Welcome to the Jewish General Hospital Maternal-Child Health Division

Welcome to the Jewish General Hospital Maternal-Child Health Division

Dear parent(s), We are pleased to welcome you to the Maternal Child Health Division of the Jewish General Hospital, which includes the Family Birthing Center, the Postpartum Unit (5W), and the Neonatal Intensive Care Unit (NICU). We are giving you this booklet to explain the services you will receive during your hospital stay and to help you prepare for the birth of your baby. Having a baby is an important event. Whether it is your 1 st or 8 th baby, each one is special with his or her own personality. We hope to provide you with the best possible care during your stay with us, and to help you get to know your newborn baby. Prepared by: The Maternal-Child Division Health Care Team Jewish General Hospial 3755 Chemin de la Côte-Ste-Catherine Montreal, QC H3T 1E2 Reviewed by: Dr. Louise Miner jgh.ca Revised : August 2012 This information should not be considered as medical advice. It is not to be used in place of a visit with a doctor, nurse or other healthcare professional. If you have questions about your individual medical situation, please consult with your healthcare professional.

Pre-registration You can register for your stay in the hospital ahead of time, starting as early as your first pregnancy visit. This is done in the Admitting Office at H-173. You will get a copy of the Quebec Government book From Tiny Tots to Toddlers when you pre-register. This book is also available at http://www.inspq.qc.ca/tinytot/. What to bring to the hospital Your valid Medicare card and hospital card. Your prenatal record, and any blood results and ultrasound reports that come from a lab or clinic that is outside of the Jewish General Hospital. Your doctor will give you your prenatal record in the month before your expected due date. The From Tiny Tots to Toddlers book that you were given. Items that you may find helpful during labour: Popsicles/clear juices/broth/hard candies Extra pillows Lip balm Warm socks and slippers A warm pack Relaxing music CDs Magazines Lock Anything else you might like to have Items you will need after the birth that the Hospital does not provide: Sanitary pads - extra absorbent (at least one full package) Maternity bra and underwear Diapers and wipes for your baby Toiletries (tooth brush, tooth paste, soap, shampoo, Kleenex and anything else you might need) Plastic shoes/sandals for taking a shower Clothing for you and your baby (for the hospital stay) Baby blanket (for taking your baby home) Pyjama for support person (father) The baby blanket we lend you right after the birth belongs to the hospital and should not be taken home. Baby car seat 1

When to come to the hospital If any of the following things happen to you, please contact your doctor or midwife and follow their instructions. If you cannot get in touch with your doctor or midwife, please call the Family Birthing Center at 514-340-8277 and follow the instructions of the doctor or nurse. When it is time for you to come to the hospital, you will go to the Family Birthing Center which is located in Pavilion B on the 5 th Floor. Please remember that the following are general guidelines. If your doctor or midwife gives you specific instructions, then you should follow those. If you think you are in labour and you are less than 37 weeks pregnant The first signs of preterm labour (labour that starts before you are 37 weeks pregnant) may begin slowly. You will not always feel pain. If it is caught soon enough, early delivery can often be stopped or delayed. This can give your baby extra time to grow inside you. If you have any of these signs and they are new for you, DON T WAIT, call your doctor or midwife and then come to the Family Birthing Center. Excessive pressure in your pelvis (lower belly between your hip bones) or lower belly; Unusually strong or rhythmic pain in your lower back; Cramps in your belly, with or without diarrhea; Regular contractions or a feeling of tightness in your uterus more often than every 20 minutes; Any change in the kind of discharge from your vagina (watery, mucous or bloody), or more discharge than before. If you are more than 37 weeks pregnant and you have been having painful contractions every 5 minutes regularly for at least 1 hour. If your water breaks (a slow leak or a sudden rapid flow) at any time in your pregnancy, even if you are not having any contractions. If you have bleeding from your vagina If your pregnancy is less than 20 weeks and you are bleeding, please go directly to the Emergency Room (ER). If your pregnancy is greater than 20 weeks and you are bleeding, go directly to the Family Birthing Center. 2

