Connecting Pregnancy Group Prenatal Care

Welcome to Connecting Pregnancy! Connecting Pregnancy offers group prenatal care and education at one convenient time and location. This program not only offers peer support and a place for you to talk about your concerns about your pregnancy but it also provides an opportunity for you to be active in your care. The overall goal is to help you feel a greater sense of empowerment and confidence in yourself and your ability to care for your new baby while meeting a new community of moms and families. Every session includes:

A “mom and baby check": blood pressure, weight, and private time with your care provider.

Time to talk about pregnancy with other women and families Time to socialize with other members of the group

You meet 8 times throughout your pregnancy and again for a reunion class. Since you know well ahead of time when your group meets, you can plan your work or school schedule and child care needs. Please arrive on time for all sessions so you can get the most out of them. There is lots of useful information in this binder intended to complement the sessions and the book Baby's Best Chance (See Useful Websites). The binder format allows you to add to this book as you find more useful information throughout your pregnancy. Usually women do not feel the need to take other prenatal classes and no other medical appointments are necessary unless we have discussed this specifically with you. If you have a problem between the group session you may call for an appointment with your original Family Practice Maternity Service Doctor or contact us if is is an emergency at 604-875-2161. Remember that these sessions are designed for you so please do let us know if there is anything we can do to make your experience even better! .

Connecting Pregnancy Group Guidelines

Group is a place to: Ask questions Give answers Express your worries and fears Share your joys Learn more about yourself Make new friends

Because people will be sharing some very personal issues and to make group sessions fun and productive – we’d like you to follow these few guidelines: Whatever is said in this room- stays in this room.

Only one person talks at a time. Respect others and listen to what they are

saying. Try not to interrupt.

Try really hard to be on time for group. Group starts and ends on time.

Bring this Notebook to every session. We will use materials from the book each time.

Turn off all cell phones and pagers while in the group space.

Welcome to the Family Practice Maternity Service

Who We Are

• We are a group of family doctors with a special interest in pregnancy and birth. Each member of this group has

been carefully chosen because they are highly experienced, caring, and share the same philosophy

Our Phi losophy

• We believe that pregnancy and birth are healthy, natural phases of life.

• We take a holistic approach, valuing emotional, social and spiritual health as well as physical health and safety

for both mother and baby. The whole family is important and their participation is welcome, according to the

mother’s wishes.

• We believe in a woman-centered philosophy of care. We work in partnership with the woman and her family

giving support, information, and offering choices.

• We prefer to minimize the use of technology and medications in birth, offering physical and emotional support

as a first choice, because this usually results in fewer complications for the mother and baby. However, every

person and every birth are different and we respect your choices.

Avai labi l i ty and On-cal l

• You will have one primary doctor who will see you for most of your pregnancy.

• For labour and birth, and for emergencies related to the pregnancy, a doctor is always available 24 hours a day.

The on-call doctor can be reached through the hospital paging at (604) 875 2161.

• You will have an opportunity to meet the other doctors at a “Meet The Doctors Night” evening.

Communicat ion and Trust

• We feel the relationship between you and your doctor must be based on communication and mutual trust. We

encourage you to ask questions and share your concerns so that we can help you have the kind of birth you

hope for.

Welcome to the Family Practice Maternity Service

Structure o f Care

• Your first visit in early pregnancy is a longer visit where we discuss our philosophy of care, your preferences,

and your health history. Your second visit includes a complete physical examination, and may include a pap

test and discussion of genetic screening options. We normally send you for a dating ultrasound in early

pregnancy and a detailed ultrasound at about 18-20 weeks. It is at this later ultrasound when you can find out

your baby’s gender, if you wish.

• Later, you visit once a month where we check weight, blood pressure, growth and position of the baby, and

listen to the baby’s heartbeat. Various topics related to that stage of the pregnancy are discussed and there is

time for questions. After 30 weeks, you visit every 2 weeks, and after 36 weeks, you visit every 1-2 weeks.

• Your partner, labour support people, or other children are welcome to attend at all visits.

• If you do not have a family doctor, it is a good idea to start looking for a family doctor for you and your new

baby while you are pregnant. We can assist you in this process.

Labour and Bir th

• We see you frequently during labour and will generally be present continuously from when you are pushing

until approximately one hour after the baby is born.

• You will be visited daily in hospital by a doctor until you go home.

• After discharge from the hospital, you may have postpartum care until 6 weeks with one of our doctors. After

that time, you will return to your regular family doctor’s office with the baby to resume on-going care with

them.

