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Calendrier du suivi de grossesse — Canada

Une traduction française est en préparation. Les informations ci-dessous sont affichées en anglais pour le moment.

This is a general overview of the prenatal visits many people in Canada are offered during pregnancy, drawn from public guidance by the SOGC and the WHO. Every pregnancy is different — your own care provider decides which checks and timing are right for you. It's here for reference and orientation, not as medical advice.

Disclaimer: BabyBerry est destinée à l'information générale et au suivi personnel. Ce n'est pas un dispositif médical et elle ne donne ni avis médical, ni diagnostic, ni traitement. Consultez toujours un professionnel de santé qualifié.
  1. First Prenatal (Booking) Visit — Semaines 8–10
  2. First Trimester Screening (eFTS / IPS Part 1) — Semaines 11–13
  3. Anatomy Ultrasound (Detailed Fetal Scan) — Semaines 18–22
  4. Second Trimester Routine Visit — Semaines 24–26
  5. Gestational Diabetes Screen + Rh Immunoglobulin — Semaines 26–28
  6. Tdap Vaccine and Growth Check — Semaines 28–30
  7. Third Trimester Routine + Growth Check — Semaines 32–34
  8. Group B Strep Screening — Semaines 35–37
  9. Term Visit — Pre-Delivery Assessment — Semaines 38–39
  10. Post-Dates Assessment and Induction Planning — Semaines 40–41

First Prenatal (Booking) Visit

Première visite prénatale · Semaines 8–10 · Un jeûne peut être nécessaire

Pregnancy confirmation, full booking blood panel, dating ultrasound, provincial enrolment (OHIP/MSP), care provider selection (OB, family physician, or midwife)

Bon à savoir: In Canada, your booking visit is where you confirm who will lead your care — an obstetrician, a family physician offering maternity care, or a registered midwife. All three are covered by provincial health insurance. Midwifery care is publicly funded in every province, and you can choose hospital, birth centre, or home birth (where available). The booking visit sets your due date, establishes baseline health, and enrols you in provincial prenatal programs like eFTS (Ontario) or the Perinatal Services BC program.

Examens courants

  • Dating Ultrasound — A dating ultrasound is typically done between 8 and 12 weeks to confirm a viable intrauterine pregnancy, rule out ectopic pregnancy, measure the embryo, and confirm the estimated due date (EDD). In Canada, the first-trimester dating scan is considered the most accurate method for determining gestational age and is covered by all provincial health plans.
  • Complete Blood Count (CBC) — A CBC measures red and white blood cells and platelets, establishing a baseline for anemia, infection, and clotting. Hemoglobin is tracked throughout pregnancy because iron demand rises in the second and third trimesters.
  • Blood Type and Rh Factor with Antibody Screen — Identifies ABO blood type and Rh status, plus screens for red-cell antibodies. Rh-negative patients in Canada receive Rh immunoglobulin (WinRho) at 28 weeks and again after delivery if the baby is Rh-positive — a standard SOGC recommendation to prevent hemolytic disease of the newborn.
  • Infectious Disease Panel (HIV, Hepatitis B, Syphilis, Rubella, Varicella) — SOGC recommends universal screening for HIV, hepatitis B surface antigen, syphilis, rubella immunity, and varicella immunity at the first visit. Early detection lets the care team prevent mother-to-baby transmission (HIV antiretrovirals, hepatitis B immunoglobulin at birth) and flag non-immune patients for postpartum MMR and varicella vaccines.
  • Urinalysis and Urine Culture — Screens for asymptomatic bacteriuria, urinary tract infection, protein, and glucose. Untreated bacteriuria is a known risk factor for pyelonephritis and preterm labour, so treatment with pregnancy-safe antibiotics is standard if a urine culture is positive.
  • Cervical Screening (Pap Test) if due — If your last Pap test is overdue per provincial screening guidelines (generally every 3 years in Canada), it may be done at the booking visit. Pap testing is safe throughout pregnancy and does not increase miscarriage risk.
  • Blood Pressure and Weight — Baseline measurements are recorded and repeated at every visit. A sustained rise in blood pressure after 20 weeks is the key screen for pre-eclampsia, and weight trajectory informs nutritional counselling per Health Canada guidelines.
  • Medical and Obstetric History — Your care provider reviews menstrual history (LMP), previous pregnancies, surgeries, chronic conditions, medications, allergies, family genetic history, and psychosocial factors. This establishes risk stratification (low-risk vs. high-risk) and determines whether referral to an OB or maternal-fetal medicine specialist is needed.

