Routine Prenatal Care

A checkup before conceiving will help you prepare for pregnancy. Early and regular prenatal care will help you have a healthy pregnancy and baby.

A medical checkup before you are pregnant can help ensure you are in good health and are making healthy choices that support a healthy pregnancy. A checkup before you are pregnant can also screen for any illnesses or conditions that could affect your pregnancy.

The main goal of prenatal care is to ensure a healthy mother and baby. Regular prenatal care:

  • Supports healthy pregnancy
  • Prevents and identifies health concerns
  • Provides the opportunity to ask questions
  • Provides links to helpful community services

Ideally, prenatal care begins as soon as you learn you are pregnant. However, prenatal care at any point in pregnancy is good for your health and the health of your growing baby. Early confirmation of pregnancy is important because it allows for early prenatal care.

Prenatal care is delivered by different health care providers, including obstetricians, family doctors, Registered Midwives, and Nurse Practitioners.

Routine prenatal care delivered by any of these health care providers is covered by the Ontario Health Insurance Plan (OHIP). The availability of prenatal health care providers depends on where a mother lives and the health status of the mother and baby. In addition to a primary health care provider, health care professionals such as Registered Nurses, Registered Dietitians, and others may also be involved in providing prenatal care.

It is important that you have a primary health care provider you trust and feel comfortable with.

During your pregnancy, you will see your health care provider:

  • Every month during the first 30 weeks of pregnancy
  • Every two weeks from week 32 to 36
  • Every week (or more frequently if needed) from week 36 until you have your baby

Routine prenatal care visits with your health care provider will help monitor your health and the health of your baby.

Routine prenatal care visits are scheduled at least monthly and usually include checking:

  • Your weight
  • Your blood pressure
  • Your urine (for protein and sugar)
  • Baby’s growth
  • Baby’s position (once able to determine)
  • Baby’s heart rate (once able to detect)

Each time you visit your health care provider, you can ask questions about your pregnancy. Your health care provider or another member of the health care team can provide you with information to help you during each stage of your pregnancy.

A visit to your dentist is an important part of your prenatal care to help reduce the risk of cavities and bleeding gums.

Throughout your pregnancy, you may be offered a variety of different medical and laboratory tests. This could include:

  • Diagnostic ultrasound
  • Blood tests
  • Urine tests
  • Prenatal screening tests, including genetic screening
  • Vaginal cultures or swabs
  • Glucose screening
  • Group B Streptococcus (GBS) screening
  • Other tests as needed

Prenatal tests that are routinely recommended

List of prenatal tests that are routinely recommended.
Integrated Prenatal Screening (IPS)Done in two parts: Part One is an ultrasound and blood tests done between 11 weeks and 13 weeks + six days. Part Two is a blood test done between 15 and 20 weeks.A screening test that assesses the possible risk of Down Syndrome, trisomy 18 or birth defects of the spine and brain. A positive result only indicates a higher risk or chance and that further testing is needed.

Integrated Prenatal Screening replaces the Maternal Serum Screening (MSS), a blood test only, done at 15 to 20 weeks. Women who do not want an ultrasound may still ask for a Maternal Serum Screening.
Ultrasound16 to 20 weeksUsed to help confirm a pregnancy, estimate due date and baby's size, determine the position of the placenta, and detect or rule out complications
Glucose Challenge Screening (GCS)26 to 28 weeksA blood test done one hour after a woman drinks a sweet liquid (glucose) to detect high glucose levels, which may indicate gestational diabetes. If positive, a second test called the Glucose Tolerance Test may be performed.
Group B Streptococcus (GBS)35 to 37 weeksA swab to detect the presence of Group B Steptococcus bacteria, a common bacteria found in the vagina or rectum of many women. If positive, you will be treated with antibiotics during labour.

Prenatal tests or procedures that may be recommended

List of prenatal tests or procedures that may be recommended
Amniocentesis15 to 20 weeksA needle is used to remove a sample of the amniotic fluid from the womb to check for genetic and chromosomal abnormalities, such as Down Syndrome. It is only recommended if the risk for such conditions is higher than usual, such as abnormal screening results, or a family history.
Glucose Tolerance Test (GTT)24 to 28 weeksA blood test is taken once every three hours after you drink a special sweetened drink. A more involved test than the Glucose Challenge Screening.
Rh Immune Globulin (Injection)28 weeks and after your baby's birth (if your baby's blood is Rh positive)The Rh Factor is a protein on the surface of some people's red blood cells. If you have the Rh Factor your blood type is Rh Positive and if you do not, it is Rh Negative. If you have Rh negative blood you will be given Rh immune globulin to prevent the possibility of your blood reacting to your's blood in case she has Rh positive blood.
Non-Stress Test (NST)After 26 to 28 weeksThis test measures the baby's heart rate in response to the baby's own movements. Reasons it may be done include: assessing the health of the baby, or if you are past your due date. May be done with a Biophysical Profile.
Biophysical ProfileAfter 26 to 28 weeksAn ultrasound is done over 30 minutes to check your baby's behaviour by observing his breathing movements, body movements, tone and amniotic fluid volume. It is done to assess the health of the baby.

Prenatal education programs are an important part of your care and support during pregnancy.

Prenatal education can be a series of classes, either online or in-person, provided for pregnant women, their partner, and support people.

Prenatal education can:

  • Provide the information and skills you need to have a healthy pregnancy and baby
  • Promote a positive birthing experience
  • Prepare you for parenting
  • Prepare you for breastfeeding
  • Enhance communication between partners about pregnancy and parenting

Learn more about how to access routine prenatal care.

The following may help you locate a health care provider in your area.

Adapted and reprinted with permission by the Best Start Resource Centre

August 11, 2016