Pregnancy
We are happy to be a part of your care team during your pregnancy. We specialize in high-risk pregnancy consultations. If you have a low-risk pregnancy, we recommend our excellent family physician colleagues at Peace Arch Maternity Clinic or registered Midwives at Semiahmoo Bay Midwifery, for your prenatal care. We deliver babies at Peace Arch Hospital.
FAQs regarding your pregnancy
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Who should care for me during my pregnancy?
In our community, there are three main options for prenatal care: registered midwives, family physicians, and obstetricians. Our obstetricians work closely with the midwives and family physicians who care for patients at Peace Arch Hospital. If you have a low-risk pregnancy, a registered midwife may be an option for you. Registered midwives are trained to care for healthy, low-risk pregnancies. If you have complications in your pregnancy, an obstetrician will be consulted. Peace Arch Hospital has a well-established Maternity Clinic, a group of family physicians who provide prenatal care for patients in our community. Family physicians care for low-risk pregnancies. The Peace Arch Maternity Clinic (PAMC) is located in the hospital, in the Vine unit. You may be seen by one or more of the physicians during your pregnancy and will be seen at the hospital by the on-call physician for that group. If you have complications in your pregnancy, an obstetrician will be consulted. Obstetricians are trained in all aspects of prenatal care and delivery. An obstetrician can care for low- or high-risk pregnancies, but is well suited for patients who have health- or pregnancy-related risks that require attention. Examples may include a history of pregnancy complications, your own health problems or problems in this pregnancy. Your usual family physician will usually tell you if they prefer you to see an obstetrician. Obstetricians can preform operative deliveries such as forceps deliveries, when required, and can preform C-sections when needed. Our group provides support for the local PAMC and midwives when their patients become more high risk.
Who will deliver my baby?
At Peace Arch, most of the delivery providers work in groups. If you are being cared for by an obstetrician, you will generally be seen for office visits by your usual obstetrician. When you go to the hospital, however, whether for a pregnancy concern or in labour, you may be seen by any of the five obstetricians working in our group: Dr. Wilson, Dr. Fung, Dr. Tierney, Dr. Jackson, or Dr. Moodliar. There may also be a locum physician, who is also a trained obstetrician, working in our group at any given time. You may be attended by a male physician, and we can never guarantee that you will only have female care providers. You will not be seen by a trainee (such as a resident or medical student) without you giving your prior permission.
How often do I need to see the doctor?
On your first visit you will be seen by your obstetrician, who will confirm your pregnancy and perform an initial obstetrical assessment. You will generally see the same physician for most visits in the office, though you may meet one of the other members of the group. Our members work together as a team to ensure you recieve excellent care throughout your pregnancy. The guideline we use for scheduling prenatal visits is every four weeks for the first 28 weeks of pregnancy, every 2-3 weeks until 36 weeks, and weekly after 36 weeks. Some patients may need more frequent visits. Some pregnancies are more high risk than others. While an uncomplicated prenatal visit might take just a few short minutes, some visits may take much longer. If there is a change in the status of your pregnancy we will let you know. Please do not schedule yourself too tightly for visits, as that will cause unnecessary stress should yours or a previous visit take longer than expected. We ask that if you are unable to keep an appointment to please call to cancel or reschedule. Someone else will be able to use the time that we had reserved for you. If we need to reschedule your appointment due to an unexpected medical emergency, you will be contacted as soon as possible.
Can I reach you by telephone in an emergency?
If you have a routine question, it can often be addressed at your next prenatal visit. We encourage you to call and make an appointment for pregnancy concerns. Our front desk staff are not able to answer medical questions. If you have an urgent concern during business hours, please call our office first, unless it is an emergency, so we can be aware of your concern. If you have concerns after hours, you will be prompted to contact Peace Arch Hospital. If you have an emergency (bleeding, leaking amniotic fluid, baby is not moving, severe pain, etc.) you should immediately contact Peace Arch Hospital at (604) 535-4500. The Labour and Delivery ward is reached at extension 757273. Keep this number handy. The phone is answered 24 hours a day by a trained labour and delivery nurse who can contact the on-call doctor if needed. If you are less than 20 weeks pregnant, you will likely be directed to the Emergency department. If you are more than 20 weeks pregnant, you will likely be seen on the maternity ward, depending on your symptoms.
Should I take a prenatal class?
