Getting Ready for Baby

• If this is your first baby, consider attending prenatal classes. Classes review many topics including prenatal issues, labour and delivery, and post-partum care and breastfeeding.  
• It is a good idea to write down any questions that you have so that you and your care provider can discuss them at your regular appointments. You might consider developing a birthing plan with your care provider.

For more information about prenatal classes offered in the local and surrounding areas, visit the website of the Haliburton, Kawartha, Pine Ridge District Health Unit or call 1-866-888-4577 ext 5003. Information on prenatal resources across Ontario is available in the Ontario Prenatal Education Program Directory

Alternatively, the HKPRDHU offers online prenatal education which can be found at: HKPR Online Prenatal Class

If this is your first baby and you would like to have a tour of the Maternal Child Care program area there are “Getting Ready for Baby” information sessions and tours available the first and third Tuesday of the month from 6:00 PM to 7:30 PM. Preregistration is required. Call NHH at 905-372-6811 ext 4122 to register. The sessions include:

• A short presentation from representatives of both NHH’s Maternal Child Care program and the HKPRDU on the services and supports available in Northumberland;
• A tour of the Maternal Child Care Unit at NHH; and
• A question and answer opportunity to cover any questions you may have related to your birthing options.

Please note: the information is designed for those in the third trimester (later stages) of pregnancy. It is recommended that sessions be scheduled for when you are at or after 32 weeks gestation.

Ontario’s Healthy Babies Healthy Children program provides free and confidential home visits by public health nurses.

After your baby is born, a Public Health Nurse may call you once you are discharged from the hospital. This phone call is to see how you and your baby are doing. Home visits may be offered depending on your needs. You can also self-refer to this program before or after your baby’s birth by calling the Health Unit number listed below.

You can receive information and support about:

• Having a healthy pregnancy and birth
• Bonding with your baby
• Feeding your baby
• Staying physically and emotionally healthy
• Dealing with occasional feelings of sadness
• Being a parent
• Encouraging your baby's growth and development
• Keeping your baby safe
• Finding community resources that you may need
• Other questions you may have

Contact: Haliburton, Kawartha, Pine Ridge District Health Unit
Telephone: 1-866-888-4577 ext 5003
Visit: Healthy Babies Healthy Children Program

What is a Non-Stress Test (NST)?

The NST is a way to check your baby’s well-being. It records your unborn baby’s heart rate and pattern as a way of checking his/her health.

The NST is not a routine test but your physician may order a non-stress test in the following instances:

• You feel your unborn baby is not moving as much as usual.
• You are past your due date.
• Any reason to suspect that the placenta is not functioning adequately.
• High risk for any other reasons.
• You have spotting or bleeding.
• Your unborn baby is smaller than expected for gestational age.
• You have high blood pressure, diabetes or other health problems.
• For reassurance of the unborn baby’s condition.

How is the NST done?

• The test is completed by attaching two monitors with belts to your abdomen: one to measure the fetal heart rate, and the other to measure any contractions.
• Uterine contractions and fetal heart rate are measured for a minimum of 20-30 minutes.

If you have an NST scheduled, remember to eat before your appointment because your baby will be more active.

Smoking at any time is harmful. Smoking during pregnancy can affect the unborn baby's heart rate, therefore you should not smoke for at least two hours before the test.

1 in 5 new mothers will experience a perinatal mood disorder. It can begin during pregnancy, after giving birth and/or after several weeks or months after giving birth. Remember – you are the expert on what is normal for you. If you feel something is not right, trust your instinct and know that help is available.

Warning signs include the following:

• Feeling overwhelming sadness or despair.
• Being unable to sleep.
• Having trouble concentrating or remembering things.
• Loss of your appetite and not wanting to eat.
• Having thoughts of harming yourself or your baby.
• Feeling guilty or ashamed
• Having thoughts/feelings that you are not a good mother.
• Just not feeling like yourself.

If you are experiencing any of these symptoms, seek help early.

• Ask for help from family, friends, and your health care provider.
• Take care of yourself.
• Take time for yourself.
• Join a support group.
• Talk with your health care provider about the best course of treatment.  

Remember: there are resources available to help you and your family.

To get more information on the resources in your area, contact:

• Service Ontario INFOline (to find your local public health unit and/or other supports): 1-866-532-3161
• Telehealth Ontario: 1-866-797-0000 or TTY: 1-866-797-0007

Mental Health Helpline: 1-866-531-2600

Click the link below to download and print this checklist of what to bring to the hospital:

What to Pack for Hospital Checklist

Whether or not you have had an induced labour, you should call the NHH Maternal Child Care team and plan to come to the hospital for assessment when:

• You have any concerns about yourself or your unborn baby.
• Your water has broken (membranes have ruptured).
• When regular contractions begin (40 to 60 seconds in duration, and approximately five minutes apart) – Note: contractions are measured from the beginning of one contraction to the beginning of the next; it’s important to measure how long each contraction lasts.

