Regular prenatal care is an important step towards having a healthy baby. During prenatal appointments, your health and the health of your growing baby are followed closely.

Prenatal health care can be provided by:

Family doctor – provides care for all family members including new babies. Some family doctors deliver babies while others may refer you to an obstetrician or midwife.

Nurse Practitioner – provides prenatal care for you and care for your new baby but will refer you to a doctor for delivery.

Obstetrician – a doctor who provides care to women during pregnancy, birth and up to six weeks after birth. A referral from a family doctor is required for care.

Midwife – a health care professional who provides care for women during pregnancy, birth and to both mother and baby up to six weeks after birth.

For midwifery care in Renfrew County and District contact:

 Madawaska Valley Midwives

Ottawa Valley Midwives

The Midwifery Collective of Ottawa

If you prefer midwifery care, it is recommended you call a midwife early in your pregnancy as they often have limited availability.

Several resources are available to families seeking a doctor in Renfrew County and District:

• Find a doctor using Health Care Connect.
• Dial 211 or 1-877-330-3213 (toll free) and ask about doctors accepting new patients in your community.
• Contact your local hospital for a list of doctors accepting new patients.

There are five hospitals serving Renfrew County and District:

• Pembroke Regional Hospital
• Renfrew Victoria Hospital
• St. Francis Memorial Hospital in Barry’s Bay
• Deep River and District Hospital
• The Arnprior and District Memorial Hospital
• Pembroke Regional Hospital(PRH) provides labour and delivery services. Click here for a virtual tour of the PRH’s Maternal Child Care Unit.

Doulas provide physical and emotional support to families during pregnancy, birth and postpartum. To learn more or to find a doula, contact Renfrew County Doulas or ontariodoulas.org.

For more information on other prenatal programs and services in Renfrew County and District, please contact Renfrew County and District Health Unit’s Family Health Intake Line at 613-735-9774 (direct line), 1-800-267-1097 Ext. 589 (toll-free) or email familyhealth@rcdhu.com.

What to Expect During Prenatal Appointments
During your pregnancy, you will see your healthcare provider:
• every month during the first 30 weeks of pregnancy
• every two weeks from week 30-36
• every week (or more frequently) from week 36 until childbirth

During your first prenatal check-up, your healthcare provider will:
• take your medical history;
• discuss your medication use; and
• offer advice about having a healthy pregnancy.

At each visit, your healthcare provider will:
• test your urine;
• check your blood pressure and weight; and
• check your baby’s growth.

During regular visits, your healthcare provider will discuss any prenatal tests that may be required or recommended. Be sure to ask your health care provider any questions you have about your health, your pregnancy, or your baby.

Preparing for Prenatal Appointments
• Write down your questions before your appointment.
• If possible, bring a support person to appointments.
• At the beginning of your appointment, let your health care provider know that you have a few questions.
• Summarize what you understand from the conversation at the end of the appointment.
• If necessary, request to have new information written down or emailed to you.

A birth plan is a tool to help communicate your preferences to your health care provider(s). It is best to keep your birth plan realistic, flexible, and simple. Many hospitals offer birth plan templates online, for example the Society of Obstetricians and Gynecologists’ of Canada.

Prenatal tests are offered to all pregnant women to help ensure the healthiest pregnancy possible. It’s important to be well informed about the prenatal tests you are offered in order to make the best decisions during your pregnancy.

Screening Tests: 

Description:

• Offered to all women to check general health and baby’s growth and
  development.
• Assess your baby and its position in your uterus.
• Assess the possibility that your baby may have certain
  conditions.
• Provide information to help your doctor know if more diagnostic testing is recommended

Examples:

• Blood tests, e.g., integrated prenatal screening (IPS)
• Ultrasound
• Swab for Group B Strep

Diagnostic Tests:

Description:

• Determine if a specific condition is present.
•  May involve some risk.
• Your doctor should explain the risks and benefits of any diagnostic test to help you decide if you want to have the test

Example:

• Amniocentesis

Multiple Births refer to the birth of twins or a greater number (triplets, quadruplets).
A multiple-birth pregnancy has unique needs. Linking with other families of multiples can help build your knowledge and confidence.

To help keep you and your baby healthy, your health care provider will ask you about your immunization history and may suggest immunizations during pregnancy. Immunizations not only protect you from getting an illness, but also protect your baby during pregnancy.

