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 Clinical Practice Guidelines on GBS  

AOM Guide to Prelabour Rupture of Membranes 

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.

Hypertensive disorders of pregnancy

AOM Clinical Practice Guideline – Hypertensive Disorders  

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.

Deciding How To Give Birth After Caesarean Section

AOM Clinical Practice Guideline – VBAC  

SOGC Clinical Practice Guideline – VBAC    

Best Birth Clinic VBAC Information Booklet

 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. 

Postdates pregnancy handout 

AOM Clinical Practice Guideline – Pregnancy beyond 41 weeks

Most women who are expecting a baby at age 40 or older are healthy, and have normal pregnancies and births. Your midwife will review with you the research on risks associated with maternal age, and discuss the option of extra monitoring of your pregnancy towards your due date and an earlier induction of labour. 

Pregnancy beyond 40 handout

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 

Mother Matters Online Support Group 

Blues and PPD Fact Sheet  

Canadian Mental Health Association

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