Labour suppor t

• We welcome working with labour support people, either a doula, or anyone of your choosing whom you wish

to have present at the birth. Siblings of the baby are also welcome – discuss this with your doctor.

Contact information: Tamara Guerra

(administrative assistant)

Tel: 604-875-3436

E-mail: info@birthdocs.ca

Ambulatory Clinic

Tel: 604-875-2160

24-hour Emergency and Paging

Tel: 604-875-2161

www.birthdocs.ca

www.facebook.com/birthdocs

What to do for labour, birth and emergencies

Call 604-875-2161

A doctor is always available everyday, 24 hours a day. Ask for the doctor on call for your group. You are assigned to either FPMS Group #1 or Group #2 depending upon the first doctor you saw in your pregnancy. If you are not sure which group to call, please ask us and we will clarify this for you.

Do not hesitate to call your doctor if you experience any of the following:

Regular contractions, 5 minutes apart or contractions that are very painful change in the baby’s movement, especially if the baby is unusually quiet

Fluid gushes form your vagina that you think isn’t urine or normal vaginal discharge

Vomiting and /or diarrhea for more than 24 hours Fever of more than 38°C that doesn‘t go away within a few hours of taking

acetaminophen, which is also called Tylenol Pain, burning when you pee Bad headaches, seeing spots, double vision or other vision problems Sudden swelling in your face, eyes, hands, & feet A desire to bear down or push the baby out Severe cramps or regular contractions more than 3 weeks before your due date Unusual environmental exposure to chemicals, toxic fumes, or smoke from fires Domestic violence or sexual assault Any motor vehicle accident A fall, especially if you hit your tummy Breathing problems, especially if you are asthmatic or at increased risk for

blood clots Shortness of breath with chest pain Heavy, red, vaginal bleeding Fainting or extreme dizziness If you are worried about any symptoms you are having If you have been admitted to ANY hospital or are in the BC Women’s Hospital assessment room please have your doctor paged.

Useful Phone Numbers

24 Hour Family Practice Maternity Service Emergency Phone Number 604-875-2161 Family Practice Maternity Service Program Assistant 604-875-3436 BC Women’s Hospital: 604-875-2424

Ambulatory Clinic 604-875-2160 Physiotherapy 604-875-2126 Dieticians 604-875-2330 Breastfeeding Clinic 604-875-2282

BCAA ICBC Car seat Info Line 1-877-247-5551

Breastfeeding (La Leche League) 604-520-4623

Health link 811

Community Health Centres:

• CHA1 (3 Bridges) 1292 Hornby St. 604-736-9844

• CHA2 (North) 1651 Commercial Dr. 604-253-3575

• CHA3 (Evergreen) 3425 Crowley Dr. 604-872-2511

• CHA4 (Pacific Spirit) 2110 West 43rd Ave. 604-261-6366

• CHA5 (Raven Song) 2450 Ontario St. 604-709-6400

• CHA6 (South) 6405 Knight St. 604-321-6151

Healthiest Babies Possible 604-877-4673

Mother Risk (which medications are safe in pregnacy? ) 1-416-813-6780

Nausea & Vomiting in Pregnancy Helpline (or call us on call) 1-800-436-8477

Newborn Hotline 604-737-3737

Options for Sexual Health 604-731-7803

Pacific Post Partum Support Society 604-255-7999

Poison Control 604-682-5050

Program for Victims of Domestic Violence 604-875-4924

Connecting Pregnancy

Useful Websites

Family Practice Maternity Service and BC Women’s Hospital Birthdocs website www.birthdocs.ca Facebook www.facebook.com/birthdocs BC Women’s Hospital & Health Centre www.bcwomens.ca Anti-Violence Vancouver Rape Relief and Women’s Shelter www.rapereliefshelter.bc.ca/ Battered Women’s Support Services www.bwss.org/ Women Against Violence Against Women www.wavaw.ca/ Baby’s Best Chance Baby’s Best Chance www.bestchance.gov.bc.ca Breastfeeding BC Lactation Consultants Association http://www.bclca.ca/ Breastfeeding Online www.breastfeedingonline.com Dr. Jack Newman www.breastfeedinginc.ca KellyMom www.kellymom.com La Leche League International www.lalecheleague.org Cesarean Section, Breech Birth and Vaginal Birth after Cesarean (VBAC) Best Birth Clinic and Power to Push campaign www.powertopush.ca Optimal Birth BC http://optimalbirthbc.ca/ Vaginal Birth-After Cesarean (VBAC) www.vbac.com Child Health Canadian Institute of Child Health www.cich.ca Canadian Pediatric Society www.cps.ca Car Seats http://www.bcaaroadsafety.com /child-passenger-safety/ Circumcision http://www.caringforkids.cps.ca /handouts/circumcision