Infections can include:
Rubella (German measles): can cause serious birth defects if you are exposed early in pregnancy. Most women have either been immunized against rubella or have antibodies to protect against it. A vaccination is available but should not be given to you during pregnancy. It is best to receive this vaccine at least three months before you become pregnant or after the delivery of your baby.

Group B Streptococcus (GBS): is a bacteria that many women carry in their bodies, commonly in their vagina or rectum and sometimes in their bladder, kidneys, or uterus. You can have this bacteria and have no symptoms. But if left untreated, GBS could pass to your unborn baby and cause serious illness. To screen for GBS, health care providers swab your vagina and rectum, and/or take a urine sample at around the 36th week of pregnancy. If the screening is positive, you will be treated with antibiotics during labour.

Toxoplasmosis: is an infection caused by a common parasite found in raw or undercooked meat, cat feces and garden soil. To prevent this infection, cook meat well, wash your hands and cooking utensils well after handling raw meat, have someone else clean the cat litter box, or wear gloves and wash well afterwards if you must clean it, and use garden gloves when working out in the garden.

Listeriosis: is a rare but serious disease caused by a type of bacteria (Listeria) often found in food and elsewhere in nature. Pregnant women, especially those in the third trimester, are particularly at risk. If a pregnant woman develops listeriosis during the first three months of her pregnancy, she may miscarry. Listeriosis later on in the pregnancy can result in a stillbirth, premature birth, or the birth of an acutely ill child. Some foods are more likely to carry Listeria and should be avoided during pregnancy, including raw or contaminated milk, soft cheeses, and ready-to-eat meats such as hot dogs, pâté, and deli meats. Proper hygiene and safe food handling and preparation practices are important in preventing the spread of all foodborne illnesses, including listeriosis.

Fifth Disease: is sometimes called “slapped cheek” syndrome because of the red rash it causes. It is an infection of the airway and lungs.ParvovirusB19 causes fifth disease. It’s most common in late winter to early spring. Fifth disease can spread from a pregnant woman to her unborn child. There is a very small risk that an unborn child can develop anemia before birth. If you are pregnant, you can have a blood test done to determine whether you had fifth disease in the past. If you did, you would be immune to it now. There is no vaccine to prevent the infection and no medication to treat it. The best way to prevent the spread of any infection is to wash your hands often. You should call your health care provider if your child becomes ill with fifth disease, and you are pregnant.

HIV&AIDS: causes infections that can harm a person’s immune system. As people become more ill with HIV infections, they are diagnosed with Acquired Immune Deficiency Syndrome (AIDS), a very serious, life-threatening illness. HIV testing is voluntary and highly recommended when pregnant. If infected, you can pass the virus on to your baby during pregnancy, delivery, or while breastfeeding. If you are found to be HIV positive, there are a number of ways that the risk of giving the infection to your baby can be reduced.

Sexually Transmitted Infections: routinely screened for during pregnancy. It is very important that you continue to practice safer sex and to tell your doctor/midwife if you think that you may have been exposed to an STI.

Pregnancy is a time of enormous change. The hormonal changes within your body during pregnancy can trigger different emotions. Emotions such as joy, excitement, fear, and nervousness are all common during pregnancy. Your emotions may be related to the anticipation of parenthood and your changing roles and priorities. Dads-to-be often experience similar kinds of emotional changes. It is also normal for your emotions to be affected by your body’s changing hormonal levels after giving birth. One moment you may be incredibly happy and the next you find yourself in tears. You may find it difficult to cope with these sudden changes and new stresses in your life but remember to give yourself time to recover and to adjust to your new role.

Postpartum Emotions
4 in 5 new mothers will experience the postpartum blues. The blues usually begin on the third or fourth day after the birth of your baby. You may feel sad and tearful, irritable, exhausted, or overwhelmed. You may have changes in your sleeping or eating patterns. These signs are often temporary, disappearing in about one to two weeks
without treatment. However, the symptoms can last longer and develop into a more serious condition.

1 in 5 mothers will suffer from some degree of postpartum depression and anxiety. Postpartum Mood Disorders (PPMD) can affect you during the first year after giving birth. The cause of PPMD is not fully understood – hormonal changes, lack of support, stress, and the demands of the new role as a mom may all have an impact. Consult with your family doctor/midwife if you are experiencing any symptoms.

