There are many reasons why one might want to call their midwife. We encourage the use of the pager number for emergencies and urgent matters only. The following are common emergencies:

• if you think you may be in labour*

• any abnormal physical changes

• spotting or bleeding of any kind

• persistent fever

If you need to speak to a midwife about a non-urgent matter, please call the clinic and leave a message with our administrative team. Phones are checked and answered during clinic hours, M/T/T/F 9am-5pm. Midwives are usually on site specific days to run their clinic and can generally respond to messages on those days. Please understand that for privacy reasons, we cannot give out the private emails or phone numbers of our midwives and contact must go through our reception. Please call the clinic at (416)-530-7468 for any of the following:

• enquiries about test results

• documentation

• requisition forms

• appointment changes or cancellations

• non-urgent questions to your midwife

*If you're having your first baby, we adhere to the 4-1-1 rule of labour. Please page your midwife when your contractions are 4 minutes apart from the beginning of the contraction until the beginning of the next contraction (4), your contractions are 60 seconds long (1) and this pattern has been consistent for at least 1 hour.

If this is not your first baby, please page with 3-4 contractions in a row that are strong, and different from regular mild cramping or discomfort of late pregnancy.

If you're unsure, you can always page your midwife for labour guidance.

1. Call the pager number (located on your appointment card)

2. Press 1 to listen for the name of one your midwives. (if you do not recognize any of the names page any midwife)

3. Click the corresponding number for your midwife on the list.

4. Listen and confirm it is the correct phone number for your midwife to return your message.

5. Leave your message at the tone. State your name and reason for calling clearly.

* If your midwife does not respond after 10 minutes, please page again. If your midwife does not respond after another 10 minutes, please page another midwife.

Stage 1: Early Labour

• Early labour constitutes on average, an entire two thirds (2/3) of labour time

• Your cervix will soften, thin and open to 4cm

• You will likely have irregular and mild contractions lasting less than one (1) minute

• You may have pink discharge or soft stools

• This is a good time to eat, drink lots of water and get some sleep

• Tylenol and Gravol are safe to take during labour. These medications help to ease early labour discomfort and help you save your energy for active labour. Its recommended to take 1000mg of acetaminophen (Tylenol) and/or 50-100mg of dimenhydrinate (Gravol)

Stage 2: Active Labour

Only start timing your contractions when your contractions start to become regular, strong, and lasting 60 seconds

• Your cervix will continue to thin and open to 7cm

• You will begin to have regular and strong contractions lasting 60 seconds and every 3-4 minutes

• You will likely be unable to talk through your contractions

• You may find yourself becoming very serious and focused as your contraction intensity and length increases 

• This is a common window of time for the epidural if it is a part of your birth plan

• It's recommended that you change positions every 30 minutes, rest in between contractions, hydrate after every contraction and try to urinate at least every 2 hours

Stage 3: Transition Labour

• Your cervix will fully open to 10cm

• You will have regular and intense contractions lasting 60-90 seconds every 2-3 minutes 

• You may experience some shaking and vomiting at this stage in labour as this is the most intense (and shortest) part of labour

• As the baby descends, you will feel rectal pressure 

• This is a great time to use hydrotherapy if it is a part of your birth plan

Stage 4: Pushing and Birth

• Contractions may space out

• The pressure on your rectum may increase

• The urge to push might be involuntary. The pushing stage can take a few hours as the baby’s head rocks back and forth until it stays “2 steps forward, 1 step back”

• You may feel worried or excited to feel the baby in the birth canal

• Your breathing will be very focused and serious

Stage 5: After Birth/Placenta Delivery

• You may feel hot or cold or shaky after the birth

• You may feel cramping in your uterus

• It’s time to birth the placenta!

• You may need vaginal or perineal repair at this point

This information has been provided by the Association of Ontario Midwives

If you have had a caesarean section (C-section) before, your midwife will talk to you about your options for giving birth this time. How to give birth is a personal decision with no right or wrong answer. Your midwife will support your choice, and they will help make your birthing experience as positive as possible, however you choose to birth your baby.

A vaginal delivery is a safe choice for most birthing parents who have had a C-section. Some who plan for a vaginal delivery will end up having another C-section or you may choose to have a planned C-section, which for some may be the safer option.

The Association of Ontario Midwives has provided detailed information on TOLAC (which you may have previously seen referred to as vaginal birth after caesarean or VBAC) which can be found here.

Pregnancy hormones can alter how your body uses and reacts to insulin, which can lead to the development of Gestational Diabetes Mellitus (GDM). Your body uses insulin to help regulate the amount of glucose, or sugar, in your blood. Blood glucose levels rise when the body is unable to produce enough insulin. You and your baby may experience health problems during pregnancy, delivery, and possibly even during the postpartum period if you have high blood glucose levels for an extended period of time. Please speak to your midwife for more information on how gestational diabetes can affect you and your baby.

At our clinic, we screen for gestational diabetes between 24-28 weeks. If you have booked your OGCT (Oral Glucose Challenge Test) with us, please read the following protocol to prepare for your test:

• You do not need to fast but try to have less sugar for breakfast and more protein such as eggs, cottage cheese, etc

• Please show up for your scheduled appointment 45 minutes in advance

• When you arrive, our reception staff will provide you with the glucose drink

• Please finish your drink within 5 minutes of arrival, and notify reception when you have finished

• After your finish your drink you will need need to completely fast, including no water, as well as limit physical activity

• Your blood will be drawn by your midwife during your appointment

There is a lot to consider when preparing for birth. Many people like to have a comprehensive plan in place before they go into labour, including your experience during labor, delivery and post-birth; such as the baby’s care after birth; how you plan to feed and much more. Luckily, we have provided a birth plan questionnaire to help you organize your thoughts.

