This section provides information about doulas, blood tests, delivery, prenatal classes, suggested reading, and more. If you do not find the information you are looking for here, please feel free to ask your doctor for guidance to get the resources that are best for you.

Click on the headings below to review helpful tips and information, or follow the links to other sites our doctors trust.

  • O Mama

    This is a bilingual website and app. It is a joint project by the Better Outcomes Registry and Network (BORN Ontario), a program of the Children’s Hospital of Eastern Ontario (CHEO), with the funding support of eHealth Ontario.

    You will find trusted information on over 150 topics related to pregnancy, birth, and early parenting.

    Android and iPhone users can download the mobile app to receive weekly advice as well as track notes, symptoms and appointments. A detailed glossary offers definitions of key maternity care terms.

    Go to the website.

  • Coping with Nausea

    Here are a few tips from our OB doctors to help reduce, eliminate, or manage nausea during pregnancy.

    • Eat small, frequent meals
    • Eat something when you wake-up, before getting up
    • Get up slowly – sudden movement can aggravate nausea
    • Avoid fried, fatty, or highly spiced food
    • Reduce or eliminate fluids with meals – be sure to take these fluids between meals
    • Try to avoid odours when cooking – turn on the hood fan above your stove, open windows or have another person do the cooking
    • Eat foods that are “soothing” – carbohydrates tend to be more appealing
    • Avoid milk and red meats – they are most upsetting
    • Have fresh air while sleeping
    • Occasionally, iron containing vitamins can worsen stomach upset. If these bother you, just take folic acid supplements and restart prenatal vitamins when morning sickness subsides.
    • Eat a high protein snack at bedtime
    • Take food with you wherever you go
    • Listen to your body and do whatever works best for you
  • Depression in Pregnancy

    According to the Public Health Agency of Canada, 10 % of women will experience depression during pregnancy.

    If you are experiencing symptoms such as crying spells, thoughts or feelings of worthlessness or hopelessness, difficulty concentrating or organizing thoughts, feelings of guilt or inadequacy, changes in sleep or appetite, withdrawing from family and friends – please seek help. Come talk to your doctor.

    Mothers Offering Mother Support (MOMS) – Depression support groups 613.725.3601 x117

    Book: Pregnancy Blues, What every Woman Needs to Know about Depression During Pregnancy, by Dr. S. Mirsi

    Mental Health Crisis Line – Telephone support available 24/7 613.722.6914 or 1.866.996.0991

  • Kegel exercises - strengthening the pelvic floor

    Strengthening the Pelvic Floor with Kegels

    Pelvic floor exercises can help you improve your bladder control. When done properly and regularly, this series of exercises, called Kegels, can build up and strengthen the muscles of the pelvic floor to help you hold your urine during your pregnancy and after childbirth. These exercises can be started during pregnancy, and be continued after delivery.

    What is the pelvic floor?

    Layers of muscle stretch like a hammock from the pubic bone in the front to the end of the backbone. These firm, supportive muscles are called the pelvic floor and they hold the bladder and bowel, as well as the uterus, in place.

    How does the pelvic floor work?

    The muscles of the pelvic floor are firm and slightly tense to control the flow of urine from the bladder, or feces from the bowel. When you urinate or have a bowel movement, these muscles relax. Afterward, they tighten again and stay that way to restore control. Pelvic floor muscles can sag, however, because of an injury, lack of exercise, childbirth, or just getting older. When this happens, there is less control and urine and feces can leak.

    How can pelvic floor exercises help?

    Pelvic floor exercises can help strengthen the pelvic hammock so it will once again give support. This will help you improve your bladder control and reduce or stop the leaking of urine.

    Learning to do pelvic floor exercises:

    Pelvic floor exercises are designed to strengthen the muscles of the pelvic hammock. Make sure you learn how to do the exercises the right way and check from time to time that you are doing each exercise correctly.

    How to feel the muscles of the pelvic floor:

    It is important to learn how to feel the muscles of the pelvic floor as you contract them – to be sure that you are exercising correctly.