We believe that the more you learn about what is happening during pregnancy, birth and the months after delivery, the more fun you will have and the healthier you will be. There are many resources within Fraser Health to help you along the way. Fraser Health offers a “Best Beginnings” program. By registering your pregnancy, you will be connected to our services to support you along your pregnancy and after your baby is born. You will receive a prenatal package in the mail which includes helpful information about healthy food choices, childbirth classes, free prenatal breastfeeding classes and feeding and caring for a new baby. You will learn about community services and programs that are right for you. You may receive a call from a public health nurse to connect you for further support. You can also contact the local public health unit. The South Surrey/White Rock Public Health Unit is in the Vine unit at 15476 Vine Avenue. The phone number is (604) 542-4000 and they operate Monday to Friday from 8:30 am to 4:30 pm.
Should I plan to breastfeed?
Our goal is to support the patient in finding their own best plan for feeding their baby or babies. There are recognized health benefits to breastfeeding. However, every woman, baby and family has their own individual situation that may make breastfeeding impractical or even impossible. You may read posts on the web that suggest that breastfeeding is the only good way to feed a baby, and that women harm their babies by not breastfeeding. Those comments are untrue and lead to shame and disappointment if breastfeeding is not successful. Remember that the benefits of breastfeeding are minimal and never worth damage to the baby or your self esteem: “Baby friendly” should not come without “mommy friendly.” If you plan to breastfeed, studies have shown that learning about breastfeeding and preparing in advance of birth lead to longer and more successful breastfeeding. Luckily, there are many resources available to support your plan to breastfeed. Online, you can find your local “La Leche League”, an international organization to support breastfeeding mothers. Currently, they are not offered at the local health unit (please feel free to contact them and request that they resume) but they are offered at nearby health units. Whether you plan to breast, bottle or mix feed your newborn, please let us know your plans so we can support you along the way.
Should I get a doula?
What is the difference between a midwife and a doula?
A doula provides non-medical support to someone who is pregnant during labour and childbirth, and also during the postpartum period. Doulas provide emotional and physical support. They are not medical practitioners and are not there to make medical decisions for you. Family members may not be the right ones to offer that support in some cases. We encourage all our patients to have a labour support person (family member or doula) that they have chosen in advance of labour. Doulas charge between $300 and $1500 for a birth package. A registered midwife is a health care provider who provides medical care throughout pregnancy and labour and one-on-one support during your labour.
What tests do I need when I am pregnant?
As part of good prenatal care, our staff recommends certain tests to detect infections and other conditions in pregnancy. At your first visit, the following tests will probably be ordered: • CBC: This test will check for anemia and other factors. • Blood Type and Rh: A pregnant woman who is Rh-negative may need to receive a blood product called Anti-D Immune Globulin (RhoGAM). This prevents the breakdown of your baby’s red blood cells, a serious condition which causes hemolytic disease. • Antibody Screen: This test will check for red blood cell antibodies. • Syphilis: A sexually transmitted disease which can cause birth defects. • Hepatitis B: If the mother has this viral infection of the liver there is an increased chance that without treatment the baby will be infected. The baby can be treated at birth to prevent infection in most cases. • TSH: A screening test for thyroid disease. • Rubella (German Measles): An infection can lead to severe birth defects. If a woman is not immune, a vaccine can be given to her after the baby is born. • Pap Smear: A screening test for cervical cancer. This will usually be done if it is due or becomes due during the pregnancy. We will know whether or not you need a pap from the results of your last pap test. • Chlamydia and/or Gonorrhea: Screening cultures that can detect sexually transmitted diseases that can potentially be harmful to you and your baby if not treated. • Urinalysis: A screening test for urinary tract infection and culture. At a visit between 24-48 weeks, these tests might be ordered: • Glucose Screen: To check for diabetes in pregnancy. • Blood Count: To recheck for anemia. • Antibody Screen: If you are Rh-negative, administration of RhoGAM. At a visit between 35-37 weeks: • Group B Strep Culture: Group B Strep is a common bacteria found in many women’s vaginas that could infect the baby. The swab is taken by placing a swab at the opening of the vagina and onto your anus. This is not invasive and does not usually hurt.
Should I do the extra testing for genetic conditions such as Down Syndrome?
