Goldman Herzl - Family Medicine Obstetrics Group

1. Our philosophy

The family medicine obstetrics group at the Jewish General Hospital aims to provide comprehensive prenatal, intra-partum and postpartum care to women in the greater Montreal region. Our highly trained group of physicians practice in a variety of locations across Montreal. Our patients deliver at the Family Birthing Centre of the Jewish General Hospital, a McGill University affiliated tertiary care centre.

Our approach is patient centered and our goal is a healthy pregnancy and delivery. Many of us work as part of multidisciplinary teams including nurses, social workers, dieticians, psychologists and midwives. We recognize the diversity of our patients and have the necessary resources and expertise needed to treat women of various cultural backgrounds.

2. Thinking about getting pregnant?

If you are thinking of getting pregnant, here are a few important things to consider:

  • Consider seeing a physician for an annual check up to make sure you are in good health prior to conceiving
  • Check your immunity to common infections such as rubella and varicella through a simple blood test
  • Take folic acid - This is probably one of the most important things you can do prior to conceiving. A daily dose of 1mg of folic acid is recommended three months prior to conception and during the first 12 weeks of pregnancy. This can be taken in the form of a routine prenatal vitamin or as a pure folic acid supplement. Some women are candidates to take 5mg of folic acid daily; check with physician to see which dose is right for you.
  • Adopt a healthy lifestyle; eat healthy and try to avoid smoking, alcohol and drug use
  • Consider pre-conception genetic screening if you have a family history for certain genetic diseases such as  cystic fibrosis or if you are of  Ashkenazi Jewish descent.

3. Physician appointments

Schedule of appointments:

  • Every month for the first 28-32 weeks
  • Every two weeks from 28/32-36 weeks
  • Weekly from 36 weeks on

4. Prenatal follow up

  • First prenatal visit – You are encouraged to make an appointment in the first trimester (before 12 weeks).
  • Your physician will perform a thorough history and physical examination.
  • She will attempt to listen to your baby’s heartbeat which can usually be heard between 9-14 weeks.
  • You will be sent for a series of routine blood and urine tests
  • You will discuss with your physician the possibility of genetic screening.
  • Your physician may perform a routine gynaecologic examination, a pap test and screen for vaginal/cervical infections (or this may deferred this to a subsequent appointment)
  • Routine ultrasound (18-20 weeks) – a detailed study of the baby’s anatomy. The gender of the baby can be determined at this time.
  • Gestational diabetic screening – usually done between 26-28 weeks. Your physician will send you for a blood test to determine if you have gestational diabetes. You do not need to fast for this blood test and therefore may present yourself as late as 7PM to the Jewish General Hospital test centre (Monday-Thursday) for this test. At the test centre, you will be given a sugary drink, after which you will return one hour later for a blood test. It is best to drink the solution quickly and to take a short walk during this hour to help metabolize the sugar! Your physician may also send you for additional blood tests at this time if needed.
  • Screening for group B streptococcus – usually done at 34-36 weeks. This is a vaginal-anal swab collected by your physician. Roughly 30% of women are carriers for this infection. While this bacteria will likely not cause you any problems, babies born to women who are carriers can develop various complications: respiratory difficulties/pneumonia, meningitis and even sepsis. It is for this reason that GBS carriers are treated with antibiotics once their water breaks or if they are in labour.

5. Preparing for your delivery

During the visits leading up to your due date, you will discuss with your physician what to expect during your labour as well as your individual desires for your delivery.
Some thing to think about:

  • Should I devise a birth plan outlining my wishes during the delivery?
  • Who will accompany me to the delivery?
  • Do I wish to hire a doula or birthing coach to assist me during my labour and delivery?
  • Have I pre-registered? Pre-registration can be done as early as 26 weeks. It is beneficial to pre-register as it will alleviate stress for both you and your partner and will ensure that all is organized for your hospital stay. You will also be given a useful handbook when you pre-register called From Tiny Tot to Toddler which is an excellent resource for expecting and new mothers.
  • Do I wish to take any medications/epidural for pain control?

While our physicians will try our best to accommodate your requests, the health of mother and baby are our primary concern.

6. What to bring to the hospital

Here is a list of things to bring with you for your hospital stay:

The essentials

  • - hospital/medicare cards
  • - a copy of your prenatal record, which should be given to you by your MD at approximately 36 weeks gestation
  • - diapers/baby wipes
  • - sanitary pads (special for postpartum)
  • - pyjamas/change of clothes for you and baby
  • - toiletries (including soap which is not provided by the hospital)
  • - nursing bra/nursing pads

Optional items

  • extra pillow
  • popsicles, clear juices, broth or hard candies which may be eaten during labour
  • your own CDs

7. Labour and delivery

When is it time to come to the Family Birthing Centre at the Jewish General Hospital?

  1. You are in labour
    • For a first baby – if you have painful and regular contractions every 5 minutes or less for > 2 hours.
    • If it is not your first – once the contractions are regular
  2. If you break your water
    • You might experience a big gush of fluid
    • You might notice a slow trickle of fluid or that your undergarments are wet
    • If you are not sure, it is better to present yourself to the Family Birthing Centre for evaluation
  3. If you notice any vaginal bleeding
  4. If your baby is not moving as much or not at all

The Family Birthing Centre is open 24 hours/day 7 days/week. It is located in Pavilion K, 3rd floor, which can be directly accessed from Legaré Street. If you have any question as to whether or not to come in, you can call your physician’s office or the Family Birthing Centre directly to speak with a qualified nurse at (514) 340-8277

While our aim is for a normal vaginal delivery, there are instances when we need to intervene. These may include but are not limited to fetal distress or a slow/arrested labour. This may involve the use of an instrument to help deliver your baby such as a ventouse/vacuum or forceps. Our colleagues in the obstetrics department are available at all times in case a caesarean section is needed.

8. Your stay in the Family Birthing Centre

When you arrive, you will be assessed by a nurse and one of our family medicine residents. There is family physician on call at all times. Your physician may or may not attend your delivery depending on her preferences and availabilities. During your delivery, there will be a family physician, resident and nurse present in your room. You are allowed up to 2 visitors with you in your room at one time. This allows sufficient space for the team to work safely and efficiently.

9. Postpartum

The usual duration for your stay on the postpartum unit is 48 hours. Should there be any complications, you may be asked to stay longer than 48 hours. Patients who have a caesarean section stay for 72 hours postpartum with close CLSC follow-up upon discharge from hospital. We encourage you to have your baby sleep with you in your room to facilitate breastfeeding and bonding with your newborn.

Our team strongly encourages breastfeeding for the numerous benefits it affords both mother and baby. Our physicians and postpartum and nurses are there to assist you in breastfeeding. The Goldfarb Breastfeeding Clinic at the Herzl Family Practice Centre is an additional resource to help support breastfeeding mothers. 

The newborn should be seen in follow by a physician/nurse within 1-2 weeks of life. Mom should be seen for a routine postpartum check-up 6 weeks after the delivery.

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