Blood tests and ultrasounds

  • First, a prenatal blood tests including: CBC (complete blood count), Blood Type and group, Rubella (German Measles) titre to check immunity, Hepatitis B and C testing, HIV test, Syphilis test, TSH (for thyroid function) and VZV (for chicken pox immunity). If you have contact with cats you should also consider being tested for Toxoplasmosis immunity.

    There are optional screening blood tests offered to evaluate your risk of chromosomal abnormalities and neural tube defects. These are called the Serum Integrated Prenatal Screening (SIPS) tests and are time sensitive. The first blood test is done at 9 to 13+6 weeks (ideal time is 10 – 11+6 weeks) and the second blood test is done at 15 to 20+6 weeks (ideal time is at 15+2 – 16 weeks). If you will be over 35 years at the time of delivery, you also qualify for a NT or nuchal translucency ultrasound which measures the fetus neck fold width. – see ultrasound information below. For more information http://www.bcprenatalscreening.ca on prenatal screening please visit http://www.bcprenatalscreening.ca. At 24-28 weeks it is recommended that you have a test for gestational diabetes. This is a one hour glucose tolerance test which is non fasting. You will be given a 50g glucose drink and a serum blood sugar level is drawn after one hour. At the same time you will have your hemoglobin checked to rule out iron deficiency anemia. If the one hour glucose tolerance test is abnormal, you will need to go back and do a 75g 2 hour sugar test. If the 2 hour sugar test is abnormal, then you would be referred to the diabetes clinic.

  • A urine culture is also taken at your 1st visit to rule out a bladder or urinary tract infection. Another urine sample can be drawn to rule out sexually transmitted diseases such as chlamydia and gonorrhea. If either of these tests come back abnormal, we will inform you and discuss with you and your partner regarding treatment options.

    If your blood type is Rh negative you will need a rhogam injection at 28 weeks and possibly after delivery. Since rhogam is a blood product, we will need you to sign an authorized consent form to file on your chart before we administer it to you. Certain ethnicities are also susceptible to thalassemia and you and your partner may be subjected to further testing if required.

    At 36-37 weeks, expect a swab for Group B Strep (GBS) from the vaginal and anal region. Group B Strep exists in 15-40% of the normal prenatal population. This will determine whether intravenous antibiotics will be required when you go into established labour. Non-Invasive Prenatal Testing (NIPT) is a relatively new non-invasive blood test that measures the amount of cell-free fetal DNA circulating in maternal serum. NIPT accurately measures the quantity variance of fetal and maternal chromosomal material and provides a screen risk for Down syndrome (trisomy 21), trisomy 18, and trisomy 13. The Down syndrome detection rate is >99% with a false positive rate of 0.1%.

  • It is recommended that women get a first trimester ultrasound for dating, ideally between 7-10 weeks. This is especially important if you have irregular periods or are unsure of the first day of your last menstrual period. Ask your physician to order one for you when you see them for the first time to confirm your pregnancy and estimate your due date. The first trimester ultrasound ( < 13 weeks) is the most accurate method of determining your due date as there is less variation in growth of the fetus at this time compared to later on in the pregnancy.

    If you are over 35 years of age at the time of your delivery, you may also qualify for a nuchal translucency (NT) ultrasound. These ultrasounds are extremely time sensitive and are performed between 11 – 13+6 weeks at an accredited imaging facility. For more information on criteria for a Nuchal Translucency Ultrasound please visit MedRay Imaging here: https://www.medrayimaging.com/ultrasound-nuchal-translucency

    A detailed ultrasound is offered at 18-20 week gestational age. You may want to inquire about the gender of your child. If you do not wish to know the gender, please inform us so we can specify ” Do not disclose gender” on your ultrasound requisition. 3D ultrasounds and ultrasounds for gender identity specifically are done privately at various imaging facilities. Please inquire at each facility regarding their protocol and fees.

Appointments and referrals

  • Your appointments are monthly until 30 weeks, then every 2 weeks until 36 weeks and then weekly until you deliver. We will schedule appointments all the way up until 40 + 6 weeks since most are induced at 41+0 weeks for post dates. If you are over age 40 at the time of due date, we would induce you at 40 weeks. Elective repeat C- Sections are usually scheduled around 39 weeks.

  • Ideally we prefer referrals to be made by 10 weeks gestational age. Please have your initial blood work and dating ultrasound ordered by your regular family doctor prior to transferring care to a maternity clinic.

  • You would be paying privately out of pocket for all your visits. Please check with the maternity clinic for costs.

  • You still have to pay privately until your MSP is valid. Please check with your maternity clinic for more details.

  • If anything is related to your pregnancy, then you should call the clinic taking care of your pregnancy. Anything that is not related to your pregnancy, you should consult your own family doctor. The reason is because since they are your family doctor, they know your entire history, what you are susceptible to, what antibiotics work for you, if you’ve had these previous problems and what works best for you.

Hospital information
and labour & delivery

  • After hours you are encouraged to call the Royal Columbian Hospital labour and delivery ward at 604-520-4586.

    We suggest you call the hospital first since the staff are always available 24/7 and in case the labor and delivery room is extremely busy or on diversion, the staff will advise you when the best time to come to the hospital would be.

  • All deliveries take place at Royal Columbian Hospital only. However, from time to time, the Royal Columbian Hospital goes on diversion and you may be diverted to a different hospital which is not full at the time.

    Other hospitals also may go on diversion and for those patients, they may be sent to the Royal Columbian Hospital in return, so it works both ways.