There are many options available for prenatal screening in BC. Some of these are covered by Medical Services Plan at no additional cost, and some are offered at additional cost. Standard prenatal testing can detect Trisomy 21, Trisomy 18 and offer early diagnosis of spina bifida. Additional testing can detect Trisomy 13 and some heart defects. Trisomy 21 is also called Down Syndrome and is the most common genetic defect in newborns. Babies with Trisomy 21 have developmental defects and sometimes heart and other defects. Trisomy 21 can sometimes be missed on standard ultrasound, which is why additional testing is offered. Trisomy 13 and 18 are much less common (1 in 7000 pregnancies) and nearly always cause major defects that can be seen on ultrasound at 19-20 weeks, but can be discovered earlier with prenatal testing. Trisomy 13 and 18 are not compatible with life. People with Trisomy 21, on the other hand, can lead long and full lives. The first decision to make is whether to have prenatal screening at all. The risk of your pregnancy being affected by Trisomy 21 depends on your age. If you have an IVF pregnancy with a donor egg, it depends on the age of the donor. The risk of Trisomy 21 at various ages is: Age 25: 1 in 1250 Age 35: 1 in 356 Age 40: 1 in 98 Age 45: 1 in 24 Prenatal screening tests can detect up to 99% of cases of Trisomy 21. The screening options available in BC are all a little different and include the SIPS, IPS, FTS, NIPT and amniocentesis.
When should I have an ultrasound? Are they safe for the baby?
Prenatal ultrasound tests use high frequency sound waves, inaudible to the human ear, that are transmitted through the abdomen via a device called a transducer to look at the inside of the abdomen. With prenatal ultrasound, the echoes are recorded and transformed into video or photographic images of your baby. Studies have shown that ultrasound is not hazardous. There are no harmful side effects to you or your baby. In addition, ultrasound does not use radiation, as X-ray tests do. The ultrasound can be used during pregnancy to show images of the baby, amniotic sac, placenta and ovaries. Major anatomical abnormalities or birth defects are visible on an ultrasound. Most prenatal ultrasound procedures are preformed topically, or on the surface of the skin, using a gel as a conductive medium to aid in the image quality. A transvaginal ultrasound is an alternative procedure in which a small probe is inserted into the vagina. This may be used early in pregnancy to get a clearer view of the uterus or ovaries or to determine how far along you are in your pregnancy (gestational age). An ultrasound is generally performed for all pregnant people: In the first trimester: This is generally done between 7 to 14 weeks to determine your due date. That due date does not change based on later studies. It also shows if you are having twins. At around 20 weeks: During this ultrasound, the doctor will confirm that the placenta is healthy and that your baby is growing properly in the uterus. The baby’s heartbeat and movement of its body, arms and legs can also be seen on this ultrasound. If you wish to know the sex of the baby, it can usually be determined by 20 weeks. Be sure to tell the health care provider performing the ultrasound whether or not you want to know the sex of the baby. Please note that ultrasound is not a foolproof method to determine your baby’s sex. Some pregnant people may also have an ultrasound in the third trimester if required. This may be used to determine the health and growth of the baby if in question, placental location if needed, position of the baby if uncertain, and expected weight if thought to be very large or small. This ultrasound is not always needed.
When should I stop working?
The majority of pregnant people can continue to work until late in pregnancy without any complications. Sometimes, however, the physical changes that occur in pregnancy and/or the demands of one's job can create difficulties. Please let us know if you have any concerns in this regard. We are usually able to suggest simple steps to deal with fatigue, “morning sickness” or aches and pains that can be particularly challenging at work. If you experience more serious symptoms, or concerns about potential workplace hazards to you or your baby, please inform us. If your doctor determines you should be placed on disability or medical leave, you will often need to obtain forms from your employer. The fee our doctors charge for completing disability forms varies, based on length and complexity. Please allow 10 business days for completion of these documents.
When can I travel?
Travel during pregnancy can be tricky. Those with low-risk pregnancies can often travel relatively safely during the mid-portion of pregnancy. Short trips, especially within the country and in urban areas are usually safe, but always ask your care provider in advance of travel. If you choose to travel, here are some pointers: • First 12 weeks: In the first 12 weeks, there is up to a 1/5 chance of miscarrying the pregnancy. This sometimes comes with severe pain and heavy bleeding, and could necessitate hospitalization and possible a blood transfusion. Consider where you are planning to go and access to medical care at your destination. Also, you will want to check if your travel insurance will cover you with a diagnosed pregnancy. Though not a problem for some, “morning sickness” during this time can make vacations less appetizing. • From 13-23 weeks: During this time the chance of pregnancy loss is lower, but not zero. This is often a time where women choose to travel. Keep in mind that some blood tests (such as the SIPS) generally are scheduled during this time, as well as your detailed pregnancy ultrasound. If you deliver the baby during this time, it will not survive and medical care will be primarily for you. Again, you should consider whether your travel insurance will cover you. • From 23-36 weeks: We strongly recommend that you do not travel outside of Canada during this time. If the baby delivers early, particularly before 34 weeks, they will likely need to stay in a specialized nursery and receive medical care. This is unlikely to be covered by your travel insurance and this care can be extremely, extremely expensive.