Client Area
When you should page AFTER the baby is born
Labour is an obvious time to page your midwife but following the birth women struggle with what constitutes a “good” or appropriate reason to page. This list should help with that. Ultimately, any time you are concerned and feel you need medical attention you should page: 1-800-805-9363
Mother:
• If you have a fever over 38C
• You have severe uterine pain with fever and foul smelling bleeding
• Your breasts have a red area that is hot/hard and you have a fever
• If you have painful urination and suspect a bladder infection
• If your nipples are severely damaged and you can no longer latch your baby
• If you have severe depression and have thoughts of harming yourself or your baby
Newborn:
• If your baby has a temperature over 38C and they are appropriately dressed (one layer of clothing more than you are comfortable in)
• If you are unable to latch you baby and it has been more than 6 hours from the previous feed. (newborns normally nurse at least 8x in 24hrs but will often have one long stretch of 3 to 6 hrs in 24)
• If the baby is more than 4 days of age and has less than 3 wet diapers in 24hrs or they have rusty crystals in their diaper.
• If the umbilical area (skin around cord) is red and swollen. It is normal for the cord to smell and ooze and sometimes bleed, this is not an infection.
• If the sclera (white part of the eye) is red and irritated looking. Newborns often have a yellowish discharge from their eyes which can get crusty, this is not an infection and should just be wiped with warm water regularly.
How to reach us: URGENT and NON-URGENT Situations
HOW TO CONTACT YOUR MIDWIVES
All non-urgent questions, concerns, and requests for prescription refills should be directed to the clinic at 705-523-8000. Calls are normally returned within one business day.
Paging should be reserved for emergencies or urgent situations. For example: labour, significant bleeding, ill newborns, etc.
When you have an urgent situation, page your midwives as follows:
1) Phone the paging service at 1-800-805-9363
2) Ask the operator to page BOTH your midwives (See teams below).
3) Give the operator your first and last name*, your telephone number, and tell the operator the reason for your page, for example “I think I’m in labour”.
4) One of your two midwives will return your call in 15-20 minutes. Please keep the phone line clear.
5) If you do not hear back within 15-20 minutes phone the paging service again, tell them you did not hear from a midwife, and ask them to re-page. Ensure you again leave your full name, number, and the reason for your call.
6) If you are more than 20 weeks pregnant and think you need to go to the hospital, please page your midwives first. Hospital Policy dictates that an attending midwife will see you; many concerns can be dealt with on an out-patient basis.
*Please use the last name that is on your Health Card even if this is not the name you normally use.*
During your pregnancy and 6 weeks postpartum your midwives are the main caregivers for you and your baby. If you have urgent concerns for you or your baby you should contact them either at the clinic, or for emergencies by pager. One of them will assess the situation and decide what care is needed, including if specialist care is required.
PLEASE REMEMBER TO ASK FOR YOUR MIDWIFE’S FULL NAME ALWAYS LEAVE YOUR FULL NAME AND PHONE NUMBER IF YOU PAGE MIDWIVES DO NOT CARRY CLIENTS’ FILES WITH THEM.
Please keep your line free after you call 🙂
TEAMS:
Debbie Younger and Lynne Sullivan
Shelley Ann Clarke-Dolby, Trina Desjardins and Jillian Ashick-Stinson
Meredith Crowder and Sara Vildis
Elizabeth (Buffy) Fulton-Breathat, Keatha Walsh and Dana Cuddy
Think you are in labour? When to page your midwife at term (37+ weeks)
Labour
Your labour may start with irregular contractions (i.e. 5-10 minutes apart, of variable length). Though these may be uncomfortable, or for some painful, the optimal place for you and your baby to be at this stage is at home, resting and staying well hydrated as your body prepares for real labour to begin.
Early labour contractions (once called ‘false labour’), are needed to do the groundwork for the dilating phase that will come later. During this time; your’ baby will be descending into a better position, your cervix can start softening and thinning, and yo.ur body will start producing the endorphins that will help you cope with the pain. Early labour may last for several hours, several days, or may even stop completely. If your water has not broken, try laying in the bathtub on your side (so the belly is underwater), as this can help you relax.
