Pregnancy Questions?
Frequently Asked Pregnancy Questions
How often should I see a doctor during my pregnancy?
The Society of Obstetricians and Gynaecologists of Canada recommends visits every 4 weeks until 28 weeks of pregnancy. After that, it's every 2 weeks until 37 weeks, and then weekly until your baby is born. This is a general guideline, and can change depending on your individual situation.
What is prenatal testing?
Prenatal screening is an optional test offered to all pregnant women in Ontario to screen for Down Syndrome (Trisomy 21), Trisomy 13, and Trisomy 18 For detailed information about prenatal screening and subsequent diagnostic testing, go to: Prenatal Screening Ontario
A screening test called NIPT (non-invasive prenatal testing) is offered to women at high risk of having a baby with genetic abnormalities:
• 40 years of age or older at the time of delivery
• Positive serum screen result
• Nuchal translucency (NT) ≥ 3.5mm
• Previous pregnancy with a chromosome abnormality
Women with these same risk factors have the option of proceeding directly to invasive diagnostic testing (amniocentesis or chorionic villus sampling). NIPT testing can be carried out as early as 9 weeks gestation. Women who do not meet these high-risk criteria can pay for NIPT themselves. Price varies by company (approx. $550).
Discuss prenatal screening with your doctor early in your pregnancy so that you can learn about all of your options.
A screening test called NIPT (non-invasive prenatal testing) is offered to women at high risk of having a baby with genetic abnormalities:
• 40 years of age or older at the time of delivery
• Positive serum screen result
• Nuchal translucency (NT) ≥ 3.5mm
• Previous pregnancy with a chromosome abnormality
Women with these same risk factors have the option of proceeding directly to invasive diagnostic testing (amniocentesis or chorionic villus sampling). NIPT testing can be carried out as early as 9 weeks gestation. Women who do not meet these high-risk criteria can pay for NIPT themselves. Price varies by company (approx. $550).
Discuss prenatal screening with your doctor early in your pregnancy so that you can learn about all of your options.
What tests are routinely ordered?
Lab tests may include screening for your blood type and antibody screen, anemia, thyroid function, diabetes, infectious diseases and immunity to certain illnesses.
Ultrasounds are usually done in the first trimester for dating confirmation, prenatal screening (if elected), and at 18-20 weeks for growth, fluid and anatomy assessment. Your doctor may order further ultrasounds if needed. Ultrasounds are not harmful to the developing fetus.
Ultrasounds are usually done in the first trimester for dating confirmation, prenatal screening (if elected), and at 18-20 weeks for growth, fluid and anatomy assessment. Your doctor may order further ultrasounds if needed. Ultrasounds are not harmful to the developing fetus.
How should my diet change during pregnancy?
All pregnant women should take a prenatal vitamin containing at least 0.4 mg of Folic Acid.
One important thing to remember is that you are not "eating for two". Instead, you should focus on eating twice as healthy. Avoid overconsumption of sugary foods, including pop and juices. Food preparation is very important to avoid dangerous infections, so wash your fruits and vegetables thoroughly, and cook all meat, eggs, and seafood completely.
That being said, there are certain foods that should be avoided in pregnancy in order to avoid illness:
Some foods are ok to eat but only in moderation:
Consult Healthy Eating in Pregnancy and Breastfeeding for more details.
One important thing to remember is that you are not "eating for two". Instead, you should focus on eating twice as healthy. Avoid overconsumption of sugary foods, including pop and juices. Food preparation is very important to avoid dangerous infections, so wash your fruits and vegetables thoroughly, and cook all meat, eggs, and seafood completely.
That being said, there are certain foods that should be avoided in pregnancy in order to avoid illness:
- Alcohol (there is no amount of alcohol that has been proven safe in pregnancy)
- Deli meats and hot dogs (these are ok only if fully cooked to steaming hot)
- Refrigerated pates and meat spreads
- Unpasturized cheeses, juices and cider, and other dairy products
- Raw sprouts of any kind (alfalfa, mung bean, radish, etc.)
- Any meat, egg, or seafood that is not fully cooked. Yes, sadly, that means no sushi!
- Seafood high in mercury (swordfish, king mackerel, tilefish, shark)
Some foods are ok to eat but only in moderation:
- Caffeine - limit to 2 or fewer cups per day
- Seafood moderate in mercury (tuna) - limit to 8 ounces per week.