Contact the Maternal Child Care team directly before heading to the hospital so they can prepare for your arrival.
Call: 905-372-6811 ext. 4122

Where to go and what you need to do:

If you arrive between 7:30 AM – 3:30 PM: Please enter through the main entrance and stop at the Admitting/Registration Desk.

If arriving after 3:30 PM, and before 7:30 AM: You will need to enter through the NHH Emergency Department entrance and register at the ED Admitting/Registration Desk.

Women in labour may be dropped off at the entrance but vehicles must be parked in the parking lot to maintain access for others using the hospital.

During Labour, Delivery, and After the Birth

A maximum of 2-3 labour support persons (including partner) will be permitted in the room with the mother. This includes during the labour, the delivery, and for approximately one hour of recovery time after your baby’s birth, at the discretion of nursing staff.

Visiting family and friends are asked to wait in the waiting room or cafeteria, and not in the hallways, to ensure privacy and safety for everyone in the unit.

Although family or friends may be concerned about you, we ask that they refrain from calling the unit to ask about your labour progress. To protect your privacy, staff members are not able to provide any patient information.

Visitors may visit following the recovery period (approximately one hour after birth), dependent on the delivery mother’s wishes and the discretion of nursing staff.  

During a caesarean birth (C-section), only one labour support or partner can be with the mother in the operating room (provided she is awake through the procedure). Following birth by C-section, one support person may be present during the recovery period (approximately one hour), at the discretion of nursing staff.

Induction is a medical procedure used to start your labour when required.

You may need an induction if:

• You have high blood pressure.
• Your water has broken (membranes ruptured) and you have not started labour.
• Your baby’s health is of concern.
• You are seven or more days past your due date.
• You have a complication with your pregnancy.

The decision to induce your labour is made when the benefits of starting your labour are greater for your health and the baby's health than the risks of not letting labour begin on its own.  Your doctor or midwife will discuss your options. Together you will decide the best choice for your particular situation.

How is labour induced?

The first step of the induction process is to soften your cervix so it will be ready to dilate (open). This is usually done with Prostin gel or Cervidil, although there are other methods (e.g. foley catheter) that your health care provider can discuss with you.  

Protin Gel Induction

If Prostin gel is identified as the option for you, the gel will be inserted into the vagina to soften and open your cervix.

You will be monitored with a non-stress test prior to the gel insertion. You will also be monitored for at least one hour after gel insertion. If the non-stress test is normal, you will be discharged home. Your nurse and/or physician will give you a specific time to return the following morning. You are expected to return sooner with regular contractions or if your water breaks (rupture of membranes).

Cervidil Tape Induction

If Cervidil is the preferred option for you, the Cervidil tape is inserted into the vagina. A gauze-like tape, it slowly releases medication to soften and open your cervix

You will be monitored on a non-stress test for two hours after the procedure. You might be asked to remain in the hospital overnight.

Your partner or support person should be with you for each step of the induction process. When you are discharged, a person must be with you constantly to assist you and help you to safely return to the hospital when it is time.

Other Induction Options

Induction may also involve an artificial rupture of the membranes (breaking of water) and you may receive medication by mouth or intravenously (I.V.) to start regular contractions.

Every mother’s experience is different. Labour duration can vary but all labour occurs in three stages.

The First Stage: Early and Active Labour

This is the longest stage. It begins with regular labour contractions and lasts until your cervix is fully dilated (10 cm). The length of this stage varies for each woman and each birth.

Pain is usually is felt in the abdomen, and sometimes in the back during contractions.

You should arrive at the hospital when your contractions are five minutes apart.

After arrival at the hospital, your nurse or midwife will ask about your labour, assess your contractions, the baby’s heartbeat and your vital signs. They will then assess how much your cervix is dilated.

The use of distractions is helpful during this time, including: your partner, support individuals, laptops, listening to music, birthing ball, and position changes.

Ask your health care provider about pain management options, such as narcotics or an epidural.  

What the support person can do to help you:

• Keep track of contraction times.
• Provide a calming influence.
• Massage your abdomen and lower back.
• Provide comfort, verbal reassurance and support.
• Provide distractions.

Sleep chairs are available for one support person to stay overnight with the mother. The support person will be responsible for providing his or her own meals and personal care items.

The Second Stage: Delivery

Your health care team will let you know when you have reached this stage. At this stage your cervix is fully dilated at 10 cm and it is time to push and deliver your baby.

Pain and pressure will be felt in the pelvic and vaginal area during this stage. Your health care provider will help you know when it is time to push.

The length of time required for pushing is different for each women and birth. If this is your first pregnancy it is not uncommon to push for 2 – 3  hours.

It’s important to remember to rest between pushes.

It is normal and common for you to have a bowel movement or urinate when you’re pushing.

