Follow up Visits

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Depending on your midwifery team, follow up visits are 20 to 30 minutes in length. During each visit, the health of you and your baby will be carefully assessed by evaluating the following:

• taking blood pressure
• reviewing lab or other test results
• palpating your belly
• listening to your baby's heartbeat
• discussion and assessment of fetal movements

Laboratory and diagnostic tests (such as ultrasounds), or referrals to other healthcare providers are booked as needed.

Time is spent discussing important issues to the mother and her family; preparation for labour and birth, emotional and mental health, coping strategies, relationship concerns, sibling and parenting matters, balancing work and family.

Every visit is an opportunity to get to know your care providers and for us to get to know you! We welcome all questions and concerns.

Vaginal Birth After Caesarean Section (VBAC):

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Vaginal Birth After Cesarean Section (VBAC):
If you previously had a cesarean section, you may be wondering what options are available for your current and future pregnancies. Your midwives will carefully review your history, the surgical report from your cesarean and offer you a consultation with an Obstetrician to see if you are a candidate for a Trial of Labour After Cesarean (TOLAC). The majority of women will meet the criteria for a TOLAC and will go on to have a successful VBAC.

Resources:

• Association of Ontario Midwives: Deciding how to give birth after a caesaren section
• Alberta Health Services: Vaginal Birth After Caesarean (VBAC)

In early pregnancy you will complete blood work.

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Your initial blood work will include testing of your blood type. If you have a negative blood type it is recommended that you receive a blood product called WinRho. WinRho helps to prevent antibodies from forming if your baby has a positive blood type. Please see the link below from the SOGC for more information. Your midwives will discuss this with you during one of your visits.

Resources:

• Society of Obstetricians and Gynaecologists of Canada (SOGC) Your pregnancy Routine tests - Rh blood groups -
• Alberta Health ServicesWhen You Need Rh Immune Globulin -

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The Society of Obstetricians and Gynaecologists of Canada (SOGC) recommend that all pregnant people are offered screening for gestational diabetes in pregnancy. Screening will be offered to you between 24 and 28 weeks of pregnancy and depending on your risk factors, may involve a 50g or 75g of glucose drink and require up to 2 hours at a lab.

Risk factors for developing Diabetes in Pregnancy include:

• Maternal Age greater than 35 years
• Pre-Pregnancy BMI greater than 30
• Ethnicity (Indigenous, Hispanic, South Asian, Asian, African)
• Family History of Diabetes
• Gestational Diabetes in a previous pregnancy
• Previous Macrosomic baby (Large baby)
• Certain medications

It should be noted that people who do not have the above risk factors may still have gestational diabetes. It is recommended that everyone be tested for gestational diabetes in pregnancy.

The earlier we can diagnose diabetes in pregnancy, the more likely we can suggest diet and lifestyle changes which can help. You may be referred to a special Diabetes in Pregnancy clinic for extra support.

Resources:

• Gestational Diabetes
• Screening for Gestational Diabetes - AHS
• Preparation for a Glucose or Lactose Tolerance Test
• Gestational Diabetes - What NOT To Do! - Lily Nichols RDN (a copy of her book ‘Real Food for Gestational Diabetes’ is available in our lending library)