Comment se préparer

  • Come fasting (no food or non-water drinks for 8-12 hours) — the booking bloodwork may include fasting glucose and lipid panel.
  • Bring your health card (OHIP, MSP, RAMQ, etc.) and two pieces of ID. If you recently moved provinces, confirm coverage before the appointment.
  • Note the first day of your last menstrual period (LMP) — this is the starting point for dating your pregnancy.
  • Prepare a list of medications, vitamins, and supplements, plus any chronic conditions and past surgeries.
  • Gather both sides of family medical history — genetic conditions, birth defects, diabetes, high blood pressure, and mental health history.

Conseils

  • Start taking a prenatal vitamin with 0.4 mg (400 mcg) folic acid daily — Health Canada recommends starting at least 3 months before conception and continuing throughout the first trimester. Higher doses (up to 5 mg) are prescribed for specific risk factors.
  • If you do not have a family doctor, use the provincial find-a-doctor service (e.g., Health Care Connect in Ontario) or contact a local midwifery practice directly — midwives take patients without a referral.
  • Expect this visit to take 45-90 minutes. Bring a snack for after the bloodwork and a partner or support person if you have questions about decisions ahead.
  • Avoid raw or undercooked fish, unpasteurized dairy, deli meats, and alcohol. Limit caffeine to under 300 mg per day (about 2 cups of coffee).

First Trimester Screening (eFTS / IPS Part 1)

Visite 1 · Semaines 11–13

Nuchal translucency (NT) ultrasound plus maternal serum markers (PAPP-A, β-hCG, PlGF, AFP), and option to discuss NIPT as a funded or self-pay alternative

Bon à savoir: Prenatal screening in Canada is opt-in and decision-making should feel informed, not rushed. You can choose the integrated eFTS/IPS combination, NIPT alone, both, or decline screening altogether. No test is perfect — screening estimates probability, while diagnostic tests (CVS at 10-13 weeks, amniocentesis at 15+ weeks) confirm a diagnosis with approximately 0.1-0.3% procedure-related pregnancy loss risk. Provincial genetics programs offer free counselling if any result is outside the expected range.

Examens courants

  • Nuchal Translucency (NT) Ultrasound — A specialized ultrasound between 11 weeks 2 days and 13 weeks 3 days that measures fluid behind the baby's neck. Combined with maternal blood markers, it screens for trisomy 21 (Down syndrome), trisomy 18, and trisomy 13. NT measurement requires an accredited sonographer and is part of the provincial Enhanced First Trimester Screening (eFTS) program in Ontario, BC, and most provinces.
  • First Trimester Maternal Serum Screen (PAPP-A, β-hCG) — A maternal blood test measuring pregnancy-associated plasma protein A (PAPP-A) and free β-hCG. Combined with NT and maternal age, the eFTS test gives a personalized risk estimate for chromosomal conditions with approximately 90% detection and a 3-5% false-positive rate.
  • Non-Invasive Prenatal Testing (NIPT) Discussion — NIPT analyzes fetal DNA in maternal blood and has >99% sensitivity for trisomy 21. In Canada, NIPT is publicly funded for higher-risk pregnancies (age 40+, positive eFTS, previous chromosomal condition) and available as a private-pay option ($400-700) for average-risk patients. A positive NIPT still requires diagnostic testing (CVS or amniocentesis) for confirmation.
  • Fetal Heart Rate (Doppler) — Handheld Doppler is used from 10-12 weeks onward to confirm a reassuring fetal heart rate (typically 110-160 bpm). If the heart rate cannot be found, an ultrasound is done to confirm viability rather than assuming a problem.
  • Blood Pressure and Weight — Routine recording continues at every visit. Health Canada's pregnancy weight-gain guidelines are based on pre-pregnancy BMI — your provider will share a personalized target range.