Taking care of yourself

It is important to take care of yourself, especially when you are pregnant or have had a baby. The following are things you can do to take care of yourself:
• Eat well, exercise and get sleep.
• Take time to relax, reduce your stress.
• Do something you like to do.
• See your health care provider regularly and discuss any symptoms and concerns.
• Accept help from family and friends; do not try to do everything on your own.
• Build a “circle of support” (support network) of family, friends, neighbors, co-workers, and others.
• Attend parenting programs before and after the birth of your baby.
• Know the symptoms of PPMD and get help if needed.
• You may also find a Postpartum Depression Support Group helpful.

How your partner, family and friends can help:
• Ask you how they can help
• Listen and provide support
• Allow you to get some sleep
• Make sure you eat well and get some physical activity
• Help with housework and meals (or arrange for help).
• Take some time for themselves as well
• Find someone they can talk to
• Encourage you to seek professional help
• Educate themselves about mental health

Coping After Baby: A Cognitive Behavioral Therapy (CBT)-based Workshop

Pregnant and new birthing parents with babies up to 18 months of age, who have been experiencing feelings of sadness, worry, or anger, may be eligible to participate in a free, one-day, virtual CBT-based workshop that is group-structured and lead by Public Health Nurses (PHNs). During this workshop you will explore practical strategies to manage symptoms of depression and anxiety by recognizing and gaining control over thoughts, feelings, and behaviours.

For more information, available dates, and to determine eligibility, please contact RCDHU’s Family Health intake by:

phone: 613-735-9774 (direct line) OR 1-800-267-1097 Ext. 589 (toll free), or
email: familyhealth@rcdhu.com.

Loss of a baby can occur at any time in pregnancy and for a wide variety of reasons. For many people, loss happens due to miscarriage before they had even announced the pregnancy, for others it happens later in the pregnancy, or at delivery. Loss at any time can cause a variety of emotions for you and your partner. It is important to talk about the loss, and about your feelings, with people you trust.

Does your partner…

• Yell at you?
• Call you names?
• Blame you for being pregnant?
• Break your things?
• Hurt or kill your pets?
• Threaten to hurt you?
• Always need to be in charge?
• Keep you from seeing friends and family?
• Keep you from seeing your health care provider?
• Control what or how much you eat?
• Control the money?
• Threaten to take the kids away?
• Hit or kick you?
• Hurt your breasts, belly or between your legs?
• Force you to have sex?

If you said yes to any of the above questions, you and your baby may be in danger. All kinds of abuse can hurt you.

Abuse during pregnancy can cause you to:
• Feel sad and alone
• Feel anxious
• Feel bad about yourself
• Have pain and injuries
• Turn to alcohol and drugs
• Not eat or sleep well
• Lose your baby

Abuse during pregnancy can cause your baby to:
• Be born too small
• Be born too early
• Be stillborn
• Have injuries or infections
• Have later health problems
• Be abused after birth

Abuse usually gets worse over time. It will not stop when your baby is born. There is support. You are not alone. You have the right to be safe. If you are being hurt, it is important to plan for your safety and the safety of your family. Even if you are unsure about leaving, there is help.

What you can do:
• Tell someone you trust about what is going on
• Find people to help: family, friends, a public health nurse, your doctor or midwife, a counsellor, your prenatal educator, a shelter for women
• Get services to develop a safety plan
• Get help
• Hide your internet use

Are you a family member neighbour, friend, co-worker? Here is how you can help.

Are YOU and your baby safe? For help call:
In an emergency call 911

Bernadette McCann House for Women

24HourCrisisLine:613-732-3131or1-800-267-4930 (toll free)
Text: 613-639-1233 (response time may vary)
Email: help@wsssbmh.org (response time may vary)

If you are being hurt, it is important to plan for your safety and the safety of your family.

Renfrew Victoria Hospital (RVH) – Regional Assault Care Program
1-800-363-7222 or 613-432-4851

Ligne de soutien pour femmes victimes de violence
1-877-femaide (366-2433)

Assaulted Women’s Helpline
1-866-863-0511, TTY# 1-866-863-7868, Mobile: #SAFE (#7233)
They offer help in 150 languages 24 hours a day, 7 days a week.

Renfrew County Virtual Triage and Assessment Centre (RC VTAC)
If you do not have a family physician or nurse practitioner or cannot access your regular primary care provider, call RC VTAC at: 1-844-727-6404 for support from medical receptionists, family physicians and community paramedics.

Health811
To connect with a registered nurse day or night for free, secure, and confidential health advice, call Health811 at: 811 or 1-866-797-0007 (toll free).