    Here are ways to identify the muscles:

    • Next time you to the toilet, try to stop the stream of urine about halfway through emptying your bladder. Then relax the muscles and allow the bladder to empty completely. The muscles you use to stop the flow of urine are the same muscles you will be squeezing when doing the Kegel exercises. Do not repeat this as an exercise;
    • The woman may place one or two fingers into her vagina. Tighten the pelvic floor muscles to squeeze your fingers. Your doctor or your health care professional may be able to help you with this the next time you have a vaginal examination; and
    • Imagine trying to stop yourself from passing wind from the bowel. You would squeeze the muscle around the anus. Try squeezing that muscle as if you really did have wind.

    Do it now. You should be able to feel the muscle move. The buttocks and thighs should not move at all. You should be aware of the skin around the anus being pulled up and away from whatever you are sitting on. Really try to feel this.

    HOW TO DO THE KEGEL EXERCISES:

    Exercise 1 Lying on your back, on the floor or bed, breathe deeply (don’t hold your breath) and tighten the anal muscle, pulling inward and upward.

    Exercise 2 Now tighten the vaginal muscle, pulling inward and upward. Hold the anal and vaginal muscles tight, slowly counting “one and two and three and tighten.” All the while continue to breathe deeply and evenly. Then relax.

    A Few Simple Rules to Remember:

    1. Do them properly – check often to be sure that you are using correct muscles.
    2. Do them regularly in sets of 5-10 contractions at a time in the morning, at noon, in late afternoon, and before going to bed. After 3-4 weeks, increase the number of contractions in each set and hold each one longer, up to the count of 10. When you can comfortably hold the contractions for 10 seconds, you might consider gradually increasing the length up to 20 seconds.
    3. Do the exercises intelligently – learn to use the muscles when you need them the most, especially during times of stress, excitement, or when you feel you need better bladder control.
    4. Keep doing them- muscles work best when they are exercised. Once you have learned how to improve your bladder control, continue to do the exercises to keep the pelvic hammock in good shape.
    5. Watch your weight- keeping yourself fit also means staying at your best weight
    6. Drink plenty of fluids – 6-8 glasses of water every day.
    7. And don’t fall back into the habit of going to the toilet “just in case”. Go only when you feel the need to pass urine.

    Do you have any questions?

    This information is designed to teach you how to control your bladder, so that you’ll be dry and comfortable. If you have problems doing the exercises, or if you don’t understand any part of this information sheet, ask your doctor for help.

    Do the Kegel exercises regularly. Have faith in them. You should begin to see good results in a few weeks.

    Kegel Exercises – The Mayo Clinic

    Kegel Exercises – Web MD (Slideshow & video)

  • Circumcision

    Circumcision in the newborn is a surgical procedure that is not medically necessary.

    Historically, circumcision has been practiced by those of Jewish and Muslim faiths for religious reasons. Circumcision for non-religious reasons has gone through various stages of favour and disfavour. There is evidence to suggest that circumcision reduces the risk of urinary infections in boys to 1/12 of what it would be otherwise. This potential benefit must be weighed against the fact that urinary tract infections in male infants are rare to begin with.

    The overall benefits and risks are so evenly balanced that the Canadian Pediatric Society does not recommend routine circumcision.

    Your decision with the knowledge of the potential risks and benefits must be based on personal, religious and cultural factors. If you are concerned about the boy looking different from other children or his father, remember that the implications of circumcision or non-circumcision are no greater than other natural physical differences such as hair colour, build, or size.

    Choosing not to circumcise

    The advantage of choosing not to circumcise are mainly the avoidance of the risks of circumcision as a surgical procedure; specifically bleeding, infection, and surgical trauma.

    At birth, the foreskin is tightly attached to the head of the penis, and normally cannot be pushed back. The foreskin of many children spontaneously goes back by the age of 5 years. Pushing the foreskin back before it is ready and breaking down the adhesions may cause significant infection and could cause tightening of the foreskin around the head of the penis. It is therefore not recommended that the foreskin be pushed back. The penis should simply be washed daily without pushing back the foreskin.

    Choosing to circumcise

    Circumcision is the surgical removal of the foreskin, or prepuce. This procedure is performed at the clinic, and takes about ten to fifteen minutes. Using a freezing technique called “dorsal penile nerve block” a small amount of local anesthetic is injected under the skin at the base of the penis, to numb the area. The technique uses the Mogen clamp, which is fast and protects the head of the penis.