- Herbal teas - some may be harmful to your pregnancy. Consult with your doctor before consuming herbal teas.
Consult Healthy Eating in Pregnancy and Breastfeeding for more details.
Is it ok to exercise in pregnancy?
Ask your doctor for specific advice about your pregnancy before starting any exercise program in pregnancy, but for most uncomplicated healthy pregnancies, the answer is a resounding YES for all three trimesters, even if you have never exercised before!
Exercising in pregnancy has many known benefits, including:
Some general guidelines to follow are:
Exercising in pregnancy has many known benefits, including:
- Shorter and easier labour
- Decreased leg swelling
- Decreased need for pain medication
- Less back pain
- Less constipation
- Better sleep
- Greater energy levels
- Faster postpartum recovery
- Less weight gain
- Decreased risk of gestational hypertension, gestational diabetes, depression, caesarian section and other delivery complications
Some general guidelines to follow are:
- When lifting weights, you should be able to talk and breathe normally. If you have to hold your breath/grunt, the weight is too heavy.
- If you are doing cardio, it's ok to huff and puff a little and break a sweat, but you should still be able to speak to the person next to you. If you are too out of breath to talk, you are going too hard.
- Avoid activities that put you flat on your back or abdomen.
- Avoid overheating (i.e., hot yoga) and don't use hot tubs or saunas afterward.
- Avoid any activity that puts you at risk for trauma to the abdomen. So, if snowboard half-pipe, kickboxing, or horseback riding is your sport, you will need to take a 9-month hiatus.
Are there vaccinations I should receive in pregnancy?
If you have already received your routine childhood vaccinations, the vaccinations you need during pregnancy are the flu vaccine (during flu season), a pertussis (Whooping cough) vaccine, and COVID-19 vaccine.
COVID-19 vaccine:
Pregnant women are at higher risk of severe complications from COVID, including pneumonia, hospitalization, and ICU admission requiring intubation. When a pregnant mom gets COVID, the fetus is at higher risk of premature birth, growth impairment, and death. We strongly recommend the COVID vaccine for our patients. For more details, see the CDC recommendations on the COVID-19 vaccine and pregnancy.
Flu vaccine: Flu vaccines are very safe in pregnancy! Flu shots are a safe and effective way to protect the mother and her unborn child from serious illness and complications of flu. The flu shot has been given to millions of pregnant women over many years. Flu shots have not been shown to cause harm to pregnant women or their babies. It is very important for pregnant women to get the flu shot. The Flu is more likely to cause severe illness in pregnant women than in women who are not pregnant. Changes in the immune system, heart, and lungs during pregnancy make pregnant women (and women up to two weeks postpartum) more prone to severe illness from flu, as well as hospitalizations and even death. Pregnant women with flu also have a greater chance of serious problems in their unborn baby, including miscarriage, and premature labor and delivery. Getting a flu shot is the first and most important step in protecting against flu. Naturopathic/homeopathic vaccines have not been proven to successfully protect against the flu and should not be relied upon. The flu shot given during pregnancy has been shown to protect both the mother and her baby (up to 6 months old) from flu. The nasal spray flu vaccine should not be given to women who are pregnant. Infants 6 months old and up can receive the flu vaccine.
Pertussis (Whooping cough) vaccine (Tdap):
Immunization in pregnant women is safe and allows high levels of antibody to be transferred to newborns during the first two months of life when the risk of severe illness and death from pertussis infection is the highest. One to three deaths related to pertussis occur each year in Canada, particularly in infants who are too young to be immunized. All pregnant women at or after 26 weeks of pregnancy should be encouraged to receive Tdap vaccination.
Adults of any age, who have not received a dose of Tdap vaccine in adulthood and who are in contact with infants (e.g., parents, grandparents, childcare providers), should receive pertussis vaccination.
Rubella (to be given AFTER pregnancy):
You may be advised to get your Rubella vaccine booster BEFORE or AFTER your pregnancy, if you have been found to be non-immune, in order to protect future pregnancies. This is because a rubella infection during pregnancy can have significant effects on your developing baby, including cataracts, deafness, and heart, lung and brain abnormalities. Having rubella infection in the first three months of pregnancy also increases your risk of having a miscarriage.