If you have headaches that last a long time and hurt a lot, blurred vision or sudden swelling of arms, legs, hands, feet and/or face. If there is a change in your baby s normal activity Every baby is different and there will be times in the day when a baby is more active and times when he or she is less active. You will become used to the way your own baby moves during your pregnancy. After 28 weeks of pregnancy, if you notice a change in your baby s regular activity pattern, you may count his/her movements. A movement may be a kick, a turn, a flip or a rub. Have something to eat, and rest by lying on your left side; and Try to relax and focus on your baby s movements. If in 2 hours, you have not counted 6 movements, please call and then come to the Family Birthing Center right away. You should also go to the hospital RIGHT AWAY IF: You feel NO baby movements in 8 hours, OR You FALL, OR You are in a CAR ACCIDENT, OR You are HIT in the belly. Do not wait until the next day. You and your baby s well-being depend on it! REMEMBER: If you are not sure if you should come to the hospital or if you have any worries about your health or the health of your baby and you cannot get in touch with your own doctor or midwife, you can call the Family Birthing Center at any time, day or night at 514-340-8277 and ask to speak to a nurse. 3

Who will provide your care? There are several different members of the Maternal-Child Health Division Team that you may meet during your pregnancy and when you have your baby. Our team is made up of both male and female Health Care Professionals. Their goal is to work together to provide care for you and your baby. Obstetricians At the Jewish General Hospital, the Obstetricians work as a team. There is always an Obstetrician present in the hospital twenty-four hours a day. That doctor is said to be the on-call staff doctor and is responsible for all the pregnant women and postpartum mothers during his or her shift. Because of this system, the obstetrician you saw during your pregnancy may not be at your delivery unless he or she is on-call at that time. If you saw an Obstetrician during your pregnancy, your baby will be delivered by the on-call Obstetrician. Family Medicine Physicians The Family Medicine Group at the Jewish General Hospital delivers the babies of Family Medicine patients. They work apart from the Obstetricians, but if there is a complication or if you need a Caesarean section, the Family Medicine Group will consult with the Obstetricians. Your family doctor will discuss their availability for your delivery. Either your own Family Doctor or the on-call Family Doctor will deliver your baby. Anesthetists If you choose to have an epidural for pain relief while you are in labour, or if you are having a cesarean section, your pain control will be taken care of by the Anesthetist. He or she will answer any questions you might have about these procedures at that time. Pediatrician / Neonatologist / Family Physician This doctor examines all newborn babies on the first or second day after their birth. He or she may also be called to come to the delivery room when your baby is born, if needed. You will meet the NICU team only if your baby needs special care. If you already have a Pediatrician please inform your nurse. Medical Students and Residents The Jewish General Hospital is a McGill teaching hospital. This means that medical students who are working with the on-call staff doctor may be involved in your care. The on-call staff doctor will also be assisted by residents. Residents are not medical students. They are doctors who are doing specialized training. They work in close contact with the on-call staff doctor (Obstetrician, Family Physician, Anesthetist or Neonatologist) and keep him or her fully informed about you and your baby s condition. The on-call staff doctor will be called by the resident at the appropriate time for your delivery or when needed. The on-call staff doctor is always aware of your medical condition and is always close by. 4

Nurses You and your baby will receive care from nurses throughout your stay in the hospital. Nurses will be there to care for you and support you during your labour and delivery, as well as after your baby is born. If you have any questions about the care that you or your baby is receiving, you can ask your nurse at any time. The JGH is a McGill teaching hospital. This means that nursing students who are working under supervision of nurses may be involved in your care. Visiting Policy Visitors in the Family Birthing Center The birth of a new baby is an event families want to share and it is important for your family to be with you. But to make sure you are getting the best care and resting as much as you need during labour, our visitor policy is that you can only have 2 visitors in the room with you at any one time. All other visitors must wait in the waiting area. Please note that children under the age of 16 are not permitted to visit the FBC. For the safety of all, WAITING IN THE HALL- WAY OF THE FAMILY BIRTHING CENTER IS NOT PERMITTED. Visitors to the Postpartum Unit (5 West) Visiting hours are between 15:00 and 20:30. This is to make sure you have time to rest. It is very important to be able to rest after the birth of your baby and it is hard when there are a lot of visitors. We also need time to teach you the things you want to learn before you go home. Please ask only your very close family members to visit you and your baby while in hospital. Visitors may be asked to leave if it is better for you and your baby s health, or if is better for your roommate. Children under the age of 16 cannot visit, except for the baby s brothers and sisters. You can only have 2 visitors in your room at any one time. Your partner or support person will be able to stay at all times as he/she in not considered a visitor. *People who are sick should not visit you in the Family Birthing Center or on the Postpartum Unit. Postpartum Unit (5 West): After you deliver your baby, you and your baby will be moved to a room in the Postpartum Unit (5 West) where you will stay until you go home. Length of stay You will stay between 36 and 48 hours (1 1/2-2 days) for a vaginal birth with no complications. You will stay 72 hours (3 days) if you have a cesarean section (C-Section) delivery with no complications. If you want to go home before the recommended time, you will need to notify your nurse. Discharges are not possible after 20:00. If you need nursing care after you go home, we will arrange follow-up with your local CLSC. 5

