Back to the Obstetrical Care Program
Your first prenatal visit
Second prenatal visit
Subsequent prenatal visits
Genetic Testing
Ultrasound
Glucose 'Sugar' Test
Other Tests
Group B Streptococci (BGS) Swab
Cervix Check and 'Stretch & Sweep'
Your First Prenatal Visit
During your first prenatal visit your care provider will talk about what you can expect during your pregnancy. This will be an opportunity for you to ask questions
You will have regular appointments once a month from weeks 0-32, once every 2 weeks from weeks 32-36 and every week from week 36 onwards. Your caregiver will suggest some tests to assess your health and to help identify any possible risks to you and your baby.
Routine Blood Tests ordered at your first visit:
These tests will require taking three or four vials of blood to test for the following:
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Blood type, including your Rh factor: If you are Rh negative and your baby is Rh positive, your body may produce antibodies which destroy your baby's blood cells; this happens when your blood is mixed together (which usually occurs during childbirth). Although this is rarely a problem during a first pregnancy, the reaction that occurs during the first pregnancy can threaten your next pregnancies. This problem can be easily prevented by an injection given to you at 28 weeks or in other circumstances when your blood mixes with the baby's blood.
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Rubella (German measles): Rubella is a virus that causes a mild illness in most people. Symptoms of this illness are a temporary rash, mild fever, and joint aches. Some people do not get any symptoms at all. Most Canadian women are either vaccinated for rubella during childhood or had this illness early in life. As a result, they are immune to further infection. The rubella test is done to determine if the woman is immune. If a woman gets rubella during the early months of her pregnancy and she is not immune, it can cause birth defects. If you find out that you are not immune to rubella, please avoid people who have viral illnesses.
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Blood Count (CBC): This blood test is done to check for anemia. Anemia means you have too few red blood cells. This is usually caused by an iron deficiency. Because red blood cells carry oxygen to your body and to your fetus, it is important to have anemia treated as soon as possible. To treat anemia, most doctors will recommend an iron supplement.
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Hepatitis: Hepatitis B is an infectious disease that can harm your liver. Despite being able to cause serious harm, many women are infected have no symptoms. Children that get this infection from their mothers during birth are at high risk of liver disease. This blood test checks to see if you are infected. If so, your baby can be vaccinated just after birth in infancy to prevent their own infection.
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VDRL: This blood test checks for syphilis. Although this is a rare disease, untreated syphilis can cause a stillbirth or neurological damage to your baby.
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Blood Disorders: There are some genetic conditions that are more common among people from specific ethnic groups. For instance, Ashkenazi Jews and French Canadians are at higher risk for Tay-Sachs disease. Those of African, Mediterranean and Hispanic backgrounds are at increased risk for sickle-cell disease. People of Mediterranean and Southeast Asian background are at higher risk for Thalassemia. A blood test can be done if you are at an increased risk for certain disorders. This test can be done either before or while you are pregnant.
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HIV: HIV testing is offered to every woman because if you test positive, there are medications you can take to prevent the fetus from becoming infected.
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Chlamydia and Gonorrhea: Your doctor may also suggest doing tests for other sexually transmitted infections, such as chlamydia and gonorrhea, as they can both be treated safely during pregnancy to avoid harm to your baby.
Second Prenatal Visit (or prenatal major visit)
During your second visit, the doctor will do thorough physical examination, including an assessment of your: thyroid, lungs, heart, breasts, abdomen as well as a pelvic exam. We also recommend a PAP smear if you have not had one during the past 3 years.
Subsequent Prenatal Visits
During each prenatal visit your weight and blood pressure will be measured. You will also do a urine test. Your caregiver will determine the size of the uterus and listen to the baby's heart. After about 30 weeks, your caregiver will feel the position of your baby inside your uterus.
Genetic Testing - Offered Starting from Week 11
3% of babies are born with some defect (such as Down Syndrome or Spina Bifida). We can offer you tests to check if your baby has an increased risk of being born with these problems. It is your choice whether or not to do these tests.
People often have many questions about screening for birth defects. For TWH OCP patients, we will take time to talk to you about this at your appointment. The following websites are very helpful:
Ultrasound "The Anatomy Scan" - Offered at 20 Weeks
You will have an ultrasound scheduled around 20 weeks to look at the baby from head to toe. For TWH OCP patients, this is usually done at the Ontario Power Building at 700 University Avenue, or Women's College Hospital and may take up to 2 hours.
Your prenatal doctor will also be doing an ultrasound in the office to check to make sure your baby is head down. This ultrasound will take place around 34 to 35 weeks.
Many parents welcome an ultrasound as a way to get a first look at this new member of their family. Depending on the position of the fetus, the ultrasound may show whether you will have a boy or girl.
Ultrasound has been used for over 35 years and studies show that it is safe. An ultrasound may also be used at other times during your pregnancy to investigate issues of concern or simply to make sure that the baby is growing properly.
Ultrasound in pregnancy
Glucose ('Sugar') Test - Suggested Between 24 and 28 Weeks
This test takes place sometime between 24-28 weeks (at the end of the 2nd trimester). It is done to check if you are at risk for 'Gestational Diabetes', also known as Diabetes of Pregnancy. For TWH OCP patients, we will schedule the test in the computer, and remind you when to go and get it done.
You will be asked to drink a sweet orange beverage, and then 1 hour later have your blood sugar checked with a simple blood test. You do not have to fast before this test.
Other Tests - Suggested Between 24 and 28 Weeks
For the most part, these are done at the same time as your glucose test, so you do not need an extra visit. Your blood count (CBC) will be re-checked, and your urine will be tested for infection.
Group B Streptococci (GBS) Swab – Between 35 and 37 Weeks
A quick and easy swab of your vagina and rectum is done to check for a common bacteria called Group B streptococci. Although the bacteria is harmless to you, it can cause serious infections in newborn babies. If the test is positive for GBS, you will be given antibiotics during labour to protect your baby.
Cervix Check and 'Stretch & Sweep' – Suggested Around Week 38-39
About 1 week before your due date, we will offer to check your cervix to tell whether your body and baby are getting ready for labour. We can also stretch the cervical opening and "sweep' the baby's water sac off of your cervix. This may prevent you from going past your due date.