COVID-19 vaccine:
Pregnant women are at higher risk of severe complications from COVID, including pneumonia, hospitalization, and ICU admission requiring intubation. When a pregnant mom gets COVID, the fetus is at higher risk of premature birth, growth impairment, and death. We strongly recommend the COVID vaccine for our patients. For more details, see the CDC recommendations on the COVID-19 vaccine and pregnancy.
Flu vaccine: Flu vaccines are very safe in pregnancy! Flu shots are a safe and effective way to protect the mother and her unborn child from serious illness and complications of flu. The flu shot has been given to millions of pregnant women over many years. Flu shots have not been shown to cause harm to pregnant women or their babies. It is very important for pregnant women to get the flu shot. The Flu is more likely to cause severe illness in pregnant women than in women who are not pregnant. Changes in the immune system, heart, and lungs during pregnancy make pregnant women (and women up to two weeks postpartum) more prone to severe illness from flu, as well as hospitalizations and even death. Pregnant women with flu also have a greater chance of serious problems in their unborn baby, including miscarriage, and premature labor and delivery. Getting a flu shot is the first and most important step in protecting against flu. Naturopathic/homeopathic vaccines have not been proven to successfully protect against the flu and should not be relied upon. The flu shot given during pregnancy has been shown to protect both the mother and her baby (up to 6 months old) from flu. The nasal spray flu vaccine should not be given to women who are pregnant. Infants 6 months old and up can receive the flu vaccine.
Pertussis (Whooping cough) vaccine (Tdap):
Immunization in pregnant women is safe and allows high levels of antibody to be transferred to newborns during the first two months of life when the risk of severe illness and death from pertussis infection is the highest. One to three deaths related to pertussis occur each year in Canada, particularly in infants who are too young to be immunized. All pregnant women at or after 26 weeks of pregnancy should be encouraged to receive Tdap vaccination.
Adults of any age, who have not received a dose of Tdap vaccine in adulthood and who are in contact with infants (e.g., parents, grandparents, childcare providers), should receive pertussis vaccination.
Rubella (to be given AFTER pregnancy):
You may be advised to get your Rubella vaccine booster BEFORE or AFTER your pregnancy, if you have been found to be non-immune, in order to protect future pregnancies. This is because a rubella infection during pregnancy can have significant effects on your developing baby, including cataracts, deafness, and heart, lung and brain abnormalities. Having rubella infection in the first three months of pregnancy also increases your risk of having a miscarriage.
is it ok to have sex while pregnant?
Please consult your doctor for advice specific to your situation. For most women with uncomplicated pregnancies, the answer is yes, it is safe. You may find that you need to adjust positioning and use lubricant to be comfortable.
If you have vaginal bleeding, contact your doctor immediately, and avoid intercourse until your doctor tells you it is ok.
If you have vaginal bleeding, contact your doctor immediately, and avoid intercourse until your doctor tells you it is ok.
how can i make my morning sickness better?
Try the following to help with symptoms of morning sickness:
- Get plenty of rest
- Avoid having an empty stomach - eat small meals frequently and avoid large meals. Eat a protein-rich snack before bed
- Keep a snack beside your bed to eat first thing in the morning
- Take your time getting up in the morning
- Snack on things that are crunchy (crackers, ice chips), cold, salty, and bland
- Sniff fresh scents like lemons or rosemary, especially when there is a nauseating scent you can't escape.
- Exercise regularly
- Stay hydrated. Take sips throughout the day instead of big gulps.
- Try ginger tea
- Treat acid reflux
- Avoid triggers - you will learn what these are for you!
- Wear loose and comfortable clothing
what are fetal movement counts?
Fetal movement counting is an easy test you can do at home to reassure yourself of your baby's well-being, and is generally done after 26 weeks of pregnancy. For uncomplicated pregnancies, if you perceive decreased movements, you should perform a fetal movement count.
When doing fetal movement counts, find a quiet place, put your feet up and relax. Avoid distractions during the test (i.e., reading, tv, screens, electronics) that could cause you to miss fetal movements. All movements count! Big kicks and punches count just as much as little shifts and nudges.
If you do not feel six movements within two hours, you should contact your doctor or go to OB triage.
When doing fetal movement counts, find a quiet place, put your feet up and relax. Avoid distractions during the test (i.e., reading, tv, screens, electronics) that could cause you to miss fetal movements. All movements count! Big kicks and punches count just as much as little shifts and nudges.