Comment se préparer

  • You do not need to fast for NT ultrasound or eFTS bloodwork. Hydration helps — drink a glass of water an hour beforehand for clearer imaging.
  • Bring your requisition form from the booking visit — NT scans must be done at an accredited imaging centre, and you may need to book this appointment separately from your provider visit.
  • Talk with your partner about what you would do with screening results before doing the test. Think through your values — this makes decision-making less stressful if a positive result comes back.

Conseils

  • eFTS combined results typically arrive 1-2 weeks after bloodwork. If your risk estimate is higher than 1 in 350, your provider will offer NIPT (publicly funded in this case) or diagnostic testing.
  • Morning sickness usually peaks around 9-11 weeks and eases by the end of the first trimester. Small frequent meals, ginger, and B6 (25 mg up to 3x daily) are evidence-based first-line strategies. Talk to your provider about Diclectin if symptoms are severe.
  • If you are working, you can start researching your provincial parental leave options now. Canada offers EI maternity (15 weeks) and parental benefits (standard 40 weeks or extended 69 weeks) — planning early helps with financial decisions.

Anatomy Ultrasound (Detailed Fetal Scan)

Visite 2 · Semaines 18–22

Comprehensive fetal anatomy survey, placental location, amniotic fluid volume, cervical length assessment

Bon à savoir: The 18-22 week anatomy scan is the single most detailed ultrasound of your pregnancy. It is not primarily about finding out baby's sex — it is a comprehensive structural survey. About 3-5% of scans flag a finding that requires follow-up; most are variants of normal. If a concern is identified, you will be referred to maternal-fetal medicine, a fetal cardiologist, or a genetic counsellor — all publicly funded in Canada. Bring a support person; the scan is often a meaningful moment to share.

Examens courants

  • Detailed Fetal Anatomy Ultrasound (18-22 weeks) — A 30-60 minute scan that systematically examines the brain, face, spine, heart (four-chamber view and outflow tracts), lungs, abdomen, kidneys, bladder, limbs, and genitalia. Also measures biparietal diameter, head circumference, abdominal circumference, and femur length to confirm growth. SOGC recommends this scan for every pregnancy.
  • Placental Location and Cord Insertion — The sonographer identifies where the placenta is relative to the cervix. A low-lying placenta or placenta previa flagged at this scan is rechecked at 32 weeks — about 90% resolve as the uterus grows. Cord insertion is checked to rule out velamentous insertion or vasa previa, which affect delivery planning.
  • Amniotic Fluid Volume — Measured as the amniotic fluid index (AFI) or deepest vertical pocket. Too little (oligohydramnios) or too much (polyhydramnios) prompts additional investigation for fetal kidney issues, growth restriction, or gestational diabetes.
  • Cervical Length Measurement — A transvaginal measurement of cervical length is part of the anatomy scan. A cervix shorter than 25 mm before 24 weeks is a significant preterm birth risk and triggers discussion of vaginal progesterone or cerclage per SOGC preterm birth prevention guidelines.
  • Second Trimester Maternal Serum Screen (IPS Part 2) — In some provinces the Integrated Prenatal Screening (IPS) includes a second blood draw around 15-17 weeks combining first- and second-trimester markers for higher detection rates. This is typically done only if NIPT was not chosen.
  • Blood Pressure, Weight, Urine, Fetal Heart Rate — Standard at every visit from now through delivery. Fundal height measurement starts at 20 weeks — the measurement in centimetres should roughly match gestational weeks.

Comment se préparer

  • A full bladder helps earlier in pregnancy but is usually not needed at 18-22 weeks — follow the instructions from your imaging centre.
  • Book the scan early — anatomy ultrasounds are in high demand, especially in larger cities, and slots can fill 4-6 weeks out.
  • Discuss whether you want to learn the baby's sex beforehand — the sonographer will usually ask, and you can decline or leave a sealed envelope for a reveal later.
  • Write down any questions about fetal movement, sleep position, travel safety, or pregnancy-safe medications to bring to the provider visit following the scan.

Conseils

  • If you have been feeling movement (usually 18-22 weeks for first pregnancies, earlier for second+), start loosely noting when. Formal kick counting begins at 26-28 weeks.
  • Start using seatbelts correctly — lap belt below the belly, shoulder belt between the breasts and to the side of the belly. Never put the lap belt across the belly.
  • Start thinking about prenatal education classes (many are free through public health units), car seat shopping (install by 36 weeks), and choosing a paediatrician or family doctor for baby.