Rooming in 24 hours/day You and your baby will stay together in your room on the Postpartum Unit until you go home. This helps you to bond with your baby, and gives you and your family the chance to learn how to care for him or her. We encourage your partner or support person to stay overnight with you. If you have other children, make arrangements for their overnight care outside of the hospital. If your baby needs special care, he or she may be brought to the Neonatal Intensive Care Unit (NICU). Postpartum Unit room choice When you register for your hospital stay, we will ask you what type of postpartum room you would like to have. Public room (4 beds): This is the basic type of room and it is paid for by Medicare. This type of room is shared with three other new mothers. Semi-private room (2 beds): This type of room is shared with one other new mother. Private room: We cannot guarantee that a private room will be available because these rooms will be given first to mothers who need one for medical reasons. Otherwise, private rooms are given out based on time of delivery. We ask that you be respectful of the people you are sharing a room with. Please keep the noise level low. And, the person staying with you overnight should always be properly clothed. Meals The Hospital provides meals for mothers on the Postpartum Unit at these times: Breakfast 08:00-09:30 Lunch 12:00-13:30 Dinner 17:00-18:30 You may want to bring some snacks with you to have in between meal times. Partners or support people do not receive hospital trays and must provide their own food. Safety and Security: Do not bring valuables or large amounts of money with you to the Postpartum Unit. The hospital is not responsible if your personal things are stolen. Lockers are provided for all patients, you can bring a lock. There are call bells by every bed and in the washrooms. You can use these to call your nurse if you or your baby need help. Your baby s safety and security is one of our main concerns. You and your partner or support person will wear an infant hospital identification (ID) band that matches you to your baby. This ID band will be checked by the nurse on every shift 6

and when moving your baby in and out of the nursery. You will only be able to enter the Nursery if you are wearing this ID band. Your baby will have three ID bands attached to his or her ankles. Two of these will match your ID band and one will be the baby s individual identification. It is very important that you NEVER LEAVE YOUR BABY ALONE and that you and your partner or support person wear the ID bands during the entire hospital stay. You may take a shower with your ID bands on. Always move your baby in and out of your room in a hospital crib and NEVER in your arms. There is often a lot of activity in the hallways, and we want to make sure your baby is safe and does not get knocked out of your arms by accident. Babies must sleep on their backs in their own crib. You may do skin-to-skin or breastfeed your baby in your hospital bed. But for your baby s safety, he or she must sleep in the hospital crib. You may keep the crib close to your bed. All staff caring for you and your baby wear an identification card. Do not let someone you do not recognize take your baby from your room. Call your nurse right away if this happens. Cell Phones No cell phones are allowed in the hospital building. They prevent medical equipment from working properly. There is a phone next to your bed and there are also pay phones in various locations throughout the hospital. Discharge Teaching Every day the nurses on the Postpartum Unit give a group teaching session to prepare you for going home. They will announce over the intercom system when the session is starting. We encourage all parents to attend the class because it gives you important information for your recovery, and how to care for your baby when you go home. If you have any questions about your health or your baby s, let your nurse know and she will get in touch with the doctor on call. Going Home from the Hospital: CLSC referral Your nurse will let your local CLSC know that you have had a baby and that you are leaving the hospital. Usually the first or second day after you return home, the nurse from the CLSC will call you and will arrange a time to come by to visit you at home if needed. Call your CLSC if you do not hear from them within 2 to 3 days. Please make sure your hospital nurse has your correct home address and phone number. Also, let her know if you will be going to stay at a different address when you leave the hospital so she can let the CLSC know where you will be. Release Time You must arrange to go home by approximately 10:00 am on the day of your discharge. You may be asked to wait in the waiting room if you cannot 7