If you do not feel six movements within two hours, you should contact your doctor or go to OB triage.
what is a safe sleeping position in pregnancy?
For obvious reasons, sleeping on your stomach isn't a good idea after the fifth month of pregnancy. And it's so uncomfortable that most women stop doing it much earlier. Sleeping flat on your back is not the best either. This can compress the major vein in your abdomen, and cause low blood pressure, exacerbate existing kidney conditions and hypertension, and contribute to the development of hemorrhoids, varicose veins, and edema. The safest bet is to lie on your side (preferably your left side, which allows for maximum blood flow). If you wake up in the wrong position, simply roll over! If you simply must sleep on your back, put a wedge pillow or rolled blanket under your right hip and right shoulder that will help shift the baby's weight off of those important blood vessels.
how do i treat constipation in pregnancy?
Constipation is a common problem in pregnancy. To help things along, try adding 25-35 g of fiber to your diet. Drinking lots of water (approximately 2L per day) will help all that fiber to keep your stools soft. Find a regular time in your schedule to sit and relax and have a bowel movement. Exercising daily will also help - if you move, so will your bowels! If your constipation is still a problem, talk to your doctor to see if a probiotic or laxative is right for you.
is it safe to smoke in pregnancy?
Smoking increases your risk for miscarriage, premature birth, low birth weight, and many other problems in pregnancy. It also increases the risk of SIDS after the baby is born, as well as other health conditions such as asthma, and ear and lung infections .
If you smoke, talk to your doctor about safe ways of quitting in pregnancy. The good news is that your chances of successfully quitting smoking in pregnancy are greater than in any other time in your life! Stopping smoking won't be easy, but having a healthy pregnancy and protecting your baby is well worth the effort! Use that as motivation!
If you smoke, talk to your doctor about safe ways of quitting in pregnancy. The good news is that your chances of successfully quitting smoking in pregnancy are greater than in any other time in your life! Stopping smoking won't be easy, but having a healthy pregnancy and protecting your baby is well worth the effort! Use that as motivation!
What if i am bleeding during my first trimester (1-13 weeks)?
Bleeding during pregnancy can have many serious causes and should always be assessed by a physician.
Causes of first trimester bleeding can include ectopic pregnancy (pregnancy outside of the uterus) or miscarriage. While bleeding can sometimes be related to causes that don't affect the health of your pregnancy (like with cervical polyps or implantation bleeds), every case of bleeding needs to be investigated to rule out an ectopic pregnancy, which can be life-threatening. Testing may involve a speculum exam, pelvic exam, fetal heart rate assessment with a doppler device (if >10-12 weeks), ultrasound, and laboratory investigations to measure your beta hCG (pregnancy hormone) levels. If you are blood type Rh negative, you might need a Rhogam injection. This is a blood product that can only be accessed through a hospital. Severe bleeding or pain should not wait for your next scheduled appointment and should be assessed in the nearest emergency room or obstetrical triage.
Causes of first trimester bleeding can include ectopic pregnancy (pregnancy outside of the uterus) or miscarriage. While bleeding can sometimes be related to causes that don't affect the health of your pregnancy (like with cervical polyps or implantation bleeds), every case of bleeding needs to be investigated to rule out an ectopic pregnancy, which can be life-threatening. Testing may involve a speculum exam, pelvic exam, fetal heart rate assessment with a doppler device (if >10-12 weeks), ultrasound, and laboratory investigations to measure your beta hCG (pregnancy hormone) levels. If you are blood type Rh negative, you might need a Rhogam injection. This is a blood product that can only be accessed through a hospital. Severe bleeding or pain should not wait for your next scheduled appointment and should be assessed in the nearest emergency room or obstetrical triage.
How does age affect fertility?
Age can have a very large impact on successful pregnancy. A woman's fertility starts to decline at around age 32 and continues to decrease with each year of age. For example, a 25-year-old woman has about a 25% chance of conceiving each month. That chance drops to about 15% at age 35, 7% at age 40, and 3% at age 45. The rate of miscarriage (thought to be around 20% at age 30) increases with age as well, to well over 50% by age 45. This is mostly due to the increased risk of aneuploidy (an abnormal chromosome count) and other genetic abnormalities which affect the health and survival of a fetus.
