When You’re Expecting

Congratulations on your pregnancy. We are pleased to provide information on many aspects of your pregnancy, helping you prepare for the big day.

Abnormal Conditions and What to Do

• bleeding from your vagina
• feeling dizzy or like you might faint; loss of consciousness
• sharp pain in your tummy
• high fever, chills or rash after you have had a fever
• throwing up a lot
• feeling more sad, worried or angry; crying more than usual
• baby stops moving or moves less often (ask your provider about fetal movement counts)
• lots of swelling in your face, hands, legs and ankles; bad headaches that last for a long time; gaining weight quickly; blurry vision or spots in front of your eyes; pain in your chest or stomach area
• sudden chest pain and/or shortness of breath
• smelly fluid comes from your birth canal; vaginal itchiness
• hurting or burning when voiding; red or dark urine
• spots on your face and body that are not normally there
• signs of preterm labor (that you might deliver before 37 weeks of gestation): bleeding, sudden increase in the amount of discharge, sudden change in the type of discharge, water leaking from your vagina, low dull backache that feels different than usual; urgency to void; feeling that something is not right, period cramps; pressure that feels like the baby is pushing down contractions (period cramps with tightening of the uterus) that come more often, do not go away and get stronger, or stomach pains that do not go away, with or without diarrhea

What to Do in an Emergency

Go to the nearest emergency department. If your medical issue is related to your pregnancy and your gestational age is 23 weeks or more, you may also be seen by the maternity unit staff (depending on what the emergency doctor decides). If your medical issue is unrelated to your pregnancy, the doctor will determine if you also need to be assessed by the maternity unit staff. Many medical emergencies will not affect your pregnancy.

Constipation

Dental Care

Domestic Violence

Studies show that 6 to 8% of women suffer from intimate partner violence each year. If you feel that you are being physically, emotionally or sexually abused by your partner or another family member, please get some help or talk to your care provider. For residents of Stormont, Glengarry and Dundas, please visit the Naomi’s Center website or call 613-774-2838 or 1-800-267-0395.

Learn more about abuse in pregnancy.

Environmental/Occupational Exposures

• pesticides
• mercury (in certain food)
• lead (e.g. in lead paint)
• asbestos (in some home insulation)
• solvents (in some paint)
• extreme heat (avoid hot tubs and sauna, especially in the first three months of pregnancy)
• x-rays (where possible)
• some cleaning products

Heartburn

Heartburn is a frequent issue in pregnancy, especially as your uterus grows and compresses your stomach.

Here are a few tips for the prevention of heartburn:

• Eat small frequent meals
• Do not lie down for two hours after eating
• Avoid certain foods such as chocolate, onions, peppermint, citrus or tomato products, or spicy foods
• Wear loss clothing around your waist
• Elevate your head at night or elevate the top of the bed 20 cm with blocks. You may find sleeping in a reclining chair is easier.
• Antacids such as Tums, Maalox, Mylanta and Gaviscon are safe to use. Liquid preparations work better than tablets. However, do no use more than what is indicated on the bottle.
• If you have ongoing symptoms despite all these tips, speak to your health care provider.

Hemorrhoids

Hemorrhoids are veins that get engorged at the level of the anus. If there is increased pressure on them, they can bleed and/or cause pain while you have a bowel movement. Pregnancy predisposes women to develop hemorrhoids because of hormonal changes and the pressure of the uterus growing in the abdomen.

To prevent this, ensure that your stool is soft and that you do not have to strain when you go to the bathroom (see section on constipation). At home, you can try sit bath (sitting in the bathtub with water at 30 to 40 degree Celsius for about 10 min). If hemorrhoids are painful and before using over-the-counter remedies, speak with your health care provider.

Immunization

Pregnant women are sometimes more susceptible to severe complications from certain diseases. Some of them are preventable, and we advise pregnant women to get immunized. Certain vaccines are safe and recommended in pregnancy. For example, we recommend all pregnant women to get the flu vaccine if they are pregnant during that season. Learn more about immunization in pregnancy.