arrange transportation at this time. This is to ensure that the beds are available for all the new mothers coming from the Family Birthing Center. Please note that in some cases your release time may be delayed. Baby Release All babies must be examined by a doctor before they can go home. Car seats A car seat is required by law for transporting your baby in a car. Be sure that you know how to install and use the seat before you come to the hospital to have your baby. If you are not sure if your car seat is installed properly, you can call and make an appointment at your local police station and a police officer can check it for you. Declaration of birth During your hospital stay, you will need to obtain the baby s declaration of birth form. This form should be filled out and sent to the address shown on the paper within 30 days of your baby s birth. It is important to decide the spelling of your baby s name at this time. Information package Before you go home from the hospital, you will be given a package with your baby s vaccination book, a urine screening kit, and important information for you about your recovery and how to care for your baby. Your nurse will go over this information with you, and answer any questions you may have before you leave. Some things to think about... Prenatal Information Sessions The Hospital offers information sessions where you will learn more about what to expect during your stay. The information sessions last 2 hours. Sessions in French are on the last Tuesday of every month at 19:00. Information sessions in English are on the second Tuesday of every month at 19:00. For more information, please call the Family Birthing Center at 514-340-8277. Prenatal Classes You may contact your local CLSC to find out what prenatal courses they may offer. These courses are usually free. There are other prenatal courses offered for a fee. Talk to your doctor or nurse for more information. To Stop Smoking If you or someone in your household are thinking about cutting down or quitting smoking, remember that it is never too late. Some of the added benefits from quitting smoking are: Higher birth weight for baby Less risk of Sudden Infant Death Syndrome (SIDS) 8

Less risk of premature labour Less risk of obstetrical complications Fewer respiratory diseases and ear infections in childhood Whether you just want more information, or are thinking about starting the process of quitting, we can give you or your family members the support and resources that you need so that you can meet your goal. You can ask your nurse or doctor for more information. Or, you can contact the Ligne j Arrête telephone support line at 1-866- 527-7383, or visit their website at www.jarrete.qc.ca. Birthing Plan You may want to design a birthing plan to help you decide your needs and wishes for the birth experience. A birthing plan will allow nurses and doctors to work with you to meet these goals. For example, you may wish to tell us how you would like to manage your pain (epidural, use of a birthing ball or other aids, shower/jacuzzi, etc.). It is important to discuss your birthing plan with your doctor or midwife before you come to the hospital to have your baby. The health team will talk to you about making any changes to this plan during your labour if such changes are needed for you and your baby s safety. Skin-to-skin As soon as your baby is born, you can help stabilize his or her temperature, heart beat, and breathing by holding him or her against your skin. This also helps the baby to breastfeed whenever he or she is ready. Let your baby suckle at your breast within the first hour after birth. Keep your baby close to you for the first hours and days of birth to create the best setting for bonding and breastfeeding. Partner or support person can also do skin-to-skin. Feeding your baby Medical and nursing organizations around the world recommend feeding your baby only with breastmilk until he or she is 6 months old, and then continuing to breastfeed while adding age-appropriate foods until 2 years of age and beyond as long as mom and baby would like. Our policy supports all families in their infant feeding choice. Breastfed babies have: Fewer infections; Less risk of Sudden Infant Death Syndrome (SIDS); Better cognitive development; Less asthma, eczema and allergies; Less childhood cancers like leukemia and lymphoma; Less obesity, diabetes and heart disease later in life. 9

