top of page
Purple Cover.png

The Ultimate Montreal Pregnancy Guide 
By 
Gabriela Mizrahi & Mika Rock

Newborn baby in blue
Congratulations on your pregnancy!...

... It’s so exciting! This is a unique time in your life!

 

You may be wondering, “What do I do now?” or “Where do I start?” We have created this guide to support you as you take the next essential steps on YOUR journey.

In this Ultimate Montreal Pregnancy Guide, you will find the answers to many of your burning questions, beginning with, “I’m pregnant. Now what?”.

This is a place to explore your options. It is an opportunity to learn about the different types of care providers that are available to support you through your pregnancy and what you can expect as pregnancy follow-up, care during labour and after you give birth, as well as your options for where you can give birth with each type of care provider, home, midwife-led birthing center, or hospital. As you will see later in this guide, choosing where you give birth will determine the care providers that are available to you. What you can expect as you take these next steps in your journey will depend on your choice of care provider and birth location from the options available in Montreal.

Choosing your medical care provider is one of the most important choices and decisions you will make early on in pregnancy. We have prepared this guide for you to help you explore your options and make an informed choice that best fits your needs and preferences.

Being an active member of your maternity team and an active participant in your care can make all the difference in the care you receive. And this will inform your experiences throughout your pregnancy and birth journey, for the wellbeing of your baby, yourself and your family.

Group 281.png

Introduction

Your rights in maternity care

It is important to know your rights as a pregnant person and patient in the maternity care system. To learn more: You will find the MSSS pregnant patient maternity rights HERE, White Ribbon Alliance human rights for all pregnant women HERE

A few questions for reflection:

Before making this choice, here are a few questions for reflection that can support you in making this decision:

14.png
14.png
14.png
14.png

What medical follow-up am I hoping for?

What do I expect at my prenatal care appointments?

What is important to me while I am in labour and giving birth. Where do I feel most safe?

Do I know, at this point, if my pregnancy is considered healthy (medically low risk) or in need of close medical follow-up (medically high risk)?

Young couple sitting on the floor in embrance expecting a baby
Branch with flowers outline frame

Maternity care providers and models of care

Midwife
Midwife and a pregnant woman
Midwives are experts in caring for medically low-risk pregnancy. 

Midwives provide complete care throughout pregnancy, birth and postpartum. This includes regular prenatal visits, screening and diagnostic tests, routine blood tests, discussion of topics relevant to your pregnancy, birth and postpartum recovery, such as soothing common aches and pains of pregnancy, infant care and feeding, and emotional support.

Where do they attend births?


You can choose to give birth at home, at a midwife-led birthing centre, or in a hospital (the hospital associated with the midwife-led birthing centre and under the care of your midwife).

See table of birth placed below for details.

 


Do I need a referral? 


No. However, demand for midwives is very high, so call early in your pregnancy, or as soon as you know you are pregnant, for the best chance of registering with a midwife. You may need to call several birthing centres depending on availability for your estimated due date and add your name to the waiting lists.

Midwifery practice is built on research, evidence-based practices and guidelines and vast clinical experience following person-centered and family-centered care, which integrates the understanding that every person and family has their own unique values, needs, and preferences. 

Midwives encourage you to participate in the planning of care for you and your baby. They work with you with the belief that you are the primary decision maker about your own care. 

During prenatal visits, midwives offer you the opportunity to ask questions and will take enough time to have meaningful discussion to review your options and address any concerns as they arise, so you can make truly informed-choices. Prenatal appointments are not rushed. 

 

Yours and your baby’s health and wellbeing are at the center of midwifery care; from your experience of your pregnancy, to the birth of your baby and welcoming your baby home. Midwives are there to support you in a non-judgmental and non-authoritarian way that respects your needs and informed-choices, and upholds that welcoming your baby is a significant life event for you and your family.

 

 

Who are they trained to care for?

 Midwives are experts in caring for medically low-risk pregnancy. Midwives are healthcare providers. In Quebec, midwifery is a regulated profession. Midwives must have a license to practice from the Ordre des Sage-Femmes du Québec.

What care will I receive during labour?

