Preparing For Your Delivery

Prenatal Care

During this period you will be cared for by a family doctor, midwife and/or an Obstetrician. Your healthcare provider will review your family history and your personal medical history. They will talk to you about lifestyle habits such as smoking, use of alcohol and medications, nutrition and exercise. Any necessary physical examinations will be performed and prenatal testing will be completed.

Prenatal Appointments

You can expect to see your care provider:

• If concerns arise during your pregnancy, you and your baby may need to be assessed more frequently.
• If you or your baby requires more surveillance, you may be seen in the Fetal Medicine Clinic instead of your care provider’s office.
• Your healthcare provider will organize routine prenatal laboratory tests for you and any other tests as necessary.

We encourage you to make notes and write down questions so that you can discuss them with your healthcare provider or healthcare team in order to make the best decisions for your care.

Prenatal Tests

Ultrasounds

Pregnant persons may routinely have two ultrasounds during their pregnancy.

• Dating ultrasound at 11-14 weeks
• Anatomic ultrasound between 18-20 weeks

Most low risk pregnancies will not need further ultrasounds. However, your healthcare provider may order additional ultrasounds during your pregnancy if additional assessments are needed.

Ultrasound(s) provide important information related to your pregnancy, such as:

• The number of babies.
• The gestational age of the baby.
• The growth and development of the baby.
• The location of the placenta.
• The position the baby is in.
• The amount of fluid around the baby.
• The baby’s movement and activity.

Glucose Testing

All pregnant persons will be offered blood glucose screening for Gestational Diabetes (GD) between 24 and 28 weeks of pregnancy. If you have risk factors for GD, you may be tested earlier in your pregnancy. If you have pre-existing diabetes, you will not need this testing.

GD is a type of diabetes that occurs during pregnancy. It happens when the hormones secreted by the placenta make it harder for your body to break down carbohydrates (sugars).

Untreated GD increases the likelihood of having a large baby, and is associated with birth complications as well as health risks for the newborn (e.g., preeclampsia, shoulder dystocia). Untreated GD also increases the risk of stillbirth late in pregnancy (36-40 weeks).

Treatment of GD starts with controlling the amount and type of carbohydrates (sugar) in your diet, as well as increasing exercise. You may also need oral medications or insulin injections to keep your blood sugar normal. Your healthcare provider may refer you for additional support or education.

Most who are treated GD have normal deliveries and healthy children.

Group B Streptococcus (GBS)

Group B Streptococcus (GBS) is a type of bacteria that is normally found in the birth canal in up to 30% of pregnant persons. Although it is a normal bacterium, persons with GBS can pass it to their baby during labour and birth. Most babies who are exposed to this GBS bacteria during labour do not become sick. However, some may become very ill.

If you have GBS, treatment with antibiotics during labour may help prevent infection in the baby. As such, it is recommended that all pregnant persons are tested for GBS bacteria between 35 and 37 weeks of pregnancy.

Your healthcare provider will provide you with instructions on how to do the vagina and rectal swab yourself around your 35 or 36 week prenatal appointment.

Preparing For Your Delivery

Register at the Hospital

You will need to register for your birth at the hospital by completing the In-patient Registration Form found in the envelope given to you by your healthcare provider.

Please complete both sides as soon as possible and return it to your healthcare provider’s office.
This information will be sent to the hospital to register you for your baby’s birth.

Please ensure that the form is complete. Missing information will cause a delay in your admission as we require this before you receive care.

Accommodations

Every family will give birth in a private room, at no additional cost. If you have a caesarean section, you will deliver in an operating room, then spend time post operatively in a recovery room with your baby.

After the delivery, you will be monitored in your birthing room for approximately 1 to 2 hours. You will then be transferred to the postpartum unit. Three kinds of rooms that are available on the postpartum unit: private, semi-private, or ward rooms. Low-risk midwifery clients have the option of going home from the birthing unit 3-4 hours after birth.

You will be asked for your choice of room accommodation when you are admitted to hospital. Your room will be assigned at the time of delivery, and will be based on your request and availability. We try our best to provide you with the accommodation of your choice, but this is not always possible.

