Client Guide

Paging your midwife

 

To contact your midwife urgently please refer to your PAGING POSTER.

Please note midwives cannot respond to pages from clients not currently in care, including clients who have been accepted into care but have not yet had a visit with a midwife. 

NOTE: If you are not in care with the Lincoln Community Midwives, please seek urgent care from your Family Doctor or from your local Emergency Room.

 

Forms to Complete

Client Questionnaire Regarding Birth Preferences

Please read and discuss with your support people. It may be helpful for you to print and bring to your midwife appointment (around 30 weeks) to set intentions for your birth.                     Birth Preferences Quiestionnaire 

Hospital Pre-registration Form

Please print and complete. Bring to your midwife appointment by 32 weeks.   Pre-registration Form 

All clients, even those planning home birth should pre-register at WLMH.

To book a hospital tour contact WLMH at (905) 945-2253 ext: 391. The tour is ideally booked for 2 months before your due date.

 

If you are intending on giving birth at home, but live in St Catharines, please also pre-register with NHS.

                    Pre-registration form                           NHS Anesthetic Questionnaire

     

Student Involvement

Midwifery Students

Lincoln Midwives is a teaching practice that supports the growth of the profession by mentoring students. It is likely that you will meet a student at some point of your midwifery care. We feel that students contribute positively to a client’s experience and encourage you to view them as part of your midwife team! Should you ever have concerns, please speak directly to one of your midwives. Click here to learn more about student involvement:

Midwifery Education Program 

Important topics to consider

Group B Streptococcus / GBS

GBS is a topic your midwife will discuss with you in the 3rd trimester.

 What is Group B Streptococcus (GBS)

 How to test for GBS

 Factors that increase the risk your baby will have a GBS infection and options that aim to reduce the chance of your baby becoming sick due to GBS in the first seven days of their life (early-onset GBS)

 What choices you have to make around the management of your pregnancy and labour in relation to your GBS results (if you test).

        AOM GBS Summary   AOM GBS Guideline    AOM GBS Management of Neonate Summary  

High Blood Pressure in pregnancy

Midwives regularly measure the blood pressure of women who are pregnant or have recently given birth. Most women will have normal blood pressure during pregnancy.

About 10% of pregnant women will develop high blood pressure. Most women who have high blood pressure while pregnant or after giving birth will not experience any major problems, nor will their babies.

                                       AOM High Blood Pressure Handout 

VBAC (Vaginal Birth after Cesarean): Making an Informed Choice

A vaginal birth after cesarean (also called VBAC) is a safe choice for the majority of women who have had a caesarean section (c-section) before. Midwives are experienced in caring for women who choose VBAC. If you have had a c-section before, your midwife will talk to you about your options for this pregnancy.

AOM VBAC Handout      VBAC Decision Making Tool AOM Clinical Practice Guideline  Best Birth Clinic VBAC Information Booklet    SOGC Pamphlet on VBAC  SOGC Clinical Practice Guideline  

When your pregnancy goes past your due date

 It is not unusual for pregnancies to last longer than 40 weeks. Anywhere between 37 and 42 weeks is considered a normal term pregnancy. It’s important to keep in mind that estimated due dates are just that – they’re best guesses based on the information available (such as the date of your last menstrual period or the results of an ultrasound). Only about 5 in 100 women give birth on their due date. 

AOM Postdates Handout        AOM Practice Guideline

Experiencing Anxiety or Depression as a Pregnant Woman or New Mom?

 

Many mothers struggle with emotional changes during pregnancy and the transition to motherhood. Here are a few helpful resources. Please speak to your midwife if you are having new feelings of anxiety or depression, having negative thoughts, or feeling just unlike your self — we are here to listen and help. 

Here To Help Depression During Pregnancy Fact Sheet Depression During Pregnancy (Perinatal Depression) Fact Sheet about Treatment Mothers Matter Online Support Group Blues and PPD Fact Sheet Anxiety BC for mothers Canadian Mental Health Association

 

Choroid Plexus Cyst

The ultrasound said my baby has CHOROID PLEXUS CYSTS

The presence of isolated choroid plexus cysts (CPCs) on a second trimester ultrasound is a common cause of anxiety, although it is almost always an innocent finding. Here are the answers to some commonly asked questions about CPCs.

What are choroid plexus cysts? The choroid plexus is the part of the brain that makes cerebrospinal fluid, the fluid that normally bathes and protects the brain and spinal column. In about 1 to 2 percent of normal babies — 1 out of 50 to 100 — a tiny bubble of fluid is pinched off as the choroid plexus forms. This appears as a cyst inside the choroid plexus at the time of ultrasound. A choroid plexus cyst can be likened to a blister and is not considered a brain abnormality.

What is going to happen to the cyst? In the vast majority of cases, the cyst resolves or disappears and has no consequences.

What is the concern? As mentioned, choroid plexus cysts are present in 1 to 2 percent of normal fetuses. However, in a very small percentage of fetuses with choroid plexus cysts, there is an associated chromosome disorder called trisomy 18. Trisomy 18 is rare. It is present in less than 1 in 3,000 newborns. Choroid plexus cysts are relatively common in normal fetuses. Most fetuses with a choroid plexus cyst are normal. Furthermore, many of the abnormalities associated with trisomy 18 can be detected by a careful ultrasound. In fact, fetuses with trisomy 18 almost always demonstrate abnormalities on ultrasound in addition to choroid plexus cysts, although some of these abnormalities can be quite subtle. If no additional abnormalities are detected by the ultrasound, the likelihood the fetus has trisomy 18 is very low. Only 10% of babies born with Trimsomy 18 had chroid plexus cysts as an isolated finding.

What are the odds that it is a sign of trisomy 18? The precise rate of risk is difficult to estimate and is somewhat controversial, but most doctors believe it is well under 1 percent. In other words, a fetus with choroid plexus cysts but an otherwise normal ultrasound has a better than 99 percent chance of not having trisomy 18.

Does the size of the cyst matter? Ordinarily, the size does not matter, although multiple, large cysts are slightly more worrisome.

BUT I’M REALLY SCARED. A small study performed in 2006 (2) showed that the majority of women who had an ultrasound report showing CPCs had a negative response to the news. In addition, many women had a difficult time believing that their baby was ‘OK’. “Weeks after (learning their baby had CPCs), 62% continued to believe that the CPC presented some danger to their baby”. If you are one of the 62%, you do have the option of another ultrasound later in the pregnancy to see if the CPCs have either dissolved/disappeared or have shrunk in size. When making this decision, keep in mind 2 things: 1) what will you do with the information? 2) what if the CPCs are still present and/or the same size as the first ultrasound? Will this increase or decrease your anxiety? In terms of ‘where to go from here’, it may be a difficult decision for you to make. Sometimes looking at the whole picture is helpful. For instance, was the baby otherwise ‘normal’; what is the overall suspected risk of the baby having a chromosomal abnormality (e.g. less than 1%); how will you feel after having another ultrasound etc.? Speak with your midwives further about the topic of choroid plexus cysts as needed to help you make an informed decision.

This information is copied from a website called UCFC Medical centre (link: http://www.ucsfhealth.org/education/choroid_plexus_cysts/) References: 1. Fetal Soft Marker CPG, SOGC , No 162, June 2005 2. E A Cristofalo, J A DiPietro, K A Costigan, P Nelson and J Crino. Women’s response to fetal choroid plexus cysts detected by prenatal ultrasound. Journal of Perinatology (2006) 26, 215–223. doi:10.1038/sj.jp.7211489; published online 23 March 2006