Pregnancy tracking: visits and different tests to pass
If you don’t have health problems and your pregnancy normally happens, you should meet with your health professional at this frequency:
A first visit before 12 weeks of pregnancy;
A visit every 4 weeks during pregnancy weeks 12
One visit every 2 weeks during weeks 31;
One visit per week from 37th week of pregnancy until birth.
Who will take care of my pregnancy follow up?
Depending on the services available in your area, you may decide to be followed by a family doctor, obstetrician or midwife. Midwives can follow women who have normal pregnancy and have no medical history requiring special supervision. Regardless of your choice, pregnancy tracking is fully covered if you have a valid RAMQ health insurance card.
Follow up appointments
At the time of your first visit, your health professional will ask you a series of questions regarding your family and medical history to get an accurate picture of your health and tailor tracking to your needs. A complete physical test (blood pressure, weight, height, heart and lung auscultation, gynecological test, etc.) ) will also be carried out. If you chose to give birth with a midwife, that’s when the midwife will determine if you qualify to continue your follow-up with them.
During other visits, the health care provider will ensure that your pregnancy is well developed by checking some clinical parameters:
Your vital signs (blood pressure, pulse, respiratory rhythm);
Your baby’s heartbeats and its movements;
The size, shape and height of the womb;
Baby growth and position (later during pregnancy);
The presence or absence of contractions, liquid or blood losses.
Generally, the doctor or midwife will conduct vaginal exam only during visits near your expected date of birth.
Your healthcare professional is also here to answer your questions and give you advice. It should also address with you the important aspects of pregnancy, i.e. nutrition, common discomfort and testing available (ultrasound, prenatal screening, etc.). ).).).
The choice of place of birth
Majority of women followed by a midwife gives birth in a birth home. However, it is also possible to give birth in the hospital or at your home. Thus, during prenatal follow-up, your midwife will address the issue of birthplace with you.
No matter what professional follows you, they will prescribe urinalysis and blood tests during your pregnancy. These tests will determine your blood type (groups A, B, AB or O and Rh system [see Rh incompatibility box]), check if you have anemia, screen for diabetes and detect infectious diseases like syphilis, HIV infection and hepatitis B. The cervical cancer screening (Pap test) will also be offered along with other screening tests for certain sexually transmitted infections.
You will also be offered to pass the following exams to ensure your pregnancy goes smoothly and your baby develops well:
A prenatal screening test (down syndrome 21, down syndrome 13 and spina bifida): a first blood test between the 10th and 13th week of pregnancy and a second between the Week 14 and 16 Decisions about screening for down syndrome 21 is totally yours. An ultrasound could also be offered (between 11th and 13th week of pregnancy) to assess your baby’s narcal clarity. This measure helps to know the thickness between your baby’s neck skin and spine. A higher than normal measure can indicate a probability of down syndrome 21. However, the proposed tests may differ depending on whether screening is carried out in a private clinic or through the Quebec prenatal screening program. If the results obtained indicate a high probability of Trisomy 21, the professional following your pregnancy will propose to do an amniocentesis with chromosome study. For more information, see our Pregnancy and Trisomy 21: Amniocentesis;
An ultrasound between 18th and 20th week of pregnancy;
Screening for pregnancy diabetes (oral hyperglycemia) between week 24 and week 28;
A test for Streptococcus B around week 36: Streptococcus B is a bacteria that sometimes occurs in women’s vagina, rectum, and bladder. This bacteria is safe for the mother, but can sometimes cause serious infections in the newborn baby. Experts estimate that 15 % of pregnant women carry bacteria and 40 % will pass it on to their baby during childbirth. Thus, 1 % of babies will develop a streptococcal B infection. If you get a positive test result for streptococcal B, you will receive a prescription for antibiotics at childbirth.
What is Rh incompatibility?
Blood tests carried out during your pregnancy include detecting a possibility of Rh incompatibility between you and your baby.
On the surface of red blood cells, proteins are sometimes found in a group called the Rh system. If a person has these proteins on the surface of their red blood cells, they are said to be Rh +, whereas if these proteins are absent, the person is Rh -. Sometimes a mother is Rh -, then that the baby she carries is Rh +. If the blood of the foetus crosses the placenta, the mother’s immune system could react and produce antibodies that would attack the red blood cells of the foetus.
To prevent the child’s health from being jeopardized, pregnant women who are Rh - receive an injection of antibodies in the 28th week of pregnancy, WinRho ®. This injection will prevent the mother’s immune system from reacting against the baby’s blood. This treatment is effective in preventing complications and does not pose risks to the baby or mother. In very rare cases, an allergic reaction may occur in the pregnant woman, but the professionals present at the time of the injection will be prepared to intervene to prevent complications.