In general, live vaccines are not recommended during pregnancy due to the theoretical risks to the fetus. However, sometimes the benefits might outweigh the risks if travelling or being in an affected area.

Medications

Certain medications during pregnancy can affect the normal development of the fetus. Ensure that you inform any doctors who prescribe you medications that you are pregnant. Do not take over-the-counter medicines without talking to your care provider first. Learn more about medications during pregnancy.

If you are unsure whether it is safe to take a medication, visit the Motherisk website or call 416-813-6780 (Monday to Friday from 9 to 5).

Nausea and Vomiting

Nausea is a normal symptom during pregnancy, especially in the first three months. Most pregnant women will be free from nausea after 23 weeks of pregnancy. However, if the nausea causes excessive vomiting, please seek medical attention.

Learn more about nausea and vomiting in pregnancy.

Nutrition

It is important to maintain a healthy diet while pregnant. You will need to eat a few extra calories per day to allow healthy growth of you baby. Read the Prenatal Nutrition Guide and download the My Food Guide Services Tracker.

Healthy weight gain depends on your Body Mass Index (BMI):

BMI 18.5 to 24.9 – 25 to 35 pounds

BMI 25 to 29.9 – 15 to 25 pounds

BMI 30 or more – 11 to 20 pounds

Learn more about healthy eating and your BMI.

You want to avoid certain foods during pregnancy due to their harmful bacteria and chemicals content:

• Raw fish, especially shellfish such as oysters and clams
• Undercooked meat, poultry and seafood
• Hot dogs, non-dried deli-meats, refrigerated pâté, meat spreads and refrigerated smoked seafood and fish
• All foods made with raw or lightly cooked eggs (e.g.homemade Caesar vinaigrette)
• Unpasteurized and pasteurized soft cheeses such as Brie or Camembert and unpasteurized semi-soft cheeses such as Roquefor or Stilton
• Unpasteurized juices, such as unpasteurized apple cider
• Raw sprouts, especially alfalfa sprouts
• Fish that are high in mercury (e.g. tuna, shark)Limit your consumption of liver to no more than one serving every two weeks

 Other Tips:

• Wash your hands before, during and after you handle food
• Wash the skin of all raw fruits and vegetables well
• Cook meat, poultry, seafood, fish and eggs well
• Check ‘best before’ dates on food packages
• Limit your intake of caffeinated beverage (coffee, tea, caffeinated pop) to the equivalent of a maximum two coffees per day. Avoid energy drinks.
• Drink a lot of fluids and avoid drinking alcohol
• Remember to eat a lot fibre to avoid constipation which is most frequent in the third trimester. Increase your intake of soluble and non-soluble fibre as well as your fluid intake. Metamucil and flax seed also help to avoid constipation and are safe in pregnancy. Learn more about fibre.

Prenatal Vitamins/ Folic Acid

Vitamins cannot replace healthy foods. Try to eat a variety of fresh food and less processed foods.

However, during pregnancy, it is recommended to take a prenatal vitamin which contains iron and folic acid. 

Certain women might need extra folic acid. Talk to your health care provider.

Certain animals carry disease that could be detrimental to the health of your pregnancy.

Cats carry a bacteria called toxoplasmosis. If you contract it during your first trimester, it can cause some anomalies in the development of the fetus. During your entire pregnancy, avoid changing your cat’s litter. Ask another member of the family to do so. Also, wash your hands frequently after being in contact with your pet and before eating.

Rodents (mice, hamsters, guinea pigs) can carry a parasite called leptospirosis that can also affect the development of your fetus. Avoid changing the cage of these animals and avoid petting them as they are more likely to bite. Reptiles (lizards, turtles) can carry bacteria called salmonella that can greatly affect you and your baby's health.

Prenatal Classes

Prenatal classes are a great way to learn more about pregnancy and labour and to connect with other moms-to-be. It is recommended that you attend these classes with your partner where possible.

WDMH partners with the Eastern Ontario Health Unit to provide prenatal classes.  Learn more about local prenatal classes.

