Maternal and Perinatal Health

Antenatal/Prenatal Care

Pregnancy can bring many questions and feelings. It usually lasts about 40 weeks and has three parts, called trimesters. Prenatal care is an important part of a healthy pregnancy.

Antenatal care, also called prenatal care, is health care during pregnancy. Care may be given by one provider or by a team which may include a doctor, nurse practitioner, midwife, or family doctor. At prenatal care visits, you can learn how to support a healthy pregnancy. You can also get medical, emotional, and mental health support.

Prenatal visits and what to expect

People who get early and regular prenatal care often have better health outcomes. Your first prenatal visit should happen as soon as your pregnancy is confirmed. The number of visits depends on your health and your pregnancy.

At prenatal visits, your health care provider will ask about your health and do an exam. They may check your weight and blood pressure, listen to your baby’s heartbeat, and measure your baby’s growth. These visits may also include blood and urine tests. Your provider may also check for infections or other health concerns and tell you about helpful programs and services in your community.

Birth Plan

Your provider may help you make a birth plan. A birth plan can include where you want to give birth, who you want with you, and what kind of pain relief or comfort measures you want. Keep a copy of your prenatal record and ask questions if anything is not clear.

Maintaining a healthy lifestyle

To support a healthy pregnancy, eat healthy food, drink water, stay active if it is safe for you, and take care of your mental health. Take a daily multivitamin with 0.4 mg of folate if your provider recommends it. Avoid smoking, alcohol, cannabis, and raw or undercooked food during pregnancy.

Vaccination

Vaccines can help protect you and your baby from illness. Important vaccines during pregnancy may include the flu vaccine and the Tetanus, Diphtheria and Acellular Pertussis (Tdap) vaccine. Many vaccines are safe during pregnancy. Ask your health care provider what is right for you.

Dental hygiene

Good dental care can also support a healthy pregnancy. Try to have a dental checkup in the first trimester if you can. Tell the dentist that you are pregnant.

Emergency signs during pregnancy

Get medical help right away if you have any of these warning signs:

• Bleeding from the vagina
• Dizziness or fainting
• High fever, chills, or a rash after fever
• Strong pain in your belly
• Pain in your chest or stomach
• Vomiting a lot
• Feeling very sad, angry, worried, or crying a lot
• Your baby stops moving or moves less often
• Swelling in your face, hands, legs, or feet, especially if it gets worse
• Spots on face and body that are not normally there
• Unusual fluid from the vagina that smells bad or causes itching
• Pain or burning when you pee, or red or dark urine
• A bad headache that does not go away, blurry vision, or seeing spots
• Gaining weight quickly

If you have any of these warning signs, call your health care provider or go to the hospital right away.

Postpartum Care

Postpartum care is care after the baby is born. This care should continue over time, and not happen only once after delivery to ensure that both the mother and baby are doing well. It is a good idea to check in with a health professional 2 to 3 weeks after birth. A full visit often happens 6 to 12 weeks after birth. You can talk about your body, your mood, sleep, tiredness, birth control, baby care, and adjusting to life with a new baby.

Bonding with a new baby takes time. Try to drink water, rest when you can, eat healthy food, and move your body if it is safe for you. Avoid alcohol, smoking, and cannabis. Support from partners, family, friends, and community groups can also help.

It is common to feel many emotions after birth. Some people feel sad or overwhelmed for a short time. If these feelings are strong or last longer, talk to your health care provider as soon as possible. Get help right away if you have thoughts of suicide or thoughts of harming yourself or your baby.

• Call 911 if your life or someone else’s life is in danger 
• Get support from a local crisis centre – visit crisisservicescanada.ca and search local resources
• Call the Canada Suicide Prevention Service at 1-833-456-4566 (24 hours a day, 7 days a week) or text 45645 (4pm – 12am ET) 
• Reach out to the First Nations and Inuit Hope for Wellness Help Line at 1-855-242-3310 (24 hours a day, 7 days a week)

Your body may change after birth. You may have bleeding, discharge, cramps, breast changes, constipation, hemorrhoids, or changes when you pee or have your period. Many of these changes are normal, however, get help if something does not feel right. Other warning signs include:

• swelling in your hands, feet or face
• blurry vision or seeing spots
• severe headache
• pain in your calf, thigh or groin
• redness or swelling in your leg or groin 
• pain in your chest, stomach, back or legs
• dizziness and feeling faint 
• vomiting and trouble keeping fluids down

Call 911 right away if you have:

• shortness of breath
• chest pain
• coughing up blood
• fainting/passing out
• seizure
• thoughts of harming yourself or your baby

Newborn Care

For the first 6 months, breastmilk is all your baby needs. Your baby does not need water during this time. After 6 months, you can start other foods while continuing to breastfeed if you choose. Breastfeeding is healthy for both the baby and the parent. If you need help, ask a health care provider or a breastfeeding support group.

Hold your baby on your skin as soon and as often as you can after birth. This can help with bonding, warmth, breathing, and calmness. If you cannot do this right away, a partner or support person may be able to help. Never shake a baby.

Newborn Hygiene  

A baby’s first bath is usually delayed for 24 hours. Babies do not need a bath every day. Always stay with your baby during a bath. Keep the water below 49°C (120°F). Change diapers often to help prevent rash. If you use a change table, always use the safety straps.

Safety measures

Safe sleep is very important. Put your baby on their back to sleep on a firm, flat mattress with a fitted sheet. Do not use loose blankets, pillows, toys, or other soft items in the sleep space. Your baby may also have short tummy-time periods while awake and watched.

The safest place to leave a newborn alone is a bassinet, cradle, or crib that meets safety rules. Follow the product instructions and weight limits.

Use a rear-facing car seat that is installed the right way. Follow local guidance and the product instructions. Keep cords, small objects, and other choking hazards away from your baby.

Baby’s health

Babies may spit up, cry, sneeze, and have uneven breathing at times. These can be normal. Get medical care if your baby has any of these signs:

• frequent projectile vomit
• not drinking much and unusually sleepy (hard to wake up)
• skin colour is pale or greyish
• under 3 months of age and has a fever:
  1. rectal temperature of 38°C or higher
  2. armpit temperature of 37.6°C or higher
• breathing quickly, even when calm and not crying (more than 60 breaths per minute)
• exerting extra effort to breathe, and has one or more of the following:
  1. shortness of breath
  2. flaring of nostrils when breathing in
  3. skin is drawn between the ribs when breathing in
  4. wheezing
  5. gasping
• irritable and crying all the time (you are unable to console them)
• reacts little to interactions when awake
• has not peed in 24 hours
• has orange crystals in their diaper and they are more than 3 days old

Call 911 right away if your baby:

1. may have ingested (swallowed) poison, alcohol, medication or drugs
2. has trouble breathing or swallowing
3. is choking
4. is pale blue, grey or has very pale face or lips
5. has a swollen tongue, mouth or throat
6. has a hoarse voice or cry
7. has fainted or passed out
8. is not reacting to interactions when awake

If you are in doubt, talk to a healthcare provider immediately or seek emergency medical care.

Common myths

• Myth: Sex during pregnancy always harms the baby or causes miscarriage.
• Fact: Sex during pregnancy does not usually cause miscarriage. If you have a high-risk pregnancy, ask your health care provider what is safe for you.

• Myth: You should not exercise during pregnancy.
• Fact: Many people can safely do regular exercise during pregnancy. Ask your health care provider what type and amount of activity is safe for you.

• Myth: Feeling depressed during or after pregnancy is not normal.
• Fact: Many people struggle with mental health during or after pregnancy. Mental health support is an important part of care.