Second Trimester Routine Visit

Visite 3 · Semaines 24–26

Fundal height, fetal heart rate, blood pressure, urine, fetal movement counselling, preparation for glucose screening

Bon à savoir: From around 24 weeks your baby is considered potentially viable, meaning delivery after this point — while preterm — has meaningful chances of long-term survival with modern neonatal care. Canadian Level III NICUs routinely care for infants born at 24-25 weeks. This changes the calculation for when to seek urgent care: reduced fetal movement, persistent contractions, leaking fluid, or bleeding all warrant immediate assessment rather than "wait and see".

Examens courants

  • Fundal Height Measurement — The distance in centimetres from the pubic bone to the top of the uterus. From 20 to 36 weeks this should roughly equal the number of weeks pregnant (±2 cm). A discrepancy of more than 3 cm prompts a growth ultrasound.
  • Fetal Heart Rate — A reassuring fetal heart rate of 110-160 bpm is confirmed at every visit using a Doppler.
  • Blood Pressure and Weight Tracking — Your provider plots trends. A new elevation in blood pressure after 20 weeks, especially with protein in urine, is assessed for gestational hypertension and pre-eclampsia.
  • Urinalysis (dipstick) — A urine dipstick checks for protein, glucose, and ketones at each visit. Protein is the key screen for pre-eclampsia in the second half of pregnancy.
  • Fetal Movement Counselling — SOGC recommends formal kick counting from 26 weeks in higher-risk pregnancies and in any pregnancy where the pregnant person notices a change. The teaching: at the same time each day, count 6 distinct movements — should feel within 2 hours. Any concern means same-day assessment.

Comment se préparer

  • Bring your requisition for the upcoming glucose challenge test (GCT) — it is usually done between 24-28 weeks. Schedule it for a morning when you can stay at the lab for an hour.
  • If you have been feeling Braxton Hicks contractions (tightening that is irregular and painless), make a note — they often start around this time. Regular, progressively painful contractions before 37 weeks are different and warrant a call.

Conseils

  • Now is a good time to enroll in prenatal classes. Most provinces offer free classes through public health. Private options (often hospital-based) cover labour coping skills, breastfeeding, and newborn care.
  • Check your dental coverage — your province may cover a prenatal dental visit. Pregnancy gingivitis is common and treatable, and untreated periodontal disease is linked to preterm birth.
  • If you are travelling, most airlines allow flying until 36 weeks for uncomplicated single pregnancies. Beyond 28 weeks you may need a note from your provider.

Gestational Diabetes Screen + Rh Immunoglobulin

Visite 4 · Semaines 26–28

Glucose challenge test (50g, 1-hour, non-fasting), repeat CBC and antibody screen, Rh immunoglobulin for Rh-negative patients at 28 weeks

Bon à savoir: Approximately 3-20% of Canadian pregnancies are affected by gestational diabetes, with higher rates in South Asian, East Asian, Indigenous, African, and Hispanic populations. A positive screen is not a failure — it is your care team doing what the test is designed to do. Most GDM is well-managed with diet and monitoring; about 15-30% require insulin. Babies of well-controlled GDM mothers have excellent outcomes, and your risk of type 2 diabetes after pregnancy can be mitigated with breastfeeding and active lifestyle.

Examens courants

  • Glucose Challenge Test (GCT, 50g, 1-hour) — SOGC recommends universal screening between 24-28 weeks. You drink a 50g glucose solution, then blood is drawn one hour later. The test is non-fasting. A result of 7.8-11.0 mmol/L requires a follow-up 75g oral glucose tolerance test (OGTT); ≥11.1 mmol/L confirms gestational diabetes mellitus (GDM) directly.
  • Complete Blood Count (CBC) — repeat — Hemoglobin is rechecked because iron-deficiency anemia is common in the second trimester. Low levels prompt treatment with oral iron; severe or unresponsive anemia may be managed with IV iron.
  • Antibody Screen — repeat — Rh-negative patients have their antibody screen repeated to confirm they have not been sensitized. All Rh-negative patients in Canada receive Rh immunoglobulin (WinRho, typically 300 mcg IM) at 28 weeks regardless.
  • Rh Immunoglobulin (WinRho) — A single intramuscular injection given to all Rh-negative patients at 28 weeks to prevent anti-D antibody formation against a potentially Rh-positive fetus. A second dose follows within 72 hours of delivery if the baby is confirmed Rh-positive. This protocol has virtually eliminated hemolytic disease of the newborn from Rh incompatibility in Canada.
  • Blood Pressure, Weight, Urine, Fundal Height, Fetal Heart Rate — Standard routine at every visit.