If you are less than 37 and have not been successful trying to get pregnant for 6 months or more, ask your doctor to refer you to a fertility specialist. If you are 37 or older, it is not necessary to wait for 6 months of trying before asking for a fertility consultation. Waiting longer will only decrease your chances of having a successful pregnancy. Assisted reproductive technology (ART) can be used to help women who are having difficulty have a baby, but it's success rate also decreases with age and ART cannot guarantee a successful pregnancy.
The bottom line is that, when it comes to fertility, time is of the essence, and reproductive technology cannot guarantee success. Your best plan is an early plan, so discuss with your doctor your plans for a pregnancy long before you want to get pregnant so that he/she can help you increase your odds of a successful pregnancy.
If you are less than 37 and have not been successful trying to get pregnant for 6 months or more, ask your doctor to refer you to a fertility specialist. If you are 37 or older, it is not necessary to wait for 6 months of trying before asking for a fertility consultation. Waiting longer will only decrease your chances of having a successful pregnancy. Assisted reproductive technology (ART) can be used to help women who are having difficulty have a baby, but it's success rate also decreases with age and ART cannot guarantee a successful pregnancy.
The bottom line is that, when it comes to fertility, time is of the essence, and reproductive technology cannot guarantee success. Your best plan is an early plan, so discuss with your doctor your plans for a pregnancy long before you want to get pregnant so that he/she can help you increase your odds of a successful pregnancy.
when is the best time to do a pregnancy test?
A home urine pregnancy test will usually become positive 4-5 days after the embryo implants into the mother's uterine wall. This is usually 6-12 days after ovulation, or around the time of the missed period. There are different levels of sensitivity for detecting the pregnancy hormone (beta hCG), and this will determine how early pregnancy can be detected. The most sensitive tests can detect pregnancy a few days before your missed period. The best time to take the test is when you empty your bladder first thing in the morning, when your urine is most concentrated. A blood hCG level can detect pregnancy even earlier, at 3-4 days after implantation.
what if my baby was exposed to drugs/alcohol/medication before i knew i was pregnant?
Alcohol and illegal or recreational drugs, including marijuana should be avoided in pregnancy at all times. Women will often worry if they were drinking alcohol or using drugs before they knew they were pregnant. Some women may also have a serious medical condition that requires prescription medication that could affect the developing fetus and are not sure if it is safe to continue taking it once they find out they a pregnant. While the best strategy is to plan for this and discuss drug/alcohol/medication use before getting pregnant, this doesn't always happen.
In the case of an unplanned pregnancy and drug/alcohol/medication exposure, discuss this with your doctor as soon as possible. In London, ON, Victoria Hospital has the FRAME (Fetal Risk Assessment from Maternal Exposure) clinic that your doctor can refer you to. Many other major healthcare centres will have similar services.
If you are pregnant and are having difficulty avoiding drug or alcohol use, please get help! Discuss this with your doctor and contact Addictions Services of Thames Valley.
In the case of an unplanned pregnancy and drug/alcohol/medication exposure, discuss this with your doctor as soon as possible. In London, ON, Victoria Hospital has the FRAME (Fetal Risk Assessment from Maternal Exposure) clinic that your doctor can refer you to. Many other major healthcare centres will have similar services.
If you are pregnant and are having difficulty avoiding drug or alcohol use, please get help! Discuss this with your doctor and contact Addictions Services of Thames Valley.
ARE OLD SOUTH MATERNITY SERVICES COVERED BY OHIP?
Yes, prenatal care, delivery, and post-partum care are covered by OHIP. Like any other doctor in Ontario, there may be charges for notes and forms. Patients without OHIP coverage or private health insurance will be billed privately.
How do I get an appointment?
You can download our referral form to bring to your family doctor or a walk-in clinic. If you are having trouble getting a referral, call us at 519-438-5101.
Disclaimer: This page is intended to provide general medical information, not specific medical advice. The content of this website has been provided in good faith and is only for general knowledge purposes. It should not be relied upon for any specific purpose and no representation or warranty is given as regards its accuracy or completeness. The material is not intended to be a substitute for the advice provided by your doctor or health care providers. Please discuss all issues with your doctor. By using this website, you agree to these terms. You assume full responsibility for the use of the information herein.