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PREGNANCY JOURNEY

COVID-19 continues to impact the operations of our clinic but we are confident that we can provide excellent and safe care for you and your baby. If you have symptoms of COVID-19 or have been advised to self-isolate please call us and we will happily reschedule your visit. We are doing some visits over the telephone and doctors may call from a private number. We recommend Covid-19 vaccines for all pregnant individuals.

The Monkeypox situation continues to evolve. Here is the most current Canadian statement about Monkeypox in pregnancy.

First Trimester:
Conception – 12 weeks:
appointments every 4 weeks
at your first visit our goal is to get to know you
● review your medical history
● review past and current pregnancy history
● review ultrasounds & lab work
● review genetic screening options
● order any tests that may still be required
● answer your questions
Resources:
Prenatal Genetic Screening Program (MSP Funded)
Invitae NIPT (Private Pay)
Panorama NIPT (Private Pay)
Pregnancy Options
Pregnancy & Early Childhood
What to Expect in Pregnancy
Indigenous Mothers & Families


To help keep everyone safe:
● medical grade masks are required for all persons in the hospital and clinic
● do not come if you are not feeling well or you have been told to self-isolate
● you may bring one support person to your visit: please ensure you both have no symptoms of COVID-19
a virtual hospital tour is available

Second Trimester:
12-24 weeks: appointments every 4 weeks
during this time we will
● listen to baby’s heartbeat, measure your uterus & check your blood pressure at each visit
● at 19-21 weeks:
organize a detailed (anatomic) ultrasound
● at 24-28 weeks:
perform a gestational diabetes test
● discuss vaccinations
● discuss if Rhogam is or is not appropriate
and administer if warranted
● answer your questions

Resources: Prenatal Classes
Baby Prep
Prenatal in a Nutshell
Douglas College Prenatal Online

Third Trimester:
28-36 weeks: appointments every 2 weeks
37-40 weeks: apts once per week until delivery
during this time we will
● listen to baby’s heartbeat, measure your uterus and
check your blood pressure at each visit
● do a Group B Strep (GBS) swab
between 35-37 weeks
● discuss labour, delivery
& any birth preferences you may have
● ensure you are registered at the hospital
● ensure you have taken a virtual hospital tour
● answer your questions

Resources:
Preparing for Your Stay at LGH
Labour & Birth

Labour & Delivery:
If you think you’re in labour, or if your water breaks, it’s time to call the hospital (604) 988-3131 and ask to speak with Labour and Delivery.

Once you arrive at the hospital, you’ll be assessed by a maternity nurse who will then notify our team. We are always available to help you through this exciting time.

After delivery, during your hospital stay we continue working with the nurses to take care of you and your baby, should you require the care of an obstetrician or paediatrician we continue as a part of your support network.

Postpartum:
As you and baby adjust to the first 4-6 weeks postpartum, we continue to support you. Below is a list of common issues you might seek assistance with:
● breastfeeding
● monitoring baby’s growth & development
● healing after delivery
● mental health concerns
● contraception/birth control

Resources:
What to expect in the Postpartum Period

BABY
Baby’s Best Chance
Caring for Kids: Canadian Paediatric Society
Purple Crying
Rourke Baby Record

We typically see patients at:
1 week, 2 weeks, 4 weeks and 6 weeks postpartum:
the schedule may be adjusted based on your needs. After this we will transition you back to your family doctor.

MENTAL HEALTH
North Shore Postpartum Support Treatment Group
Pacific Postpartum Support Society
Postpartum Anxiety

BREASTFEEDING
10 Great Reasons to Breastfeed your Baby
Breastfeeding: Getting Started
Breastfeeding Support on the North Shore
Breastfeeding Video (How to Hand Express)
International Breastfeeding Centre
Kelly Mom: Solutions & Troubleshooting

If you have an emergency concern such as heavy vaginal bleeding or severe pain and cannot wait
for a response from an on-call doctor, please go directly to Emergency
OR CALL LABOUR AND DELIVERY

FAQ:

I am a patient with questions or concerns If you are not yet a patient of LGMC, please call your family doctor or walk-in clinic. After your first appointment with LGMC we are available 24 hours a day for maternity related issues.

Please call the clinic at (604) 985-6408 Outside clinic hours listen to the recording to get the name and number of the on-call doctor. We prefer you contact us with all maternity & baby related concerns rather than going to a walk-in clinic or calling the nurses help line.

We do our best to respond quickly, but occasionally are tied up in a delivery. Please call us back if we have not returned your call in 30-60 minutes.

What is the earliest I can attend LGMC? Once the pregnancy has been confirmed by ultrasound, we book your first appointment for around 10 weeks of pregnancy

What does the $50 Registration Fee cover? This fee covers uninsured services (services which are not covered by MSP) such as completion of doctors notes, employment forms, off work letters and 24/7 on call availability to speak with one of our physician

Are there vaccines I should get during pregnancy? We recommend getting a Tdap booster when you are between 27-32 weeks of pregnancy. This is to provide some immunity to babies before they are eligible to receive vaccines themselves.

I am interested in genetic screening. Can I get more information? Yes – this is one of the important discussion we have during your first appointment. We will discuss different options and you can decide which you prefer or you can choose to decline any genetic screening.

Can I have a support person in labour?
Of course! You may have two support person in labour. If these people have symptoms, have been instructed to self-isolate or have tested positive for COVID-19 you will need to find an alternate support person.

Can I have a doula? Yes! You may have a certified doula in addition to your two support people.

Are any of your doctors taking patients after pregnancy? Unfortunately no. If you don’t have a family doctor, you will need to find one before your baby’s one month visit. GP Link may be able to assist you in finding a family doctor on the North Shore.

Does our group do house visits after delivery? We do not. There are public health nurses that will contact you postpartum and they can do house visits.

Is LGMC only available for those living on the North Shore?
No. LGMC is for anyone with an active BC personal health number though all of our deliveries & clinic visits take place at Lions Gate Hospital in North Vancouver.

Do we have a Farsi speaking doctor? Unfortunately not at the moment

Are we a group of OB specialists? We are family doctors that do prenatal care for patients who are low risk: please ask your doctor or walk-in clinic to refer you to a OB Specialists if needed.

I am over 35 years old – am I considered high risk? No. If there’s any concern that requires further consultation with a specialist, we will contact them. Is 40+ considered high risk? If you do not have other health concerns that make you a higher risk, then we can do your prenatal care

I’m having twins – can I still be seen by LGMC? Congrats! No, you will need to be referred to an OB specialist for your prenatal care.

I want to have a C-section. What do I need to do? Once you get to 30 weeks of pregnancy, you will be referred to an OB specialist discussion. If you decide to do a c-section, we assist the specialist during delivery and do postpartum care.

Can I have both LGMC and a midwife? No – you can only have one prenatal care provider. If you decide to transfer care, please let us know so we can cancel your upcoming appointments.

Do I choose which doctor to deliver? No – our group works as a team, with one doctor in clinic and one doctor on-call. Whoever is on-call when you’re in labour will help you deliver your baby.

Do I need to wear a mask in labour? If you have no symptoms of COVID-19, you do not have to wear a mask while in labour or while in your room.

Can I have visitors after my delivery? Presently (Aug 2022) you may have up to two visitors at any given time. These visitors may change throughout the stay but we ask that no more than two are in the hospital at any given time. Siblings may visit.

We are happy to answer any and all additional questions during your first appointment.