Comment se préparer

  • You do not need to fast for the 50g GCT. Eat a normal breakfast. Avoid anything extra sweet in the hour before — that can falsely elevate the result.
  • Plan to stay at the lab for about an hour — bring a book, phone, or work. The glucose drink is consumed under observation, then you wait one hour before the draw.
  • If you are Rh-negative, confirm with your provider that the WinRho injection has been ordered. It is typically given on the same day as the bloodwork.

Conseils

  • If your GCT is positive, the follow-up 75g OGTT is fasting (overnight) with blood draws at 0, 1, and 2 hours. Book it within 1-2 weeks of the positive GCT.
  • Start thinking about where you will give birth — most Canadians deliver at a hospital, but midwife-attended birth at a birth centre or at home are covered options for low-risk pregnancies in most provinces.
  • Braxton Hicks contractions often increase around now. Dehydration is a common trigger — aim for 2-3 litres of water daily. If contractions are regular (more than 4 in an hour) before 37 weeks, call your provider.

Tdap Vaccine and Growth Check

Visite 5 · Semaines 28–30

Tdap vaccination (NACI recommended 27-32 weeks), growth assessment, fetal position begins to matter, review of GDM and anemia results

Bon à savoir: From 28 weeks, visits become closer together — typically every 2-3 weeks until 36 weeks, then weekly. The third trimester is when small problems can become bigger ones, and regular surveillance catches issues early. Side note: in Canada, starting at 28 weeks you can notify your employer that you plan to start EI maternity leave up to 12 weeks before your due date, giving you flexibility on timing.

Examens courants

  • Tdap Vaccination (Tetanus, Diphtheria, Pertussis) — Canada's National Advisory Committee on Immunization (NACI) recommends Tdap in every pregnancy between 27-32 weeks. Maternal antibodies cross the placenta and protect the newborn from pertussis (whooping cough) in the first 2 months before baby's own vaccines begin. Pertussis is life-threatening in newborns, and the vaccine has an excellent safety record during pregnancy.
  • Fundal Height and Growth Assessment — Fundal height should equal about 28-30 cm at this stage. If growth lags or exceeds expectations, a growth ultrasound is ordered to measure estimated fetal weight and screen for intrauterine growth restriction (IUGR) or macrosomia.
  • Review of GDM Screening and Bloodwork — Your provider reviews the 24-28 week results with you. If GDM is diagnosed, referral to a diabetes-in-pregnancy clinic is usually made within a week — care typically includes a dietitian, diabetes nurse educator, and glucometer training. If hemoglobin is low, iron supplementation is started.
  • Fetal Position Check — Your provider begins palpating the abdomen to identify fetal position (Leopold's manoeuvres). At 28-30 weeks babies move freely — position is not yet a concern — but baseline checks help detect persistent breech presentation later.
  • Blood Pressure, Weight, Urine, Fetal Heart Rate — Continuing routine surveillance for pre-eclampsia, gestational diabetes complications, and fetal wellbeing.

Comment se préparer

  • The Tdap vaccine can make your arm sore for a day or two. Mild fever and fatigue are normal — these are not contraindications to the vaccine, they are signs of immune response.
  • Ask your provider about the flu vaccine (recommended every pregnancy from the start of flu season) and COVID-19 vaccine if not recently received. Both are safe in pregnancy and recommended by NACI.

Conseils

  • Apply for parental benefits with Service Canada online — you can file up to 8 weeks before your leave start date. Gather your SIN, record of employment (ROE) from your employer, and direct deposit info.
  • Start packing a hospital bag. Include your health card, ID, a change of clothes for you and baby, nursing bras, toiletries, and snacks. If giving birth at home or a birth centre, your midwife provides a supply list.
  • Consider a car seat installation check — most Canadian fire stations and some public health units offer free car seat inspections. The seat must be properly installed and rear-facing before hospital discharge.