Mothers who breastfeed enjoy: Saving between $2000 and $4000 a year in formula feeding costs; Being able to feed easily wherever they are (as opposed to sterilizing a bottle, preparing formula, and feeding it to the baby); Decreasing their chance of breast and ovarian cancer, and osteoporosis; Earlier return to pre-pregnant weight. While you are in hospital, we will give you information and support about how to feed your baby. We have nurses specialised in breastfeeding (Lactation Consultants) working in all our units who can help you. The book From Tiny Tots to Toddlers by the Quebec Government will help to answer many of your questions. You can also get help from these organizations: Your local CLSC or call 811 or go to www.santemontreal.qc.ca to find out where your local CLSC is by using your home postal code Ligue La Leche: For English www.lalecheleaguecanada.ca 1-800-665-4324. For French www.allaitement.ca 1-866-255-2483 Nourri Source: 514-948-5160 Health Canada: http;//hc-sc.gc.ca Canadian Paediatric Society: http://www.cps.ca Mama dearest: http://mamadearest.ca Quebec IBLCE Certified Lactation Consultants Association (QCA): 514-990-0262 Breastfeeding products: JGH Hospital Auxilliary: 514-340-8222 ext. 8216 Herzl Family Practice Intake Clinic: 514-340-8222 ext. 3121 Breast Pumps If you have a premature or sick baby in the NICU or if your baby is having difficulty suckling at your breast, we encourage you to express your milk with your hand or with a breast pump. This ensures that your baby gets your breast milk (or colostrum) and that your breasts are stimulated to produce milk. Breast pumps are available for patients to use on the Postpartum Unit and in the NICU. There is no cost for using the pump, but you will need to buy a Breast Pump Kit for $20. Drug, chemical and disease safety There is a group called Motherisk that can help you if you have concerns about the safety or risk of any of these things while you are pregnant or breastfeeding. You can call 1-800-436-8477 for more information. You can also visit their website: www.motherisk.org. 10

Who should I contact if I need help? During your pregnancy Call your physician or midwife Family Birthing Centre at JGH 514-340-8277 (ask to speak to a doctor or nurse) Your local CLSC or call 514-931-1448 to indentify your local CLSC by postal cade Mother Risk: 1-800-436-8477 www.motherisk.org (Medications) After delivery Call your physician or midwife Your local CLSC JGH main nursery (up to 7 days after birth): 514-340-8222 ext. 5550 Pediatrician Montreal Children s Hospital: 514-412-4400 (for baby) Hôpital St. Justine: 514-345-4931 (for baby) Other Available Resources in the Hospital... Perinatal Center The Perinatal Center is a clinic for pregnant women experiencing complicated pregnancies. The Center is staffed by nurses, endocrinologists (doctors who specialize in thyroid conditions and diabetes), dieticians and obstetricians. They see pregnant women with Gestational Diabetes, Type I or II Diabetes, and Thyroid Conditions. They also help pregnant women who need a Non Stress Test (NST), a WinRho injection, or teaching before a planned Cesarean Section (C-Section). An NST is a simple test that takes at least 20 minutes, and will not hurt you or your baby. You will have two belts placed around your belly and you will be connected to a monitor. The monitor records your baby s heart rate and movements. If your doctor or midwife tells you that you need a Non Stress Test, please eat a meal before coming in for the test. The baby will be more active after you eat. If you are having a planned Cesarean Section, you must be assessed by a nurse and complete all necessary paperwork in the Perinatal Center before the day of your cesarean section. You will go directly to the Family Birthing Center (5 th Floor, Pavilion B) the morning of your Cesarean Section. 11

Neonatal Intensive Care Unit (NICU) If your baby needs to be watched closely or is born premature, he or she may need to receive special care from the NICU team. You are welcome to be with your baby at any time in the NICU. The NICU team will work closely with you and your family. A Mother s Corner is provided where you can breastfeed or pump your milk. Breast pumps are available for you to use. Goldfarb Breast Feeding Clinic at the Herzl clinic If your health professional (lactation consultant, CLSC nurse, or your baby s doctor) has not been able to help resolve your breastfeeding problem, they will refer you to the Goldfarb Breastfeeding Clinic at the Herzl Clinic located in Pavilion H at the JGH. Social Work Counseling Service You may contact the perinatal social worker at 514-340-8222 ext 5305 if you need help in coping with stress or any crisis during your pregnancy or right after the baby is born. Know your rights As a patient at the Jewish General Hospital you have the right to: Quality care Non-discrimination Respect for person and culture Information and consent to care Confidentiality and privacy Advocacy If you have any questions or concerns regarding your care you can speak with a member of the health care team. If they cannot help you, then you can speak with the Hospital Ombudsman who can be reached at 514-340-8222 ext. 5833. For more information regarding your rights as a patient or how to resolve problems related to your care, please go to the hospital website (www. jgh.ca). 12