In Quebec, you will typically have your primary midwife whom you will see for most of your prenatal visits, and you will meet other midwives from her team during some of your prenatal visits. Your primary midwife or another midwife from her team will attend your birth (ex. attending another birth, scheduled vacation or they are working together in shifts). 

Midwives will work together to be there for you throughout your labour and birth, no matter, when, where, or how long it takes. 

Midwives are trained to assess that you and your baby are doing well throughout your labour, that you feel safe and listen to your body. 

If necessary, midwives recognize early signs of the need for further medical assistance, in which case they collaborate with other healthcare professionals during birth to ensure the safety of you and your baby. This may involve transfer to the hospital and transfer of your continued care to a physician.

What can I expect as a postpartum care for me and my baby after birth?

After you give birth, the midwife will ensure that you and your baby are well. They will support your bonding and breastfeeding and will perform any perineal repair (stitches) as needed. They will ensure you have something to eat and drink, shower if you wish. You can choose to stay for 24h or go home after both you and baby have had a healthy checkup. The Midwifes will arrange to follow-up with you at your home within 24 hours, 3 days, 5 days and then 14 days and 4-6week at the birthing center. 

Follow this link, to learn more about the midwifery approach to care. 

Family Medicine
Family Doctor
Family doctors trained to follow pregnancies and attend births
 “Médecins accoucheurs”

Family doctors are trained to work with low-risk pregnancies and some more medically complex pregnancies. They support physiologic birth and know how to assist the birthing person as they birth in the position of their choice. They can assist you to give birth using evidence-based upright or side-lying birthing positions in the hospital, not just on your back. 

Where do they attend births?

Family doctors specialized in perinatal care attend births in the hospital. Some hospitals have a team of family medicine doctors associated with their birthing unit. 

Do I need a referral? 

No. You can contact the perinatal family medicine team associated with the hospital where you would like to give birth or specific clinic or CLSC where the family doctor(s) sees pregnant patients.

See the table of birth places and the list of contact details below for details.  

Who are they trained to care for?

Family doctors who follow pregnancy and attend births have a minimum 6-12 months of additional training after completing their family medicine residency in order to qualify as a “médecin accoucheur”. During prenatal visits, your family doctor will review some essential information about pregnancy and birth and will give you the opportunity to ask questions so you can begin the process of exploring your options to make informed-choices. These prenatal appointments may be short, so exploring topics of interest independently and preparing some questions and notes on your concerns to discuss before visits can be helpful to ensure you get the information you need. 

Nurses will care for you and your baby throughout your labour. They will advise the family doctor on-call of your arrival and labour progress. Family doctors typically work in teams, so your doctor may not be the one on-call when you are in labour or when you give birth. 

Depending on the hospital where you give birth, there may also be medical residents (and students) working with the staff doctor on duty. The medical resident and/or staff doctor on-call may introduce themselves at some point during your labour before leaving you in the care of the nurses. 

The nurses will communicate with the doctors as needed. When you are ready to give birth, especially if it is your first time, you will typically begin birthing with the nurses, and the physician will arrive when your baby’s birth is more imminent. However, some family doctors will be with you as soon as you begin birthing and stay until after the birth of your baby. This depends on the individual doctor. The nurses continue to provide care to you throughout labour and birth.

After you give birth, your doctor will ensure that you and your baby are well. They will perform any perineal repair (stitches) as needed. Nurses will continue to provide postpartum care. 

Your doctor or one of their colleagues on duty will assess you and your baby before you are discharged from the hospital 24-36 hours after giving birth. They will give you instructions to make an appointment for follow-up in 6 weeks. 

Once you are home, a nurse will call you from the CLSC within the first week home to do a phone assessment. If this is your first time coming home with a baby, the CLSC will offer you a home visit; otherwise, they may only offer phone assessment and support. 

Obstetricians
ObGyn

Obstetrician-gynecologists (ObGyns) are trained to care for women experiencing medically complex or high-risk pregnancies. Obstetrics and Gynecology is a surgical specialty. Obstetricians are surgeons. If you have a medically complex pregnancy, such as expecting triplets, planning a repeat cesarean section, or have an unstable chronic illness that could affect your pregnancy, an obstetrician is best equipped to provide your pregnancy care.