Third Trimester Routine + Growth Check

Visite 6 · Semaines 32–34

Growth assessment, placental location re-check if previously low, fetal position tracking, birth plan discussion begins

Bon à savoir: This visit is when the birth plan conversation usually starts in earnest. A Canadian birth plan typically covers: pain management preferences (epidural, nitrous oxide, hydrotherapy, movement), who will be present, skin-to-skin preferences, delayed cord clamping (SOGC recommends ≥60 seconds), vitamin K and erythromycin for baby, and feeding intentions. Your provider is your advocate — plans are flexible, but putting preferences on paper gives your team a starting point.

Examens courants

  • Growth Ultrasound (if clinically indicated) — Not routine for all pregnancies, but ordered if fundal height is discordant, if GDM is present, in multiples, or for other risk factors. Estimates fetal weight, checks amniotic fluid, and assesses placental function via umbilical artery Doppler.
  • Placental Location Recheck (if previously low-lying) — If the 18-22 week anatomy scan showed a low-lying placenta or placenta previa, a follow-up transabdominal and sometimes transvaginal scan at 32 weeks reassesses. If the placenta remains <2 cm from the internal os, a planned Cesarean at 36-37 weeks is discussed.
  • Fetal Position Assessment — By 32-34 weeks about 95% of babies are head-down. If breech or transverse, your provider discusses options: wait and see (many still turn), positioning exercises (Spinning Babies), or external cephalic version (ECV) at 36-37 weeks — a 50-60% success rate procedure covered by all provincial health plans.
  • Pre-eclampsia Screening — Blood pressure (≥140/90 on two readings 4+ hours apart), urine protein, and symptoms (persistent headache, visual changes, right upper quadrant pain, sudden swelling) are screened. Any red flags prompt bloodwork (liver enzymes, platelets, creatinine) and closer monitoring.
  • Blood Pressure, Weight, Urine, Fundal Height, Fetal Heart Rate — Standard at every visit. Fundal height should be approximately 32-34 cm.

Comment se préparer

  • Download or request a birth plan template from your care provider or hospital. Bring draft notes to this or the next appointment for discussion.
  • If attending a hospital birth, take a labour-and-delivery unit tour. Most Canadian hospitals offer these as free drop-in or bookable sessions — ask your provider for dates.
  • Review fetal movement patterns daily — you should feel 6+ distinct movements in 2 hours during active time. A persistent decrease means call your provider or go to L&D.

Conseils

  • If breech at this stage, ask about ECV — it is a low-risk, often-successful procedure that avoids a surgical birth. It is typically done at 36-37 weeks in the hospital with ultrasound guidance.
  • Finalize childcare arrangements for older children during labour. Have a backup plan in case labour starts overnight or during a weather event.
  • Canadian provinces have provincial electronic health records (e.g., Ontario's BORN) — your prenatal records follow you. If you are travelling or delivering in a different city, ask for a printed summary.

Group B Strep Screening

Visite 7 · Semaines 35–37

GBS swab, confirm fetal presentation, finalize birth plan, review signs of labour

Bon à savoir: From 37 weeks you are considered term, and spontaneous labour becomes appropriate. SOGC defines term delivery in nuanced categories: early term (37-38+6), full term (39-40+6), late term (41-41+6), and postterm (42+). Outcomes are best from 39-40 weeks, which is why elective induction before 39 weeks is generally avoided for low-risk pregnancies. Keep your phone charged, fuel topped up, and hospital bag by the door — labour rarely starts with Hollywood timing.