Doulas Doula Services on the Lower Mainland www.bcdoulas.org Doulas of North America www.dona.org Health and Nutrition Canada’s Food Guide http://www.hc-sc.gc.ca/fn-an/ food-guide-aliment/index-eng.php Health Weights when planning for pregnancy, during pregnancy or after birth www.healthypregnancybc.ca Health Link BC http://www.healthlinkbc.ca/ Health Canada – prenatal nutrition http://www.hc-sc.gc.ca/fn-an/ nutrition/prenatal/index-eng.php Public Health Agency of Canada (Includes information about healthy pregnancies, nutrition for adults and children, immunization, safety) www.publichealth.gc.ca Medication, Smoking and Drug Exposure in Pregnancy BC Smoking Cessation Program http://www.health.gov.bc.ca/ pharmacare/stop-smoking/ Motherisk www.motherisk.org Pregnancy-Related Issues in the Management of Addictions http://www.addictionpregnancy.ca/ QuitNow http://www.quitnow.ca/ Mental Health Reproductive Mental Health Services http://www.bcmhas.ca/ ProgramsServices/ ChildYouthMentalHealth/ ProgramsServ ices/ Reproductive+Mental+Health/ default.htm Pacifice Postpartum Support Society http://www.postpartum.org/ Post-Partum Depression Self-Care Manual www.bcwomens.ca/Services/

HealthServices/ ReproductiveMentalHealth/ SelfCareGuide.litm

Postpartum Support International http://postpartum.net/ Sexuality and Contraception Options for Sexual Health www.optionsforsexualhealth.org Sexuality and U www.sexualityandu.ca Miscellaneous websites HIV / AIDS in Pregnancy www.cdnaids.ca Lamaze International www.lamaze.org Society of Obstetricians & Gynecologists of Canada www.sogc.org Vancouver Coastal Health www.vch.ca/community/index.htm Vancouver Dad www.vancouverdad.com Vancouver Sun Parenting www.canada.com/vancouversun/ features/parenting/index.html Women’s Health Living www.health.gov.bc.ca/ women-and-children

Book List

Pregnancy and Birth From the Hips by Rebecca Odes & Ceridwen Morris. Birthing From Within, Pam England & Rob Horowitz The Birth Partner: Everything you need to know to help a woman through childbirth. (2nd

ed.)Penny Simkin Ina May’s Guide to Childbirth, Ina May Gaskin Natural Pregnancy Book: Herbs, nutrition and other holistic choices, Ina May Gaskin &

Aviva Jill Romm Pregnancy, Childbirth & the Newborn,(rev & updated), Penny Simkin, Janet Whalley &

Ann Keppler Rediscovering Birth, Sheila Kitzinger Thinking Woman’s Guide to a Better Birth, Henci Goer

Breastfeeding

The American Academy of Pediatrics New Mother’s Guide to Breastfeeding, American Academy Of Pediatrics, Joan Younger Meek M.D., Winnie Yu

Breastfeeding: How to Breastfeed Your Baby, Suzanne Arms, Chloe Fisher, Mary Renfrew The Breastfeeding Book: Everything You Need to Know About Nursing Your Child from

Birth Through Weaning, William Sears M.D. Ina May’s Guide to Breastfeeding, Ina May Gaskin Dr. Jack Newman’s Guide to Breastfeeding, Jack Newman and Teresa Pitman The Womanly Art of Breastfeeeding, La Leche League International

After Your Baby is Born

1, 2, 3 Magic: Effective discipline for children 2-12, Thomas W. Phelan The Baby Book : Everything You Need to Know About Your Baby From Birth to Age Two,

William Sears M.D. and Martha Sears R.N. The Birth of a Mother: How the Motherhood Experience Changes You Forever, Daniel N.