As the baby’s head is delivered, you may experience a burning feeling in the area between your vagina and anus.

Your baby will be placed, skin-to-skin, on your chest, as soon as possible after delivery.

The Third Stage: Delivery of the Placenta

The placenta is a temporary organ that joins the mother and the fetus, transferring oxygen and nutrients from the mother to the fetus and permitting the release of carbon dioxide and waste products from the fetus. Rich in blood vessels, the placenta is roughly disk-shaped, and at full term it measures approximately 15-17 cm in diameter and approximately 3-4 cm thick. It is expelled with the fetal membranes and, together, these form the afterbirth, usually delivered within 30 minutes of giving birth.

You will receive an oxytocin injection to encourage the uterus to contract and prevent excessive bleeding (hemorrhaging).

You will feel some contractions as the placenta separates from the uterine wall.

Your health care provider may gently massage your abdomen to ensure the uterus is contracting to prevent excessive bleeding.

Your newborn baby will be placed against you, skin-to-skin, usually on your chest, as soon as possible. The baby will be dried while skin-to-skin and you will be encouraged to maintain skin-to-skin contact for the first 1-2 hours after birth.  

If you have a cesarean birth, your partner/support person will be encouraged to hold the baby skin-to-skin until your surgery is completed.  

Skin-to-skin contact has many benefits for mothers and their babies. For more information, see the “For Parents” section and related resources in Ontario’s Best Start Resource Centre.

It is recommended by the World Health Organization and Health Canada that healthy-term infants are breastfed exclusively for the first six months of life.

• A nurse will help you to start breastfeeding within a half-hour following delivery, when possible.
• Your baby will have a bassinette at your bedside and remain with you for the duration of your stay at the hospital. This practice has been shown to promote successful breastfeeding.

* More information on breastfeeding will be found in the “For Parents” section of Ontario’s Best Start Resource Centre. You can also download or print a copy of Breastfeeding Matters – An Important Guide to Breastfeeding for Women and Their Families from that Centre.

New mothers may need help with learning their new roles and skills to take care of a newborn. Your partner/support person's role is to help with this transition by learning how to help you as a new mother. Be sure your support person is included in appointments, classes and care so that they are as prepared as possible to help you during this transition.

Below are some suggestions for partners/support people who choose to spend the night.

• This is a time of transition and the focus in the hospital during your family’s stay is their care, comfort, and learning. The support person is an important part of this experience and we encourage your participation in baby’s care and health teaching.
• Night time feedings and fussy periods can disrupt the sleep pattern of new families. As the support person, you will be an important resource to help through the day and the night. If you are scheduled to work the day after the delivery, and require continuous sleep, you might want to consider an alternative support person for that period of time.   
• The hours of operation of the NHH cafeteria vary according to the day of the week. See the Patient Services Directory for details and pack snacks to supplement your cafeteria and vending machine options as necessary.
• You will need to pack toiletries such as a toothbrush, soap, towel, pajamas in which to sleep in, slippers and a change of clothing.

Vitamin K Injection:

Given to the baby shortly after birth to prevent unnecessary bleeding. Vitamin K allows the baby’s blood to clot. Infants will begin to make their own vitamin K by six months.

Erythromycin Eye Ointment:

Erythromycin is an antibiotic that is placed in the baby’s eyes shortly after birth. The eye ointment protects the baby from illnesses that may cause blindness.

Newborn Screening:

A blood sample will be taken from the heel of your baby to test for rare but serious disorders. Certain disorders can result in physical or mental developmental delay or death if not treated, therefore it is important to identify them as early as possible. Test results will be completed after 24 hours of age and sent to your family health care provider.

HUGS Infant Protection Program:

A small soft band with a monitor will be wrapped around the baby’s ankle. An added safety precaution, this monitor would set off an alarm in the event someone carried the infant outside a certain area in/around the Maternal Child Care unit. This monitor provides an added level of security and peace of mind to new parents. The HUGs security band will be removed from your baby upon discharge.

• Prior to going home, your nurse will complete maternal/child discharge teaching.
• Postpartum discharge information will be provided, including information on how to properly care for yourself and your new baby after you go home, and local resources and supports.
• You should have a follow-up plan for you and your baby before being discharged to ensure timely care in the community once you get home. This could be with your midwife, delivery physician or family physician.

You are responsible for the purchase and safe installation of your baby’s care seat. Prior to discharge, you will be asked to bring your car seat to the Maternal Child Care Unit. A nurse will ensure that your baby is placed safely in the seat prior to leaving the unit.

The Cobourg Police Service (CPS) runs free Car Seat Clinics on a regular basis where you can learn how to install your child car seat properly and safely. Their car seat clinics are promoted regularly on the CPS social media channels and are by appointment only.

For more information, please visit:
ontario.ca/page/choosing-child-car-seat