Examens courants

  • Group B Streptococcus (GBS) Vaginal-Rectal Swab — SOGC recommends universal GBS screening at 35-37 weeks via a single swab of the lower vagina and rectum — you can self-collect in some practices. About 10-30% of pregnant Canadians test positive. Positive carriers receive IV penicillin or cefazolin during labour to prevent early-onset GBS disease in the newborn, which reduces the risk of neonatal sepsis by approximately 80%.
  • Fetal Position (Leopold's Manoeuvres) — By 36 weeks position is clinically important. If breech or transverse, external cephalic version (ECV) is typically offered at 36-37 weeks. If ECV is declined or unsuccessful, planned Cesarean at 39 weeks is standard SOGC practice for persistent breech.
  • Cervical Exam (if symptomatic) — Routine cervical exams are not required in every pregnancy at this stage — many patients and providers prefer to skip them. They are done if contractions are frequent, there are concerns about preterm labour, or discussion of induction requires a Bishop score assessment.
  • Review of Signs of Labour and When to Go to Hospital — Your provider reviews: regular painful contractions (typically 5 minutes apart for 1 hour for first babies — the 5-1-1 rule), rupture of membranes (any leaking fluid — go in immediately, especially if the fluid is not clear), bleeding, or decreased fetal movement. Phone numbers for triage and midwife pager are confirmed.
  • Blood Pressure, Weight, Urine, Fundal Height, Fetal Heart Rate — Routine surveillance at every visit.

Comment se préparer

  • If self-collecting the GBS swab, your provider demonstrates the technique: insert the swab about 2 cm into the lower vagina, then the same swab into the rectum. It is quick, mildly uncomfortable, and more accurate than missing the swab entirely.
  • Bring your finalized birth plan. Give copies to your care provider, partner, and doula if applicable. Your hospital may also ask for one at admission.
  • Install the car seat if you have not already. The base goes in the rear-facing position. Fire stations across Canada offer free installation checks.

Conseils

  • Nesting energy is real — many people find a second wind around 36-37 weeks. Use it to batch-cook freezer meals, set up the nursery, or tackle light organizing. Avoid heavy lifting or toxic cleaning products.
  • Start perineal massage daily from 34 weeks — 5 minutes of gentle stretching with natural oil reduces the need for episiotomy and the risk of tearing in first-time parents.
  • Discuss postpartum plans with your partner — who will cook, who will handle visitors, and what support looks like in the first 2 weeks. Canadians often underestimate how much help the first 2 weeks require.

Term Visit — Pre-Delivery Assessment

Visite 8 · Semaines 38–39

GBS result, fetal position confirmation, discuss signs of labour and induction timeline, postpartum planning

Bon à savoir: Most Canadians deliver between 39 and 41 weeks. Only about 4-5% deliver on their exact due date. Your due date is a midpoint, not a deadline. Statistically, 60% of first-time parents deliver after their due date; second-time parents are more evenly distributed. Trust your body, but also trust evidence — if you reach 41 weeks, your team will discuss induction because stillbirth risk begins to rise after 41+0 weeks even in healthy pregnancies.

Examens courants

  • GBS Result Review and Antibiotic Plan — Your GBS result from 35-37 weeks is reviewed. If positive, your chart is flagged for IV penicillin (or cefazolin if penicillin-allergic without anaphylaxis) during labour, starting at least 4 hours before delivery for full protection.
  • Fetal Position Confirmation — Most babies are head-down and engaged by this point. If still breech, ECV may be offered one more time or a Cesarean date booked. The baby's head engaging in the pelvis ("lightening") often happens in the last few weeks and feels like a sudden pressure shift — breathing gets easier, pelvic pressure increases.
  • Induction Timeline Discussion — SOGC recommends offering induction at 41+0 to 41+3 weeks for low-risk pregnancies to reduce stillbirth risk and unplanned Cesarean. Induction before 39 weeks is reserved for medical indications. Your provider discusses the process: cervical ripening (Foley balloon, prostaglandins), oxytocin, and the expected timeline (often 12-24 hours from start to delivery).
  • Postpartum and Newborn Care Planning — Your provider reviews: rooming-in with baby, newborn vitamin K (intramuscular, SOGC/CPS recommended), erythromycin eye ointment, newborn metabolic screening (heel prick at 24-48 hours, covered by all provinces), jaundice monitoring, breastfeeding support, and the first paediatric or family doctor visit (typically within 1 week of discharge).
  • Blood Pressure, Weight, Urine, Fundal Height, Fetal Heart Rate — Standard routine. Pre-eclampsia surveillance remains a priority this late in pregnancy.