Stern, Nadia Bruschweiler-Stern, and Alison Freeland Canada’s Baby Care Book: A Complete Guide from Birth to 12-Months Old, Jeremy

Friedman, Norman Saunders The Canadian Paediatric Society Guide to Caring for Your Child from Birth to Age Five,

Diane Sacks M.D. CMA Complete book of Mother and Baby Care, Lewis Younger Children The Challenge, Rudolf Dreikurs Dr. Spock’s The First Two Years: The Emotional and Physical Needs of Children from

Birth to Age 2, Benjamin, M.D. Spock and Martine T. Stein Your Baby and Child: from Birth to Age Five (Revised Edition), Penelope Leach The Happiest Baby on the Block: the New Way to Calm Crying and Help Your Newborn

Baby Sleep Longer, Harvey MP Karp Healthy Sleep Habits, Happy Child, Marc Weissbluth, MD Hidden Feelings of Motherhood: Coping with stress, depression and burnout, Kathleen

Kendall-Tackett Mother of All Baby Books, Ann Douglas The No-Cry Sleep Solution : Gentle Ways to Help Your Baby Sleep Through the Night,

Elizabeth Pantley

Secrets of the Baby Whisperer: How to Calm, Connect, and Communicate With Your Baby, Tracy Hogg and Melinda Blau

What to Expect the First Year, Arlene Eisenberg, Sandee Hathaway, and Heidi Murkoff The Wonder Weeks, Hetty van der Rijt, Ph.D. and Frans Plooij, Ph.D. Year after childbirth: Surviving and enjoying the first year of motherhood, Sheila Kitzinger

HOMAGE TO CENTERING PREGNANCY®

Group Prenatal care is certainly not unique to BC Women’s Hospital. Many institutions offer similar models of shared pregnancy care and the Connecting Pregnancy program hosted by The Family Practice Maternity Service at BCWH is one of several offered across Canada. In the United States, a similar program that has been developed is called Centering Pregnancy.

All of the varied and different Group Prenatal Programs share many common features, goals and ethics. Each value a woman’s own inner resources, knowledge about herself and her body, her unique life circumstances and her autonomy. Each program also values the power of learning from each other and the insights that shared knowledge and wisdom bring to women.

Interestingly, the positive feedback that we receive from women in the Connecting Pregnancy groups at BCWH, reflects the research that has been done about this type of shared group prenatal care. In the medical literature, women rate their satisfaction with this type of shared care higher than traditional on-on-one prenatal care, there is a higher rate of breastfeeding, a lower rate of preterm delivery and a higher rate of parental readiness for birth and baby care.

The Family Practice Maternity Service physicians recognize that for many women, the idea of participating in a Connecting Pregnancy group might not be “what they were expecting”, compared with their friends and their family members. It’s innovative and it’s relatively new in Canada. At BC Women’s Hospital, Connecting Pregnancy forms part of our wider vision of promoting excellence in women’s health and building healthy families in strong communities.

For more information on Centering Pregnancy® check out their website at http://www.centeringhealthcare.org/

Phone card or coins. Extra set of clothes and shoes, for you and children. Toys for children. Medications and Prescriptions. Extra key for house, car and office. Phone numbers of emergency shelters.

Pack photocopies or originals of the following: Birth certificates Social Insurance Numbers Driver’s license & registration Care Cards Passports Address Book Divorce paper or separation agreement Custody Agreements Insurance papers Lease/Mortgage papers Copy of restraining order or Peace bond Bank Book School & vaccination records

Before violence occurs again, think about: Going to a safe place, trusted friend,

Emergency Room, family or public place. Locating all possible ways to leave. Leaving and taking your children with you. Staying out of rooms with weapons. Getting your own bank account. Keeping some money outside the home so

that you will have it if you leave. Deciding on a code word to signal a friend

that you are leaving and need support.

Get a bag ready with the following things and leave it in a safe place

(i.e. neighbour, friend, work)

Leaving Domestic Violence: A Safety Planning Checklist

If you need a safe place the Emergency Departments are open 24 hours a day, 7 days a week.

Help is Available Don’t hesitate to call 911

Before violence occurs, leave if possible and go to a safe place.

For more copies, go online at http://vch.eduhealth.ca oremail phem@vch.ca and quote Catalogue No. CE.350.L489

© Vancouver Coastal Health, November 2010

The information in this document is intended solely for theperson to whom it was given by the health care team.

www.vch.ca

Domestic Violence Resource Numbers:

You have the right to be safe! If you are experiencing domestic

violence, it is important to plan for your safety and the safety of your

family. Prepare to leave before the threat of violence gets worse.

The Crisis Centre 604-872-3311 BC Coalition to Eliminate

Abuse of Seniors 604-437-1940 Kid's Help Phone 1-800-668-6868 Mental Health

Emergency Services 604-874-7307 Ministry of Children & Family

Development After Hours 604-660-4927 Multicultural Family Support

Services Society 604-436-1025 Provincial Gay and Lesbian

Helpline 1-800-566-1170 Re:ACT Adult Abuse & Neglect

Response Resource 604-984-5958 Adult Protection Domestic Violence Social Worker VGH 604-875-5458