Pregnant in Montreal (Part 5 of 5)

Part 5 of Pregnant in Montreal

Pregnant in Montreal (Part 4 of 5)
Your answer to this question will help identify which particular doctors or group practices you might be interested in following your pregnancy.  Here are a few things to think about when choosing a place of birth...

• What are the options for non-pharmacological pain relief; hydrotherapy, “laughing gas”, sterile water injections, etc. Whether you plan on having an epidural or not, it is always good to know what other pain relief options are available just in case the epidural is not available to you or, is not as effective as you'd hoped.
• What facilities are available in the birthing unit; availability of private bathrooms, showers, bathtubs, are all good to know about in advance (can you believe there are still shared bathrooms in birthing units??)
• Location; distance from your home, how is parking, how easy is it to access “outside” food, etc.
• Postpartum room set up; private vs semi private, access to private shower. 
• What Doctors have birthing privileges at the Hospital.*
• Access to level 3 NICU in the building (Neonatal Intensive Care Unit). **
• Your language of preference. ***

*All Montreal hospitals with birthing units have Ob/Gyns on staff.  Only a select few also have Family Doctors with hospital privileges.

These Montreal area hospitals have Family Doctors on the birthing unit:

• Saint Mary’s Hospital
• Jewish General Hospital.
• Lasalle Hospital

** A Level 3 NICU has an array of staff and specialized equipment to care for the smallest and sickest newborns 24/7.
These Montreal area hospitals have a level 3 NICU:

• Centre hospitalier Ste-Justine
• Hôpital Maisonneuve-Rosemont
• Jewish General Hospital
• Royal Victoria Hospital (Montreal Children's Hospital).

*** While most of the staff at the hospital birthing units are capable of speaking both English and French (and often many other languages), you are most likely to find staff comfortable in English at:

• Royal Victoria Hospital
• Saint Mary’s Hospital
• Jewish General Hospital.

​Part 4 of Pregnant in Montreal

Pregnant in Montreal (Part 3 of 5)
When considering what kind of doctor you want to follow your pregnancy, here are a few things to think about...

• Is your pregnancy considered “low risk”?  Family Doctors are trained to follow low risk pregnancies and deliveries.  They also tend to have more time to spend with you prenatally in comparison to most OB-Gyn practices.
• Are you planning a natural, or, un-medicated childbirth?  Family doctors are used to following normal birth.  They are less likely to intervene in a normal pattern of labour.  If you do present with a pathology, they will refer you to an OB-Gyn.
• Is your pregnancy considered “high risk”?  OB-Gyns excel at following high risk or, complicated pregnancies.  

Once you know what type of doctor you want to follow your pregnancy, now it is time to see where you want to birth your baby...

Third Decision:  Which Montreal hospital do you want to deliver in?

Part 3 of Pregnant in Montreal 

Pregnant in Montreal (Part 2 of 5)
If you’d like to have a Midwife follow your pregnancy, drop everything and call the Maison de Naissence NOW!!!  Spots for midwives fill up fast, in Montreal the demand far outweighs the supply of midwives so the earlier you call the better.
A Maison de Naissence or, Birth House is an out of hospital birth center run by certified Midwives.  The island of Montreal currently has three Maisons de Naissence; in Pointe Claire, Cote des Neiges, and Le Plateau.

​Important things to know about Midwifery Care in Montreal:
Midwives in Quebec are mandated to provide healthcare for low risk pregnancies only.  If a pregnancy becomes high risk at any time, care will be transferred to an OB-Gyn.

• Midwives are holistic care practitioners.  Expect to spend between 45 minutes to an hour at every prenatal appointment. Midwives are tasked with not only your physical care but also your emotional well being.
• Midwives help prepare you to cope with your labour.
• ​Midwives can not provide pharmacological pain relief during labour (ie. epidural analgesia).
• Each midwifery group is associated with a local hospital and offers home birth options.

​Here is the contact information for all three teams:

Maison de Naissance Pointe Claire
180, avenue Cartier
Pointe-Claire (Québec)
514 697-1199

Maison de Naissence Cote des Neiges
6560, Chemin de la Côte-des-Neiges
Montréal (Québec)
H3S 2A7
514 736-2323

Maison de Naissence Jeanne-Mance
1822 rue Ontario Est
Montréal (Québec)
H2K 1T7
514 527-2361 poste 2530

Now, if after reading this you decide you prefer having a physician following your pregnancy you have another decision to make...

Second Decision: Family Doctor OR OB-Gyn?

Part 2 of Pregnant in Montreal

Pregnant in Montreal (Part 1 of 5)

I am about to turn this conversation on its head.  Most blog posts about choosing a care provider for your pregnancy focus on the provider’s responses to certain questions.  For example; what is your C section rate?  Do you encourage VBACs (Vaginal Birth After Cesarean)?  Do you cut routine Episiotomies?  

While these are good questions, I dare say you’ll get the exact same answer from every doctor in the Greater Montreal area: 1) "I don’t know my C section rate, I only do C sections when they are medically necessary". 2) "VBAC, sure!  We’ll discuss it as you get closer to your due date".  3) "No".  Or, "only when medically necessary".

Here in Montreal, it is NOT an easy feat to shop for a care provider.  The Quebec Medicare system does not leave a lot of room for picking and choosing when it comes to selecting health care practitioners.  In fact, if you are fortunate enough to already have a doctor that follows pregnancies, many other offices will not consider taking you on as a patient.  Our system is seriously overloaded but luckily, when it comes to pregnancy you have a ticket in!  

If you are pregnant in Montreal, you will have a medical care provider - you may have to work for it and make lots of phone calls but, you will succeed!   

The strategy I suggest to newly pregnant Montrealers involves shopping around for the TYPE of care you want and then choose the PLACE you want to birth your baby.  

Here are a few questions for you consider if you are thinking about getting pregnant (or, right after getting a positive pregnancy test).

First decision: Midwifery Care OR Physician's Care?

Second Decision: Family Doctor OR Ob-Gyn?

Third Decision:  Which Montreal hospital do you want to deliver in?

Part 1 of Pregnant in Montreal