Centretown Community Health Centre in Ottawa offers free prenatal classes virtually over Zoom in English and French. For details and to register, visit https://form.jotform.com/210804705109246 or call 613-233-4443 ext. 2195.

Prenatal Visits

During your prenatal visits, your health care provider will ask you questions about your health, perform a physical examination, check your weight and blood pressure, measure your womb and take your baby’s heart rate. Your health care provider will also order blood test and check your urine at every appointment. This is a time to ask questions and address any concerns you may have.

You will be offered integrated prenatal screening (IPS). This is a screening test to see if your baby is at risk of having a neural tube defect or a genetic defect. You might also be eligible to have the non-invasive prenatal test. Please talk to your care provider about this test.

You will also go to have an ultrasound. If you have an uncomplicated pregnancy, you can expect to have two or three ultrasounds during your pregnancy. Learn more about ultrasound in pregnancy.  Learn more about ultrasounds at WDMH.

Toward the end of your pregnancy, your health care provider will perform a test to see if you carry a certain bacteria called Group B Strep in your vaginal flora. This bacteria is of no harm to you, but can cause harm to your baby at the moment of the delivery. If you test positive, you will need to come to the hospital as soon as your water breaks, whether or not you are in labour. You will be given antibiotics to protect your baby. Learn more about Group B Strep.

Preterm Labour

Preterm labour occurs when you start labouring before 37 weeks of gestational age. If you think you are in labour before 37 weeks, go to the hospital. At WDMH, we deliver mothers in labour at 36 weeks or more because we do not have the neonatal support to care for babies that are born at a younger gestational age. If time allows, you will be transferred to one of the more specialized hospitals in the city. If not, after delivery, your baby will likely need to be transferred to CHEO is he/she needs further support.

Learn more about preterm labour.

Sexual Intercourse

Intercourse is generally safe during pregnancy unless your care provider recommends against it. It has not been shown to hurt the fetus at all. If you have excessive bleeding or pain after intercourse, please consult your care provider. Practice safe sex and use condoms to protect against STDs (sexually transmitted diseases). Learn more about sexual intercourse in pregnancy.

Smoking/Drugs/Alcohol

Smoking, or being exposed to second hand smoke, can harm you and your baby. Ask for help from your healthcare provider or support network to try and stop smoking or at least to smoke less. If you smoke, your baby may not get enough food or oxygen, be born sooner or too small, die suddenly during pregnancy or have other health and learning problem. If you need help, Pregnets may be able to help.

Scientists agree that there is no safe amount of alcohol anytime during pregnancy and that it is best to refrain completely. Mothers who drink alcohol when they are pregnant may have babies who can suffer from brain damage, vision and hearing problem, birth defects, learning disabilities, etc. If you need help to quit drinking, please ask your healthcare provider. Learn more alcohol and pregnancy.

Sports/Activities

Staying active while pregnant is very important to increase your level of energy, control your weight gain and diminish your risk of gestational diabetes, hypertension, preeclampsia and backache. Learn more about exercise.

Download an exercise booklet.

If you have any medical conditions, speak to your healthcare provide to ensure that it is safe for you to do certain activities in pregnancy.

Travelling

If you plan to travel during your pregnancy, please tell your care provider. Certain destinations should be avoided during pregnancy. It is usually safe for pregnant women to travel by air up to 36 weeks of gestation, but please ask your healthcare provider.

Umbilical Cord Blood Bank

After your baby is born, we will clamp and cut the umbilical cord. Some blood will be taken from the cord to test your baby’s blood type and well-being. You might have heard about the benefit of umbilical cord blood. Learn more about umbilical cord blood.

We do not have a routine public umbilical cord blood banking process at WDMH. Please speak with your healthcare provider if this is something you are interested in. Learn more about cord blood banking.

Working during Pregnancy

If you are healthy and have an uncomplicated pregnancy, working should not be an issue during pregnancy. Ensure you have a safe work place environment and your work is not posing physical threats to your health.

Learn more about working during pregnancy.