Who Provides Prenatal Care?Family DoctorObstetricianMidwife

Midwife vs. DoctorThings to consider:

Do you have a serious chronic medical condition

Do you have someone you already see you likeHow important to you is a more individual, less

routine approachWhere do you want to deliver

Do you have a serious chronic medical condition?High blood pressure, epilepsy, heart diease

ro diabetes High RiskPrevious pregnancy complications High

RiskTwins/ multiples High Risk

If you are any of the high risk you must see an obstetrician

Sometimes you can have both if they are willing to work together

How important to you is a more individual, less routine approach

Midwives take a holistic approachMidwives have more time to answer your

questionsCan help with birth plan and drug choicesInterview or look at both options before

making final choice

Where to deliver?Hospital: midwife or doctor

Epidural optionBirthing Centers: natural birth plans where

many people can be presentHome birth: midwife

Care ProvidersDepends on where you goYou may have the same midwife all the time

or be shared by a number of midwives You may have your family doctor up until

your third trimester and then be transferred to OB-GYN for the final weeks and delivery

May not deliver your baby as it depends on who is “on call”

What’s the popular choiceObstetricians are still the most common choice

in Canada and the USA.

Where do I go for prenatal Check-ups?Doctor’s office or clinicOnly need to go to hospital for ultrasounds

and special testsThese are sometimes done in clinics as well

First Prenatal AppointmentUsually around 8-12 weeks pregnantLots of questions to answer during this time

Date of last period: estimate due datePrevious miscarriages, abortions and birthsFamily history of disease/genetic conditionsYour lifestyle : alcohol consumption, smoke,

dietaryBirth options: where you want to have your

baby

First Prenatal VisitTake Blood PressureWeight Urine test for protein to check for Pre-

eclempsiaPre-eclampsia: high blood pressure, sudden

swelling Reduced blood to placenta Can be dangerous for both baby and mother

How often will are prenatal appointments?After Initial visit:

Every 4-6 weeks up to 30 weeks pregnantEvery 2-3 weeks after 30 weeksEvery 1-2 weeks after 36 weeks till labour

What happens during those other appointmentsMeasure the baby: done by feel of the

abdomen to see if growing properlyAfter 20 weeks they will measure belly with a

tape measure (pelvic bone to top of abdomen)Measure in cm which would be similar to

weeks of pregnancyBlood testsScreening testsDiagnostic testsUltrasounds

Ultrasounds

Done by ultrasound technicians and radiologist reads it

What is an ultrasound?High frequency sound waves through uterusBounce off the baby and return sounds that

show up as imagesShow shades of white, grey and black

White: hard tissues such as boneGrey: soft tissuesBlack: fluids

Why use an ultrasound?Check baby heartbeatMultiplesEctoptic pregnancyCause of any bleedingAccurately check due dateTest for issuesOrgan developmentAmount of amniotic fluid and placentaRate of growthSex of baby

Determining Sex of BabyFrom 18 weeks onNot always possible based on baby positionNot always 100 percent certain

When are they normally done?Weeks 10-13 to confirm datesWeeks 18-20 for development and sexAny pain or bleedingGrowth concerns during weeks 28-40Multiples during weeks 28-40

Other ultrasound infoMust have full bladder to push uterus outSometimes down vaginally In Ontario you are covered by OHIP for any

ultrasounds your doctor/ midwife prescribes These ultrasounds are 2D

What is a 3D and 4D ultrasoundHigher quality imagingCan be expensiveExample:

Complete 4D package $175 (approx. 30 minutes)

Just Gender $ 99

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