Potential Schedule of Visits and Discussion Topics
Please note that this is an overview of the schedule of prenatal and postpartum appointments and the discussion topics that are planned for most clients. Your midwife may alter the schedule of visits and/or the discussion topics depending on your unique situation.
Schedule of Prenatal Visits
Before 12 weeks: Virtual Intake Appointment - model of care, team of midwives most likely involved, quality information sources, how to contact your midwife, discussion of early pregnancy tests, provide requisitions; If time permits, nutrition and exercise
12-13 weeks: 1st in person appointment - review initial results, review schedule of appointments, physical assessment, review consent forms and provide information package 18 weeks: Physical assessment, discussion of second trimester ultrasound and provide requisitions
22 weeks: Physical assessment, discussion of gestational diabetes and provide drink if client wants test done in clinic, review pre-registering at the hospital, discussion of choice of birthplace, vaccines
26 weeks: Physical assessment, gestational diabetes test in clinic (if planned), physical assessment, weight assessment and nutrition check in, fetal movement
30 weeks: Physical assessment, discussion of third trimester ultrasound and provide requisition, discussion of prenatal classes, Rhogam administered as needed for specific clients
32 or 33 weeks: Physical assessment, review/discuss birth plan, review address, review midwife call schedule, newborn medications and procedures, pain relief options in labour, preterm labour
34w (not done if client opted to come at 33w): Physical assessment, Discussion of GBS, newborn medications and tests, review midwife call schedule, pain relief options in labour, transfer scenarios for planned out of hospital births
36w: Physical assessment, GBS testing, weight check in, confirm consent form signed and sent if planning Birth Centre birth, discuss when to page, information package, review birth plan
38w: Physical assessment, review when to page, discuss delayed cord clamping and management of the placenta, provide TENS machine if client desires
39w: Physical assessment, discuss routine postpartum care, discuss what to expect if a “Transfer of Care” occurs when the OB takes over the care
40w: Physical assessment, discuss community standard and research regarding induction of labour
41w: Physical assessment, discuss labour stimulation techniques
During Labour & Birth
It is our goal to have a midwife you met prenatally attend you in labour. However, please be aware that due to the unpredictability of labour and birth, combined with the midwives’ call schedule, your midwife team may be unavailable when you are in labour. If this happens, another midwife you had not met prenatally will be with you in labour. You will get midwifery care, ideally a midwife you met prenatally, but a known midwife cannot be guaranteed 100% of the time.
Schedule of Postpartum Visits
24-36 hours postpartum at home (or within 24 hours of the birth if staying in hospital): Complete physical assessments for mom and baby, assist with breastfeeding, newborn screening and jaundice testing, review what to expect in the next few days, debrief the birth
Day 3 postpartum at home: Physical assessments for mom and baby (1st weight check by midwives since birth), assist with breastfeeding, assess stitches if present or if client requests
Day 5 postpartum at home: Physical assessments for mom and baby, tweak breastfeeding depending on any difficulties that have not yet resolved
Week 2 postpartum in clinic: Weight check. Full newborn exam. Red eye reflex if not already done in the community
Week 4 postpartum in clinic: Same as Week 2
Week 6 postpartum in clinic: Discharge appointment. newborn weight check, head circumference and length measurements, full newborn physical assessment. Pap test for client if due. Provide records and arrange follow up with health care provider