Birth Plans

You may wish to make a birth plan. Birth plans can help you feel comfortable with what may occur during your labour.

Creating your birth plan can also help you learn about your options for care. They can encourage communication between you and your healthcare providers. Share your birth plan with your healthcare team and use it as a starting off point for discussion about your labour care.

Note: It is not always possible to follow a birth plan exactly, as unpredictable situations may occur.

Childbirth Education

At THP we believe that knowledge is the key to making informed decisions.
You can get prenatal education through your healthcare providers, reading, accessing community resources, and taking formal prenatal classes.

Childbirth classes are available from public health and private organization. Prices and formats will vary.

The following are some reliable resources for your prenatal education:

Peel Public Health – Health during Pregnancy Prenatal programs:
https://www.peelregion.ca/health/family-health/during-pregnancy/classes-programs

Best Start Prenatal Education Program:
http://en.beststart.org/resources-and-research/prenatal-education-program

Prenatal Education – Government of Ontario:
https://www.ontarioprenataleducation.ca/labour-support/

OMama – Labour & Birth:
https://www.omama.com/en/labour-and-birth.asp

BridgeWay Family Centre
https://bridgewaycentre.ca/

Umbilical Cord Blood Banking

Umbilical cord blood contains stem cells which can develop into all the different cells in the body. Umbilical cord blood has been used to successfully treat various paediatric, genetic, hematological, and cancer disorders in the children they have been collected from, as well as their family members.

Your family may wish to save or donate umbilical cord blood. We encourage you to do your research and finalize plans early in your pregnancy to prepare for an umbilical cord blood collection. There are several private umbilical cord blood banking programs available in Ontario that you can use - most are privately run and for profit.

The umbilical cord blood banking program you choose will charge you directly to store the umbilical cord blood. Please inquire about additional costs with the company that you choose. There is also an additional one-time charge by the hospital, as the collection of the umbilical cord blood specimen is not an insured service under OHIP.

Please discuss the collection of umbilical cord blood with your delivering healthcare provider, as they will collect the blood from the umbilical cord after birth. It will be your responsibility to ensure that the umbilical cord blood collection kit is brought to the hospital at time of delivery.

Note: It is not always possible to collect enough umbilical cord blood for banking. In the event of an emergency, it may not be possible to collect the specimen.

What should I arrange before my admission to hospital?

Before you come to the hospital for the birth of your baby it is important that you:

• Know where you are delivering your baby. Your healthcare provider will send copies of your prenatal record to the hospital and will tell you which hospital site to go to.
• Plan your transportation in advance.
  
• If you have other children, please plan and arrange childcare in advance. THP does not offer childcare services and staff are not responsible for supervising your children.

What should I bring to the hospital?

For the birth, be sure to bring:

• Private insurance information (if applicable)
• Ontario Health card
• Lip gloss or lip balm
• Mouthwash, toothpaste, toothbrush, comb
• Soap, shampoo, lotions
• Slippers and socks
• Watch, pen, and paper
• Any medicines you are taking, in their original containers (if applicable)
• Glasses (if applicable)
• Pillow for breastfeeding with coloured pillow cases (if desired)
  

For yourself, after the birth:

• 2 to 3 nightgowns or pairs of pyjamas (front opening for breastfeeding)
• Housecoat or lounge wear
• Tissues, one package of sanitary maternity pads and underwear
• Nursing bras, nursing pads
• Fresh set of clothes to go home in
  
• Underwear (3 or 4)
  
• Sanitary pads (1 package)​
  

For your baby:

• Diapers (5 to 10 per day, newborn or size 1)
• Baby wipes
• Baby pyjamas and diaper shirts (3 to 4)
• Clothing to take the baby home in such as a gown, baby pyjamas, blanket or sweater and knitted hat, if the weather is cold
• A CSA (Canadian Safety Association)-approved car seat. By Ontario law, your baby must always ride in an approved infant car seat. Please put the seat together before coming to the hospital and check the expiry date on the car seat.
  

*** We recommend that you leave your bags in the car while you are being assessed in LAU. They can be brought to your room once you are admitted.