Visits occur monthly for 30 minutes and include:

• Check in with questions answered
• Blood pressure
• Weight
• Fetal heart rate auscultation
• Abdominal palpation for uterus size
• Review of lab results, genetic screening if completed, ultrasound and other results

Pregnancy creates a natural state of insulin resistance due to hormonal changes and the need to provide nutrients to the growing baby. For many women insulin resistance will not cause any problems however, for some it will lead to gestational diabetes. GDM causes an increase in the amount of glucose (sugar) in the maternal blood and therefore increased transfer of sugar to the growing fetus. Risk factors associated with GDM include:

• Maternal age greater than 25
• Certain ethnic groups
• A previous pregnancy with GDM
• Family history of diabetes
• Obesity

The good news is that most often we can help control blood sugars in pregnancy by making small but meaningful changes to diet and exercise.

We will review the standard of care and testing options at your prenatal appointment. Testing is offered between 24-28 weeks gestation.

*Requisition for Gestational Diabetes Screening and other labs will be provided at the 20 week visit to assist in booking a lab appointment for the 26-28 week blood collection period. There is currently a 4-6 week waiting list to book lab appointments.*

If you have a negative blood type and your partner has a positive blood type, your baby may have a positive blood type. If you have bleeding in pregnancy or have a miscarriage, there could be some mixing of the baby's blood with your blood. This mixing can lead to antibody formation in your blood. WinRho will help to prevent the formation of anti-D antibodies which will affect future pregnancies. Call your midwives if you have a negative blood type and experience any bleeding.

WinRho is given by injection into the deltoid muscle of your upper arm (intramuscularly). Most common side effects include a sore arm and redness at the site of injection. Rarely there is a risk of more serious adverse effects. Due to this risk, your midwife will give you the injection at the beginning of the visit so that she is with you for 15 minutes after which is the most common time for any reaction.

It can help with painful intercourse, muscle relaxation or strengthening, decreasing risk of prolapse, incontinence, and constipation. Awareness and control of pelvic floor muscles assists with pushing during the second stage of labour.

There are numerous pelvic floor physiotherapists that you can see to help you become more aware of these very important muscles.