You may fill out this template and bring it with you during your appointment with your midwife, or if you prefer, your midwife may also provide it to you during the appointment and you can fill it out together.

You may download our birth plan template here.

Many soon-to-be parents wonder where to start when it comes to preparing their birth bag. We have provided a list of things you may want to bring with you on the big day. This handout includes what to pack for home births, what to pack for a birth at the birthing centre and what to pack for a hospital birth. We have you covered no matter where you decide to give birth!

Unfortunately, most prenatal classes are not covered by OHIP; they are an out-of-pocket expense. If you do choose to register it is recommended to complete prenatal classes by 36 weeks of pregnancy. Topics usually covered in prenatal classes include relaxation techniques, comfort measures and coping skills, support people preparation, stages of labour, timing contractions, when to call your midwife, postpartum recovery, newborn care, infant feeding and postpartum mood support. 

SGMT has no involvement with any of the classes listed below. Clients are to book directly with the service provider.

The follow are free or covered by OHIP:

• Maternity Care Midwives 3-Part Youtube Series 

• Birthmark live classes taught by community doula’s and childbirth educators. 

• La Leche League offers virtual and in person prenatal classes in English and Spanish

Prerecorded & at Your Own Price

• Mamastefit interactive online classes taught by a Labour and Delivery Nurse, Personal Trainer and Doula. Discounts are available for clients in financial need.
  

Live and Virtual Combo

• Ottawa Childbirth Education Association 

Virtual Hypnobirthing

• Life’s Journey

• Childbirth Joy

Sunnybrook

• Offers live and virtual prenatal classes out of Sunnybrook Hospital

Toronto Birth Centre

• Currently the TBC does not offer prenatal classes, however if you’re interested in giving birth with them, they offer tours

• They also hold monthly events and workshops

SGMT has no involvement with any of the support groups listed below. Clients are to book directly with the service provider.

• Malvern Family Resource Centre - STRIDES

1321 Neilson Rd (Lower Level), Scarborough ON, M1B 5V9

Telephone: 416-438-3697 x 14349

Mondays 10am-11am.

Open to all. Register online.

• Scarborough EarlyON Centre - STRIDES

3478 Lawrence Ave E Unit C4, Scarborough ON, M1H 1A9

Telephone: 416-438-3697 x 14349

Tuesdays 10am-11am.

Open to all. Register online.

• The Hub Mid-Scarborough - STRIDES

2660 Eglington Ave E, Scarborough ON, M1K 2S3

Telephone: 416-438-3697 x 14349

Wednesdays 10am-11am

Open to all. Register online.

• Scarborough EarlyON Agincourt

3410 Sheppard Ave E Unit 304, Scarborough ON, M1T 3K4

Telephone: 416-438-3697 x 14349

Thursdays 1:30pm-2:30pm

Open to all. Register online.

• Black Creek Community Health Centre Jane Finch Mall

Suite 50A, 1911 Finch Ave W, Toronto, ON M3N 2V2

Telephone: 416-249-8000

Open to all. Call for resgister.

• Black Creek Community Health Centre Spanish Breastfeeding Group (Grupo de Apoyo a la Lactancia Materna)

Centre for Spanish Speaking Peoples, 2141 Jane St, North York, ON M3M 1A2

Telephone: 416-249-8000 x 2231

Llame para registrarse.

A water birth is when you give birth or labor in a tub or pool of water. Some people choose to give birth in the water, while others may only labor in the water as a method for pain relief or relaxation. If you are experiencing a healthy, low risk pregnancy you might want to consider a water birth.

If you have a midwife in Ontario, you can have a water birth at home, in a birth centre or in some hospitals. Your midwife will help you decide which option is best for you.

For more information on water births, the Association of Ontario Midwives has plenty of information provides on their website.

To clean your mouth properly, you should:

• floss daily

• drink fluoridated water where available

• brush your teeth twice a day for at least 2 minutes, using a soft toothbrush and fluoride toothpaste

Schedule a checkup in your first trimester to have your teeth cleaned and your oral health checked.

Morning sickness during pregnancy can expose your teeth to stomach acid and weaken the surface of your teeth by demineralizing. This puts you at higher risk of tooth decay and erosion of your teeth.

If you vomit from morning sickness, there are 3 steps to follow:

1. rinse your mouth with water or a fluoride mouth wash immediately after vomiting

2. after rinsing your mouth, wait for at least 30 minutes before brushing your teeth to further reduce the acid in your mouth

3. brush your teeth

Healthy eating and taking a multivitamin plays an important role for you and your baby during pregnancy and breastfeeding. Healthy eating is also very important for your oral health.

Eating a variety of healthy foods is the best way to help get the nutrients you need.

If you have good oral health, you can prevent a number of risks to you and your baby. Pregnant people with poor oral health have a risk of developing periodontitis (infection of bone holding the teeth in place). This type of infection has been associated with poor pregnancy outcomes such as:

• delivering a pre-term baby

• delivering a baby with a low birth weight

If you have any questions about your oral health, schedule an appointment with your oral health professional in your first trimester.

For more information on oral health care in pregnancy, please see our client handout here, or visit the Government of Canada website.