When do I need to speak to my midwife?
Your midwife will want to evaluate you and your baby when you are entering the active phase of labour. This is the point when your cervix will begin to dilate from the contractions. Active labour is defined as contractions at least 3-4 minutes apart lasting 60 seconds, with cervical dilation of 3-4cm
Coping with early labour tips
- Sleep! Gravol or Tylenol may be used every 4-6 hours.
- If daytime, do your best to ignore the contractions, go for walks, but rest between activities
- Stay well hydrated-Drink plenty of liquids, Gatorade, or juice
- EAT! Stick to easily digested foods
Page your midwives (1-800-805-9363)
For one to two hours, regardless of position, all of your contractions are:
- 3-4 minutes apart or less (from the beginning of one contraction to the beginning of the next contraction
- Lasting at least 45-60 seconds
- Increasingly painful
*Most women have difficulty speaking during true labour contractions, cannot do normal activities, and must stop what they are doing to breathe through each contraction .
What if my water breaks?
About 10% of the time the bag of waters will break before labour starts. It may be a slow, steady trickle or a large gush. Unlike urine or vaginal secretions, amniotic fluid will not gush just once, but will continue to trickle down your legs or soak a large pad (not a panty liner).
After your waters have broken you should NOT take baths, have intercourse, or use tampons. It is not always necessary to intervene immediately; vaginal exams increase your baby’s risk of infection, and as such, are ideally avoided.
Who should page IMMEDIATELY if the water breaks:
- If you are LESS than 37 weeks pregnant
- If you screened positive for Group B Strep
- If the waters are green or brown
- If your midwife has specifically asked you to-because the fetal head is high
- If fetal movements are not felt within 1 hour (try laying down with your hands on your belly)
- If you are having active labour contractions every 3-4 minutes
If none of the above apply to you (i.e. the fluid is clear, you are greater than 37 weeks, you are group B strep negative, and not having contractions every 3-4 minutes), there is no need for immediate intervention. It may take several hours for active labour to begin.
Bleeding
In the days before labour begins, a small amount of BRIGHT RED bleeding is normal, and is called ‘show’. You may need to wear a panty-liner and change it regularly. This is normal bleeding/show. Soaking maxi-pads and/or passing clots (larger than a penny), is NOT normal; you should page immediately if this should occur.
PASSING THE MUCOUS PLUG is NOT a sign of imminent labour, and does not pose a risk to you or your baby.
Timing contractions
Contraction Start Time | Contraction End Time | Length of Contraction | Frequency of Contractions |
12:00:00 | 12:01:00 | 60 seconds | – |
12:05:00 | 12:06:00 | 60 seconds | Every 5 minutes |
12:09:00 | 12:10:00 | 60 seconds | Every 4 minutes |
You are always welcome to contact us if you are concerned.
After Hours Appointments
We have had a number of clients request appointments in the evening and on weekends. We are aware that it is difficult to attend appointments during the workday, however due to the long and unpredictable hours involved in attending deliveries, midwives cannot also do prenatal appointments outside of planned clinic hours.
We will be happy to assess your labour in the middle of the night, spend all day with you while you are in labour, attend your birth at · four in the morning, even on statutory holidays, assist you with breastfeeding on the weekend, and answer your urgent concerns in the evening. In order for us to provide this time for you, our clinic time is scheduled during regular -working hours. Because midwives may be busy attending births and making home visits, each midwife schedules clinic visits on specific days each week.
In the event of canceled appointments, we will make every effort to contact you so · that you are not making a wasted trip, but there may be times when a labour or birth is happening quickly and the midwife has to run out of the clinic. Our office opens at 8:30, if you have an early morning appointment you will be called at this time if there is a cancellation.
It is your right under Ontario law to take time off from work to attend prenatal appointments. We thank you for your understanding in this matter.