics providers, registered midwives, and obstetricians. Family practice doctors and midwives offer a continuum of care for healthy mothers and babies.

 

Obstetricians have specialty training for high-risk pregnancies; they do not provide care for the newborn. Obstetricians act as consultants to your family doctor or midwife if pregnancy issues arise. We also provide primary antenatal care for women with medical conditions, obstetric risk factors, multiple pregnancies, and those with problems in previous pregnancies.

 

Speak with your primary care provider about what type of obstetric provider may be right for you.

 

 

Who will deliver my baby?

 

At Royal Inland Hospital, we are a team of six obstetrician/gynecologists who share on call duties. All physicians have identical certifications and training, and we all adhere to Canadian practice guidelines. There is always an OB/GYN on call 24 hours a day, 7 days a week. If your primary OB/GYN is not on call when you go into labour, one of the five other members of the group will be responsible for taking care of you in labour and delivering your baby.

 

Royal Inland Hospital is an approved training site for medical students and OB/GYN residents in their final years of training. A student or resident may be involved in your care, under direct supervision, at a level appropriate for their skill set. The participation of a learner has enormous benefit to the future of Canadian health care, and you will play an important role in this. However, if you choose to not have a learner involved, please communicate this and your wishes will be respected.

 

 

What are the maternity facilities at Royal Inland Hospital like?

 

Please refer to the Virtual Tour of Royal Inland Hospital published by Interior Health.  

 

 

What kind of medical tests can I expect in my pregnancy?

 

The following is a list of tests that are offered routinely in every pregnancy. High risk pregnancies will often require additional tests and monitoring.

 

First trimester:

  • Basic prenatal labwork. A comprehensive maternal screen.

  • Full physical examination

  • Pap test if indicated; swab for chlamydia and gonorrhea

  • Dating ultrasound. This helps establish your baby’s due date.

  • Optional: Nuchal Translucency ultrasound. For women age 35+; women with twins (see prenatal screening, below)

  • Recommended: IPS or SIPS part I maternal bloodwork (see prenatal screening)

  • Optional: Private pay prenatal screening (First Trimester Screen or Non-Invasive Prenatal Testing)

 

Second trimester:

  • Detailed fetal anatomy ultrasound

  • Recommended: SIPS or IPS Part II, or QUAD screen (see prenatal screening)

  • Gestational diabetes testing at 24-28 weeks

  • Testing for anemia in the second or third trimester

  • For some women: Amniocentesis

 

Third trimester:

  • Group B Streptococcus screening. A single swab of the vagina and rectum generally performed at 35-37 weeks. 

 

 

What prenatal screening tests are available to me?

 

Prenatal screening in BC is offered to all pregnant women. The results provide you with an assessment of your baby’s risk of Down Syndrome (Trisomy 21); trisomy 18, and open neural tube defects. An excellent overview can be found on the official website: http://www.perinatalservicesbc.ca/ScreeningPrograms/PrenatalGeneticScreening/default.htm

 

Testing is covered through the public system (MSP). There are also private tests available. It is always best to have a detailed discussion with your maternity care provider about the choices available to you.

 

 

What can I expect at my upcoming fetal ultrasound?

 

A second trimester detailed anatomy ultrasound (generally 19-21 weeks) is recommended for all pregnant women. The scan will look at all major elements of baby’s anatomy, the amniotic fluid, the placenta, and your cervix.

 

If you so choose, it is often possible to determine gender at the time. The ultrasound technician is unable to disclose gender to you at the time of the ultrasound, but you can discuss this with your care provider at your next prenatal appointment.

 

Information on how to prepare for your ultrasound is found in this brochure from Interior Health.

 

 

What foods are safe to eat in pregnancy?

 

Eat Safely, Eat Well, is an excellent resource for information on food safety in pregnancy is published by the BC Centre for Disease Control. http://www.bccdc.ca/NR/rdonlyres/BCE810E6-2EA1-4A4C-AD34-51D867300A70/0/EatSafelyEatWell_0806.pdf

 

 

How can I cope with morning sickness in pregnancy?

 

Morning sickness in early pregnancy is common and varies greatly in severity. Lifestyle modifications are the first step in managing this condition. There are also medications available that are safe for use in pregnancy. Be sure to speak with your maternity provider about your symptoms.

 

An excellent resource for managing morning sickness is this brochure published by Motherisk: http://www.motherisk.org/women/morningSickness.jsp

 

 

What are signs of labour?

 

1) Uterine activity. In a normal pregnancy, most women experience an increase in uterine activity as they approach term (37-41 weeks). This is often in the form of painless tightenings, called Braxton Hicks contractions. Uterine activity is often irregular and comes and goes. Labour contractions tend to be progressively more painful, last 30-60 seconds each, and fall into a predictable pattern of 3-5 minutes apart.

 

2) Rupture of membranes (waters breaking). A minority of women will experience water breaking as the first sign of labour. This is most often obvious, but can also be quite subtle. If you are leaking fluid from the vagina, be sure to report this: an accurate diagnosis of ruptured membranes is very important.

 

3) Change in vaginal discharge.  As the cervix prepares for labour, some women will notice the loss of their mucous plug, however this does not reliably occur in all women. Pinkish discharge or light bleeding are common and normal, particularly after vaginal examinations. Heavy bleeding is not normal, and should be reported immediately.

 

4) Cervical change. The cervix usually shortens, softens, and dilates in the weeks leading up to labour. In a healthy pregnancy, women are generally admitted to labour and delivery in active labour when they are around 4 centimetres dilated and contracting regularly.

 

 

When should I go to the hospital?

 

The answer to this highly depends on the underlying health of your pregnancy. You should discuss specific indications for assessment with your maternity care provider.  

 

In general, you should be promptly evaluated if:

 

- You think you have broken your waters

- You are concerned your baby has not moved for the last several hours

- Vaginal bleeding (in a low-risk pregnancy, light spotting can be normal near your delivery date)

- You think you are in labour

 

If you are unsure about whether you should go to the hospital or not, call your care provider's office, the nurse's hot line, or RIH labour and delivery to speak with a nurse.

 

 

I had a Caesarean Section for my last delivery. What are options for me in this pregnancy?

 

This is an important issue and warrants a detailed conversation with your OB/GYN. The answer to this will depend on many factors, such as the time between deliveries, the reason why you had your last C-Section, the type of C-Section you had, and risk factors in your current pregnancy.

 

If you are a good candidate for Vaginal Birth After Caesearen (VBAC), the way you choose to deliver your baby ultimately depends on your perception of the relevant risks, and personal preference. An excellent pamphlet for information on this decision is produced by the Best Birth Clinic at BC Women’s Hospital: http://www.powertopush.ca/wp-content/uploads/2010/05/Best-Birth-Clinic-VBAC-Patient-Info-Booklet-with-BC-Data_web.pdf

 

 

How can I access maternity benefits?

 

Women with employment insurance can find information about applying for benefits on this website: http://www.servicecanada.gc.ca/eng/lifeevents/baby.shtml

 

If you work outside the home, you are encouraged to speak with your Human Resources department about the specifics of your maternity leave entitlements.

 

 

 

© 2014 by Kamloops Obstetrics and Gynecology