Where do they attend births?

Obstetricians attend births in the hospital. 

Do I need a referral? 

For most hospitals, yes, you will need a referral from a family doctor in order to be followed by an obstetrician for your pregnancy. This is because obstetricians are specialized in high-risk pregnancy, so most pregnancies do not need to be followed by an obstetrician. 

What is their approach to care?

Obstetricans are specialized in high-risk pregnancy. In this specialty, pregnancy is viewed as a medical condition to be “managed” or treated, rather than a normal physiologic process. 

Prenatal appointments are typically brief and cover the essential physical assessments to ensure your pregnancy is progressing well and your baby is doing well. Opportunities for discussions about your options for your birth can be difficult during these brief appointments, so exploring topics of interest independently and preparing your questions and notes on your concerns to discuss before visits can be helpful to ensure you get the essential information you need. 

What care will I receive during labour?

Nurses will care for you and your baby throughout your labour. They will advise the obstetrician on-call of your arrival and labour progress. Obstetricians work in teams, so your doctor may not be the one on-call when you are in labour or when you give birth. 

Depending on the hospital where you give birth, there may also be medical residents (and students) working with the staff doctor on duty. The medical resident and/or staff doctor on-call may introduce themselves at some point during your labour before leaving you in the care of the nurses. 

The nurses will communicate with the doctors periodically throughout your labour.

 

The obstetrician may come to evaluate your cervix and assess your labour progress. They will likely offer certain medical interventions to speed up your labour, such as artificially rupturing your membranes (AROM) or prescribe synthetic oxytocin given intravenously, to increase the intensity of your contractions. These are also known as “active management of labour”. Each of these interventions has risks and benefits depending on your particular circumstances. One of the risks to consider is the cascade of interventions, where one intervention leads to another which leads to another. Sometimes these interventions are needed for a specific medical reason, other times, it is the usual “routine” of “actively managing labour”. You can ask questions in order to make an informed choice about whether or not you want to accept these interventions. 

When you are ready to give birth, especially if it is your first time, you will typically begin pushing with the nurses, and the physician will arrive when your baby’s birth is more imminent. You may be able to begin pushing with the nurses in various positions that are comfortable and instinctive for you. However, when the obstetrician arrives, they will most likely encourage you to move into a position lying on your back (lithotomy), as this is the position that obstetricians are most familiar with. This is the position in which they were trained to perform assisted deliveries (forceps and vacuum assisted deliveries) and other birth interventions (ex. episiotomy). You are also more likely to be instructed to use coached closed-glottis (obstetrical pushing technique similar to valsalva maneuver) rather than pushing spontaneously with open-glottis. The nurses continue to provide care to you throughout labour and birth. 

Note: In Quebec, obstetricians are the only medical care provider authorized to assist breech vaginal births; however, many do not have adequate training and experience, so it is left to chance whether the obstetrician on-call for your birth is willing to assist a breech vaginal birth or if they will do a cesarean section.

What can I expect as postpartum care for me and my baby after I give birth?

After you give birth, the doctor will ensure that you and your baby are well. They will perform any perineal repair (stitches) as needed. Nurses will continue to provide postpartum care. 

Your doctor or one of their colleagues on duty will assess you and a pediatrician will assess your baby before you are discharged from the hospital 24-36 hours after giving birth. They will give you instructions to make an appointment for follow-up in 6 weeks for you. You will need to find a family doctor or pediatrician (ped. only if your baby needs specialist care) to do follow-up for your baby.  

Once you are home, a nurse will call you from the CLSC within the first week home to do a phone assessment. If this is your first time coming home with a baby, the CLSC will offer you a home visit; otherwise, they may only offer phone assessment and support. 

*Research studies have repeatedly shown that women with low-risk pregnancies experience better outcomes for themselves and their babies when they are cared for by midwives or family doctors compared to women with the same low-risk pregnancy profile who are under the care of obstetricians. This is theorized to be due to the physiologic approach used by midwives and family doctors and the selective use of medical interventions only as necessary with mothers having low-risk pregnancies. Unnecessary routine interventions add risk without improving outcomes for mothers with low-risk pregnancies and their babies.* Here are two great resources to learn more: NICE and Health Canada guidelines.

