Pregnancy

Prenatal Resources

This site is a prenatal package of resources. Read as much as you can to family yourself familiarize yourself with pregnancy, delivery, postpartum care, and the services available in the community.

For referring providers, a checklist and summary of early prenatal care may be helpful, especially if it will be some time before we are able to see your patient.

Early pregnancy

Later Pregnancy

Post-Partum

The following is some general information about our practice and your prenatal care. A summary timeline follows below.

Doctors

The following doctors are members of the call group that sees our patients at the hospital (also called “The Centreville Group”).
Dr. Randy Dhaliwal
Dr. Lindsey Fisher (office practice)
Dr. Michelle Hanbidge
Dr. Jane Hofer Call 236-499-2249
Dr. Lindsay Kwantes
Dr. Jeff Kwantes
Dr. Aisha Manji (office practice)
Dr. Brett Poulin
Dr. Shannon Rourke
Dr. Andy Spencer
Dr. Emily Stevenson ## Shared Call at the Hospital

Due to the shortage of doctors providing obstetrical care and the professional and personal pressures that we are subject to, we cannot be present at all of the deliveries for patients we each see in our individual practices. All of the doctors in our office share a similar philosophy, and we share our “on call” responsibilities at the hospital. Where there are choices to be made, we all do our best to listen to an individual’s needs and adapt our care to them. All of the doctors have up to date obstetrical and neonatal resuscitation skills and we feel confident that you will receive excellent care from any of us as we attend your delivery.

Office Visits

During the course of your pregnancy you can expect to be seen in the office approximately once every four weeks until about 30 weeks gestation, every two weeks until about 36 weeks and once weekly thereafter.

Family, friends and children are welcome at office visits and we encourage your questions. The more you understand about the process, the easier your delivery and early parenthood will be. If we feel we do not have adequate time to discuss your concerns during your visit, we will book an additional appointment.

At each appointment you can expect that we will do a weight, take your blood pressure, listen to the baby’s heart rate, measure your uterus (after 20 wks). Some patients may need to give a urine sample.

Typically, you will see one physician during your office based prenatal care. For any hospital visits and for your delivery, the doctor who is on call will care for you.

Urgent Concerns

If you are following with us in your pregnancy and you have an urgent concern, you can consider calling the clinic during office hours at 250-549-1245. After hours and less than 20 weeks, please call 811 or visit the ER. After hours and more than 20 weeks, please call VJH Maternity at 250-558-1213 or visit the maternity unit.

Ultrasounds

It is routine to do a dating ultrasound at 10 weeks and a detailed anatomy ultrasound at 20 weeks. More ultrasounds are performed only if medically indicated. We will modify our routine for each patient as needed. Ultrasound results will usually indicate “likely male” or"likely female", given a small risk of error. Sometimes, the gender cannot be determined because of the position of the baby.

Testing

You will be typically be sent for blood tests between the 10th and 17th weeks and again at 24 to 28 weeks. Other tests may be done as needed.

Genetic Screening

There are optional screening tests that can be used to determine the likelihood of your baby having certain genetic problems. These are be done early in your pregnancy. The tests you might be offered vary, depending on your age and past medical history. Most of the testing does not involve any risk to the baby. It is important to note that the tests give a probability only and do not tell us with certainty if your child has one of these conditions. We will be discussing this at your first or second visit. When inquiring about gender results please allow a minimum of four business days after your ultrasound and a minimum of 10 business days after private blood (or ‘Harmony’) testing.

Some of the tests that are typically covered by MSP include SIPS Part 1 and SIPS Part 2 (or a single Quad Screen), Nuchal Translucency (a fetal neck ultrasound, typically offered to mothers > 35yo to predict risk of Down’s Syndrome), and a funded NIPT if the early screen suggests a higher risk.

The NIPT screens can also be done with private pay as early as 10wks of gestational age. These test for Down’s Syndrome and some other genetic conditions. They can optionally detect gender. This is essentially the same test that would be offered with MSP funding if another screen has returned higher risk. The main difference is that you can pay privately to have the test done early.

Please see BC Prenatal Screening for more detailed information.

Delivery

We deliver at Vernon Jubilee Hospital. Occasionally, patients may need to be transferred to other facilities depending on your medical condition or conditions at the hospital.

Post Partum

About one week after the delivery, we will see you and your child in the office for follow up care. When your baby is gaining weight well and there are no health concerns related to labour, delivery, and adaptation to new newborn life–your newborn will be discharged to the care of your regular family physician. We will see you approximately 6 to 8 weeks after delivery to discuss birth control and other testing as needed. This is usually our last visit of the pregnancy. At that time we will send a copy of all relevant prenatal and birth information to your family doctor.

Timeline

This is a summary of a typical maternity timeline for most of our patients. We follow the principles and recommendations of the BC Maternity Care Pathway.

For referring providers, a checklist and summary of early prenatal care may be helpful, especially if it will be some time before we are able to see your patient.

  • Week 10 (8-12):

    • Routine dating ultrasound is performed to establish due date and check the baby’s growth and development.

  • Week 10-17:

    • First round of blood tests is typically conducted.
    • Optional genetic screening tests can be offered. NIPT screens can be performed privately as early as 10th week.

  • Week 20-22:

    • Detailed anatomy ultrasound is performed to check the baby’s physical development.
    • Gender of the baby may be determined, depending on the baby’s position.

  • Week 24-28:

    • Second round of blood tests usually takes place, including a gestational diabetes screen.
    • Additional tests may be conducted as necessary.

  • Week 28-29:

    • Rho(D) Immune Globulin (RhIg), or Rhogam, is given to mothers who are Rh-negative.
    • First injection typically given around week 28 with a follow up after delivery if baby is Rh positive.

  • Week 27-35:

    • Whooping cough (Pertussis) vaccine may be administered to help protect the baby after birth.

  • Week 35-37:

    • Group B Streptococcus swab is usually performed. This checks for the presence of Group B Strep bacteria which can potentially be harmful to the baby during delivery. It is not an STD.

  • Regular Office Appointments:

    • The expectant mother can expect to be seen in the office:
      • Once every four weeks until about 30 weeks gestation.
      • Every two weeks until about 36 weeks.
      • Once weekly thereafter.

  • Week 40 - You are ‘due’!:

    • Only about 4% of babies are born on their ‘due date’. First babies tend to be later, but most babies show very little respect for a schedule.
    • After your due date, your provider may consider extra surveillance.
    • For a routine pregnancy, induction of labour is considered after 41 wks.

  • Postpartum, week 1-2:

    • Mother and baby are seen in the clinic for follow-up care, usually at least until the baby has regained it’s birth weight.
    • If circumcision is considered, contact Dr. Friesen or another provider within a few days after delivery.

  • Postpartum, week 6-8:

    • A final appointment takes place to discuss birth control and any other testing as necessary.
    • At that point we will return your care to other providers. Although we would love to keep all our new mothers and babies in our family practices, we are unfortunately unable to do that while we continue to see new prenatal patients.

Remember that every pregnancy is unique, and this represents a typical timeline. Actual timelines will depend on individual needs and specific recommendations by your healthcare providers.

The Doctors of the Centerville Clinic