Comment se préparer

  • Confirm your hospital or birth centre admission details. Know the specific triage entrance (often different from the main ER) and have a plan for transport in the middle of the night.
  • Pre-register at the hospital if offered — this cuts admission time when you arrive in labour.
  • Pack secondary items: long phone charger, lip balm, hair ties, flip-flops for the shower, loose going-home clothes, nursing bra or comfortable shirt.

Conseils

  • Increase daily fetal movement awareness — any concerning decrease means same-day assessment. Do not wait until the next scheduled visit.
  • Light physical activity — walking, prenatal yoga — is encouraged and may help baby engage. There is no strong evidence that spicy food, sex, or bouncing on a ball starts labour, but these are not harmful for low-risk pregnancies.
  • If this is your first baby, labour often starts slowly over several hours. Early labour (contractions 10-20 minutes apart, manageable) is usually best managed at home with rest, eating, hydration, and a warm bath.

Post-Dates Assessment and Induction Planning

Visite 9 · Semaines 40–41

Biophysical profile or modified BPP, non-stress test, membrane sweep option, induction booking per SOGC 41-week guideline

Bon à savoir: Going past your due date is normal and emotionally hard — you are ready, baby is slower to arrive, and well-meaning phone calls multiply. Stillbirth risk at 41 weeks is still very low (about 1 in 1000) but rises to approximately 1 in 700 at 42 weeks. SOGC balances this with the knowns of induction: most inductions for post-dates succeed vaginally, and the small risk reduction is meaningful. The decision is yours, ideally in partnership with your care team. In Canada, induction bookings happen at your hospital's L&D scheduling desk; you are usually given a call-in time within a 1-2 day window.

Examens courants

  • Non-Stress Test (NST) — A 20-30 minute monitoring of fetal heart rate and movements using two external sensors. A reactive NST (two accelerations in 20 minutes) is reassuring and defers induction for 3-7 days. Offered routinely from 41 weeks, and earlier if risk factors (GDM, hypertension, IUGR).
  • Modified Biophysical Profile (BPP) — Combines an NST with an ultrasound measurement of amniotic fluid. A normal result (reactive NST + normal fluid, ≥2 cm deepest pocket) provides strong reassurance of fetal wellbeing. An abnormal result may prompt admission or expedited induction.
  • Cervical Exam and Bishop Score — A cervical exam assesses dilation, effacement, station, position, and consistency — combined into the Bishop score. A score ≥6 predicts a successful induction; <6 may need cervical ripening first. Informed consent is obtained; the exam is usually brief but can be uncomfortable.
  • Membrane Sweep (Stretch-and-Sweep) — During a cervical exam, your provider may offer a membrane sweep — a gentle circular motion at the internal os that separates the amniotic membrane from the cervix. It can shorten time to spontaneous labour by 1-2 days in some people. It is optional, briefly uncomfortable, and can cause light spotting.
  • Induction Booking — If spontaneous labour has not started by 41+0 to 41+3 weeks, an induction date is booked per SOGC guidelines. The method depends on your Bishop score: cervical ripening (Foley balloon catheter, vaginal prostaglandins, or oral misoprostol) followed by IV oxytocin. Induction increases some intervention risk but reduces stillbirth risk overall.
  • Blood Pressure, Weight, Urine, Fundal Height, Fetal Heart Rate — Routine surveillance is maintained until delivery.

Comment se préparer

  • Ensure hospital bag, car seat, and partner are all ready for same-day activation. Review the route to the hospital and parking plan.
  • If eligible, take your provider up on a stretch-and-sweep — evidence shows it can modestly increase spontaneous labour within 48 hours.
  • Plan light, frequent meals — big heavy meals are a bad idea if labour starts.

Conseils

  • Rest aggressively. Sleep when you are tired, nap during the day, and do not let well-meaning visitors wear you out before labour starts.
  • Go for daily walks — walking does not start labour in a guaranteed way, but it helps position baby optimally and supports your mental health.
  • If induction is recommended, it is a safe, well-studied medical tool — not a lesser way to give birth. Most Canadian inductions at 41 weeks go on to vaginal delivery within 24-48 hours.
  • Stay in close contact with your care team. Decreased fetal movement, leaking fluid (clear, pink, or green/brown — any colour), bleeding, or severe headache means hospital immediately.

Sources

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Calendriers de suivi de grossesse par pays