I'm Pregnant – Now What?
Even before finding out they are pregnant, many women have strong feelings about how and where they want to give birth. Many choose hospitals while others opt for a birthing centre and some prefer the idea of a home birth. It’s worth considering all the options to ensure that you receive the kind of care and preparation you need to see you through labour and into the postpartum period.
When it comes to finding someone to provide prenatal and delivery care, women have three options: a family doctor, a midwife or an obstetrician/gynecologist (ob-gyn). The bad news is that it is very difficult to find an ob-gyn who is taking new patients. The good news is that there are other options, including midwives and family doctors.
While many people associate pregnancy care with ob-gyn doctors, almost 50 per cent of pregnancies in Quebec are followed by family doctors. “It’s not common knowledge that many family doctors do deliveries,” says Dr. Dominique Pilon, president of the Association des omnipracticiens en périnatalité du Québec (AOPQ), which represents family doctors who provide pregnancy care. “The benefits are that a family doctor can have a mother, father and their child as patients, whereas an ob/gyn only sees the mother.”
If you have a family doctor, ask if he or she can deliver your baby and, if so, at which hospital. You can also consult AOPQ’s website, www.aopq.org, to find family doctors who offer prenatal care and deliver babies.
Healthy women with low-risk pregnancies can be followed by a licensed midwife, who provides prenatal care and attends the birth at either a birthing centre (there are two on the island of Montreal), a few hospitals or at home. The Quebec Midwives Association can help pregnant women find a midwife and provide general information. To contact the association, call (514) 738-8090.
Many women search for an ob/gyn to follow their pregnancies, especially those with high-risk factors. Ob/gyns provide prenatal care, monitor high-risk pregnancies and attend births at a hospital. It is not always easy to get an appointment with an ob-gyn so ask friends and families for recommendations, call your local hospital for possible names and make sure to phone for a first appointment as soon as the pregnancy test comes back positive.
As the due date approaches, many first-time parents want to know what to expect during labour as well as in the postpartum days.
Prenatal classes are a way to find out. While classes may differ in their approach and philosophy, most will cover what to expect during labour, how to manage the pain and what partners, friends or even a birth coach can do to help the mother through labour.
Many birthing centres and hospitals offer information sessions or can recommend classes nearby. For instance, the Royal Victoria Hospital’s Bientôt Bébé childbirth education program has classes in French and English. The program covers stages of labour, pain management, medical interventions, postpartum recovery, breastfeeding and baby care, as well as a hospital tour and a lecture on pain control. They also offer infant CPR classes. For more information consult their website www.BientotBebe.ca or call (514) 426-3362.
St. Mary’s Hospital at (514) 345-3511 and the Jewish General Hospital at (514) 340-8222 offer information sessions to help pregnant women learn about labour and delivery.
You can also contact your local CLSC, many of which offer prenatal courses, or Childbirth Education at (514) 482-5108, which offers parental classes.
Those interested in using hypnotism during labour and delivery can contact the Hypnos Centre at (514) 990-7562 or Hypno Beginnings at (450) 699-1301 or www.Hypno-Beginning.com.
Women who would like to hire a doula — a woman who offers nonmedical support and assistance during labour, delivery and the postpartum period — can check with the Canadian Doulas Association at www.canadiandoulas.com.
Where to give birth
During the 20th century, North American trends have travelled the path from home births to hospitals and back again.
Today, most births in Quebec take place in hospitals. Check with your doctor or midwife to see at what hospital she or he can deliver. You’ll also want to find out about the hospital’s facilities: do you deliver and then stay in the same room or will you be transferred to a postpartum ward when baby is born? If your baby arrives early or has health problems, will he or she be transferred to another facility?
For many women, a birthing centre offers an attractive alternative to hospitals or home births. Montreal has two centres, one in Cote des Neiges and the other in Pointe Claire. Both offer private rooms with homey touches, such as rocking chairs, double beds, large bathtubs and showers. Women at the birthing centres are followed by a licensed midwife, although if complications arise during pregnancy or birth, the woman will be referred to a doctor or transferred to a nearby hospital.
While the Quebec government has announced plans to build 20 new birthing centres in the coming years, this is of small comfort to women who are pregnant now and can’t get a spot at the birth centres. Be aware that the centres have long waiting lists so call as soon as your pregnancy is confirmed. For more information call the birthing centres at CLSC Côte des Neiges, (514) 736-2323 and CLSC Lac St. Louis, (514) 697-1199.
Although giving birth at home still evokes controversy, about 1.5 per cent of women in Canada choose this option, preferring the comfort of their own surroundings and the care of a midwife. Homebirths are legal in Quebec and the Quebec Midwives Association can provide information to families who want to explore this option. For more information, call (514) 738-8090.
During pregnancy, having a caregiver you trust and can turn to with questions and concerns is essential. So take the time needed to find that special person who will be sharing this momentous occasion.