Care providers
Purple Strip.png

Finding a care provider and choosing a birthplace

Download the table outlining the options available at different birth places in the Montreal area right below.

The ultimate Montreal Pregnancy guide Promo picture.png

Maternity care providers and models of care

Midwife-led birthing centers:

Maison de naissance Cote-des-Neiges – CIUSSS Centre-Ouest
Find more information HERE.
6560, ch. de la Côte-des-Neiges
Montréal (Québec) H3S 2A7
514 736-2323

Maison de naissance Jeanne-Mance – CIUSSS Centre-Sud
Find more information HERE
1822, rue Ontario Est
Montréal (Québec) H2K 1T7
514 521-4108
 

Maison de naissance Lac St-Louis/Pointe Claire – CIUSSS OuestFind more information HERE180, avenue Cartier, 3e étagePointe-Claire (Québec) H9S 4S1514 697-1199


Maison de naissance Marie-Paule-Lanthier – CIUSSS Nord de l’Ile
Find more information HERE 
9600, rue Saint-Denis, Aile C*
Montréal (Québec) H2M 1P2
514 908-4714

L’Est-de-L’ile de Montreal
Find more information HERE
4500, rue De Contrecœur
Montréal (Québec) H1K 0L1
514 356-4044

Richelieu – CISSS Monteregie-Centre
Find more information HERE
700, rue Martel
Richelieu QC J3L 5R6
450 658-2080

Find more online information about all birthing centers HERE

Hospitals

CIUSSS Centre-Ouest:

Jewish General Hospital (JGH):

Family medicine: Find more information HERE
Obstetrics: Find more information HERE


CIUSSS Ouest:

Lasalle Hospital:

Family Medicine: Find more information HERE
Obstetrics: Find more information HERE

St-Mary’s Hospital:

Family Medicine: Find more information HERE
Obstetrics: Find more information HERE

Lakeshore General Hospital


Family Medicine: Find more information HERE
Obstetrics: Find more information HERE

MUHC-Glen-Royal Victoria Hospital

Obstetrics: Find more information HERE

Ste-Justine

Obstetrics: Find more information HERE and HERE

 

CHUM

 

Obstetrics and High Risk Pregnancy Clinic. Find more information HERE.

 

VUVA Ultraspecialized Obstetrics clinic. Find more information HERE.


Maisonneuve-Rosemont Hospital

Pregnancy follow-up info: Find more information HERE

List of clinics for pregnancy follow-up with family doctors or obstetricians if you wish to have your baby at this hospital: Find more information HERE


St-Luc-CHUM

Family Medicine:


Clinique de périnatalité Jeanne-Mance / CLSC Parthenais / GMFU des Faubourgs

Find more information HERE

Obstetrics:

Hopital Sacre-Coeur - CIUSSS Nord

Find more information HERE

Hopital Cite-de-la-Sante

Find more information HERE

List of clinics with family doctors and obstetricians if you wish to have your baby at Hopital Cite-de-la-Sante: Find more information HERE

Anna-Laberge

Family medicine: Find more information HERE
Obstetrics: Clinique obstétrique-gynécologie Châteauguay : 450 699-3185

General information about the birthing unit: Find more information HERE

Pierre-Boucher Hospital

List of clinics with family doctors and obstetricians if you wish to have your baby at Pierre-Boucher: Find more information HERE

Questions you might have once you have reviewed your options…

11.png
11.png
11.png
11.png
11.png
11.png
11.png

How do I schedule my first appointment?

When will I have my first appointment?

What will happen at my first appointment?

What can I expect?

What should I bring to my first appointment?

How should I prepare for my first appointment?

What questions should I ask at my first appointment?

 

Other questions you may have as you take these next steps:

16.png
16.png
16.png
16.png

What is a doula? What can a doula offer me?

How do I find a doula?

How do I find a childbirth education class?

When should I start?

Book a free discovery call with us!

bottom of page