  • Eagle Ridge Hospital does not have a Maternity Unit. All deliveries will be directed to Royal Columbian Hospital.

  • You will be referred around 30 weeks to the obstetrician of your choice. If you do not have an obstetrician, we will choose an obstetrician for you.

    The obstetrician will see you once to discuss your c-section and then you will continue seeing us until your delivery date. C-Sections are usually planned for 39 weeks. However if you go into labor early, we will confirm that you are in actual labor and the obstetrician would be notified and the c-section would be arranged in the next few hours or as soon as the operating room is available.

  • At the Royal Columbian Hospital, we calculate that you become overdue at 41+0 weeks gestational age based on your earliest ultrasound. We would offer you induction at 41+0 weeks but if you are age 40 years or older at the time of the due date, then we would offer you induction of labor at 40 + 0 weeks on your due date. If you have gestational diabetes and are on insulin, we would consider inducing you at 38+0 to 39+0 weeks depending on the severity.

    It is your option if you do not want to be induced but we would ask that you be assessed at 41+0 weeks ( 40+0 weeks if you are 40 years or older at the time of delivery). You may choose to decline induction as long as you understand the risks associated. We would request a non stress test on your baby and an ultrasound to be performed to make sure your baby is still well if you decline induction.

  • Most new moms usually stay 1-2 days in the hospital following a normal vaginal delivery. In the event of a cesarean section, you will usually stay 2-3 days depending on circumstances.

    Usually, the main determining factor is how long it takes for you to get your baby breastfeeding. People usually will have the most difficulty with getting the hang of breastfeeding. Please ask your nurse for help or ask to see a Lactation Consultant.

    Occasionally, your baby may develop jaundice, a yellowing of the skin and eyes from elevated Bilirubin levels and that may prolong your stay in the hospital if your baby requires phototherapy.

    Sometimes, your baby will need to be transferred to the neonatal intensive care unit or NICU if they are born too premature or have issues such as suspected infection, breathing difficulties or other complications that could have happened at delivery.

    In those situations, a paediatrician in the NICU would be looking after your baby and you may be discharged from the maternity ward separately if your baby will be staying down in the NICU.

  • There are various medications available for pain relief during labour. These medications include analgesics and can be administered in the following ways:

    Injection or intravenous (Demerol with Gravol, Morphine, Fentanyl)

    Breathing through a face mask (Nitronox, or “Laughing Gas”)

    Or

    Epidural: a needle is placed into your back and small plastic tube inserted through this needle into the “epidural space” outside the covering of your spinal cord (Demerol or Fentanyl)

    Spinal: a needle is placed into your back and a small plastic tube is inserted through this needle into the fluid area around your spinal cord (Demerol or Fentanyl)

  • Your baby is followed by your family doctor after discharge from hospital. The first visit is usually at one week of age.

Newborn care & baby development

  • If you have a family doctor we recommend calling them first.

    There are a range of free, early childhood services in the community to support your little one’s healthy development. Through SHARE Family & Community Services Society and Kinsight, there is a team of infant development specialists, speech language pathologists, physiotherapists and more. For more information please contact:

    New Westminster

    Phone: (604) 521-8078

    Email: nwcc@kinsight.org

    Tri-Cities

    Phone: (604) 525-8242

    Email: tccs@kinsight.org

    Note: your family doctor may recommend a different program/service, so please call them first.

  • Cribs, cradles and bassinets that meet the current Canadian safety regulations have been determined as the safest place for your baby to sleep to reduce the risk of Sudden Infant Death Syndrome (SIDS). Room sharing for the first 6 months is recommended. For additional information, please contact your health care provider.

Other frequently asked questions

  • Please check out our immunizations page for detailed information.

  • Generally air travel during pregnancy is considered safe for women who have healthy pregnancies unless you have been directed by your physician. Most airlines restrict travel by pregnant women after 34 weeks.

    Ideally the best time to fly is between 20 – 30 weeks gestational age. This is when you’re likely to feel your best and have the majority of the blood tests and ultrasounds done. If you are planning to travel abroad, let your physician know so he or she can determine the necessity of bringing along your prenatal records. With faxing availability, a copy of your records have been sent to the Royal Columbian Hospital ( fax 604-520-4834) after 20 weeks such that another hospital or facility could be able to access your records with your permission by phoning the Royal Columbian Hospital Labor and Delivery Ward at 604-520-4586 and requesting it.

    Travel in Canada is usually uncomplicated if you are a Canadian citizen since your medical coverage extends to other provinces. This is not true if you are travelling to foreign countries so it is important to check your travel insurance qualifications before you travel.

    Sitting for long periods increases the risk of blood clots so it is advised that you get up and walk every two hours that you are sitting for about ten minutes to increase circulation in your legs. This will decrease your risk for blood clots especially on long flights.

  • If this is your second or third pregnancy, you may not wish to. However if this is your first pregnancy and you have minimal experience in childbirth education, it is a good option. Please check out our prenatal classes page for more information and options!

  • There are various community resources that are available to help you through this difficult time. Some of these resources include:

    Empty Cradle (New Westminster)

    Compassionate Friends of Canada (Burnaby)

    Pregnancy Loss Support Group at BC Women’s Hospital (Vancouver)

Have a question? Ask a maternity care provider!

If you have a question that is not answered on this FAQ section, ask it here! click the questions to read the answers. Our maternity care providers will post the answer to your question if a similar question has not already been asked. We will notify you via email when your question has been answered.

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