    Risks

    Most babies exhibit little discomfort after their circumcision. As with any surgery, there is always the risk of bleeding or infection. If your baby has a congenital malformation of the penis (i.e. hypospadias) this may not be evident until after the circumcision. Rarely, part of the glands may bleed following this surgery. The incidence of complications of circumcision in published articles varies from 0.2% to 2%. Most complications are minor but occasionally serious complications can occur.

    Premature babies, those with bleeding problems, deformities of the penis, or other major medical problems should not undergo circumcision.

    Preparing for circumcision

    Bring extra diapers, soother, and 1tsp. sugar. There is evidence that having a baby suck on a sugar-coated soother is a great distraction during the operation.

    After the circumcision

    Instructions to look after the surgical site will be given to you after the circumcision. The tip of the penis will look angry and raw, and this is normal. With every diaper change, you will apply a generous amount of Vaseline over the area. A little bleeding is not unusual and can be stopped by applying gentle pressure with a clean gauze or cloth.

    Cost

    Circumcision is not a benefit covered by OHIP or any other health insurance. The fee is payable by cash, cheque, Visa, or Master Card and is due at the time of the surgery. The receptionist booking this visit will advise on fees.

    Urine Samples

    Unless directed by your doctor, it is no longer necessary to bring in a urine sample. When a urine sample is requested, it is appreciated when obstetrical patients bring their urine samples with them to their appointments, instead of producing their specimen upon arrival. This helps us spend more time with you in the office and reduces waits for our limited bathroom space.

    Please stop by reception on your way out for a labeled specimen container. (You do not need to refrigerate your specimen if produced beforehand.)

    If you absolutely must produce the specimen at the time of your arrival, it is necessary for you to arrive 15 minutes prior to your scheduled appointment time. Thank you!

  • Personal Hygiene

    More Risk of Infection if you Shave

    Vaginal Delivery OR Caesarean Section

    Do not shave or wax your abdominal or pubic area for 7 days prior to your due date or booked caesarean section.

    Research shows that shaving causes tiny cuts in the skin. These cuts give bacteria a way to enter the skin, which could cause infection.

    Avoiding shaving and waxing prior to delivery is recommended by the Centers for Disease Control and Canadian Patient Safety Institute, Safer Healthcare Now.

  • Suggested Readings

    What to Expect when you’re Expecting
    Authors: Arlene Eisenberg, Heidi E Murkoff, Sandee E. Hathaway
    Workman Publishing, 1996.

    The Complete Book of Pregnancy and Childbirth
    Author: Sheila Kitzinger
    Alfred A. Knopf, 2000.

    The Complete Book of Mother and Baby Care
    Author: The Canadian Medical Association
    Reader’s Digest Association, 1997.

    The Womanly Art of Breastfeeding
    Authors: La Leche League International
    Plume, 1997

    Dr. Jack Newman’s Guide to Breastfeeding
    Author: Jack Newman
    Harper Collins, 2000

    Your Baby and Child from Birth to Age 5
    Author: Penelope Leach
    Alfred A. Knopf, 2000

    Growing With Your Child: Pre-Birth to Age 5 – the Complete Guide to Your Baby’s Development (From Canadian Living Magazine)
    Authors: Christine Langlois (editor)
    Ballantine books, 1998

    What to Expect the First Year
    Authors: Arlene Eisenberg, Heidi Murkoff, Sandee Hathaway
    Workman Publishing, 1996

  • Zika virus

    To learn more about the Zika virus, you can find information from the Centers for Disease Control and Prevention.

  • Prenatal and Newborn Screening Tests

  • Prenatal Classes

  • Other Resources

    Safe Sleep Environment for Baby

    MOTHERISK – prenatal web resource and telephone help line (1-877-439-2744 Toll-free)
    Ottawa Valley Doulas Association

    Infant and Child CPR Courses:

    MotherCraft Ottawa
    Ottawa Childbirth Education Association
    Red Cross
    St. John Ambulance

    Decision guide for a vaginal birth after a Cesarean birth (VBAC):

    Ontario Midwives: VBAC guide
    Association of Ontario Midwives: Clinical Practice Guideline