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Sp e c i a l De l i v e r y
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Inside
What’s
RVH celebrates your special delivery...........5
Pregnant? No doctor? No problem!.............6
Who will take care of me?............................8
Exercise in pregnancy.................................10
Things to avoid during pregnancy..............11
When every bite counts..............................12
Barrie midwives..........................................15
How will I know I’m in labour?..................16
Give your baby the best start....................18
What about the pain?.................................20
News hound meets his match....................22
Special care for special babies...................25
RVH has ‘labour’ pains too.........................26
Taking care of children ..............................28
Help for new parents ................................30
News hound has met his match
See page 22
Published by
21 Patterson Road Barrie, ON L4N 7W6
Special Delivery Magazine is published in
cooperation with Royal Victoria Hospital’s
Corporate Communications Department
and The Barrie Advance.
TODDLER
& CASA
PROGRAM
• We accept children at 18 months
• 5 children only per classroom
• Calm, structured, consistent routine
• Daily naps in a cozy atmosphere
• Hot lunch/snacks inclusive
• We get excited about toilet training!
• Qualified nurturing instructors
• Ask about our extended before
Two Locations
and after care hours
Visit our web site and
register online at:
www.maplehillmontessori.com
Sp e c i a l De l i v e r y
147 Toronto St.,
767 Huronia Rd.,
Barrie 728-1008 Fax 728-8022
4
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RVH
celebrates the arrival of your
special delivery
C
By Dr. Vincent Wu
RVH Chief of Obstetrics
ongratulations on this exciting
time in your life and thank you for
choosing Royal Victoria Hospital for
your ‘Special Delivery’.
Last year almost 2,200 babies made their debut
at RVH and it’s always a family affair! Here at RVH,
we support a family-centred approach to maternity
care. We also believe strongly in providing care to
the new family both physically and emotionally, so
our team includes obstetricians, family physicians,
midwives, paediatricians, anesthesiologists, nurses,
as well as a staff social worker.
RVH’s attractive birthing rooms which feature
private bathrooms with showers allow women to
labour and deliver in the same bright, spacious
room. All eight rooms feature peaceful views
overlooking the nearby forest or lake. RVH has
a whirlpool tub available for labouring moms.
If complications arise, fully-equipped operating
rooms are nearby to handle emergencies.
continued on page 9
Infants to Senior Kindergarten
��
Sp e c i a l De l i v e r y
5
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Pregnant?
No doctor? No problem!
C
hristina Williamson is excited about
the arrival of her first child, but
worried because she has no family
doctor.
So the high school teacher did a bit of
homework herself and found the Barrie Prenatal
Clinic. Armed with a list of 10 questions, the
expectant mom sits in the waiting room until it is
time for her first prenatal appointment.
“This is my first child so I really have no idea
what I’m doing. I want to make sure I have the
right information and that I have someone to help
me along the way,” says Williamson.
The mom-to-be is just one of thousands
who have found the answers to their pregnancy
questions at The Prenatal Clinic.
Now in its eighth year, the clinic is open
Monday to Friday from 8 a.m. to 4 p.m. providing
prenatal care to women without a family doctor of
their own. And that means the world to expectant
moms like Williamson.
“It is very important to have a clinic like this,”
continued on page 7
Barrie Midwives provides primary care
throughout pregnancy, labour, and birth,
and for six weeks post partum.
• No doctor referral needed
• Choice of birthplace: home or RVH
• Fully funded by the Ontario Ministry of Health
• On Call 24 Hours a day, 7 days a week
705-727-7 660 • www.barr iem idwives .com
1 Quarry Ridge Road, Suite 303, Barrie, ON L4M 7G1
Sp e c i a l De l i v e r y
6
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continued from page 6
says the 31-year-old woman. “Prenatal care is
to more of a prenatal counselling role. They also
vital. It is very important to know that as the
discuss Integrated Prenatal Screening tests which
pregnancy progresses your baby’s health is being
can determine if the woman has a lower or higher
monitored. I’m a little worried and so for me, it is
chance of having a baby with Down Syndrome,
important to know that you have someone to see
genetic disorders, or an open neural tube defect
when you have questions.”
(when the skull or spine does not develop
Although well-read and a huge user of
properly).
the internet, Williamson believes there is no
Once at the clinic the mom-to-be will remain
substitute for being able to ask questions and
under the care of the clinic’s roster of three family
have them answered by a medical professional
doctors, who rotate shifts at the clinic.
face-to-face. Her questions range in subject
At the 28-week mark her care will be
matter from nutrition, foods
transferred to one of seven
to avoid, premature birth and
obstetricians at Royal Victoria
calcium intake, and whether
Hospital (RVH) or until just after
she can still play volleyball, but
the delivery of the baby.
her most pressing question is
“Pregnancy is a very exciting
about travel. She had planned
time for a woman and her
on climbing Kilimanjaro with her
family, and I just like helping
high school class, and just isn’t
these new moms through that
sure if she should still go.
time,” says Dr. McNaughton. Her instinct was right - the
“We want the women and
energetic teacher is advised to
their babies to get off to a good
put her travel plans on hold –
start.”
for now. Williamson admits just
Once the baby is born, the
having her first few questions
mom is welcome to go back
answered has already put her
to the Well Baby Clinic where
mind at ease.
her child will receive regular
That’s good news for the
immunizations and checkups
physicians who work at the clinic,
until the age of four.
Dr.
Jennifer
McNaughton
(left)
because it is the very reason the
And for Williamson, she’s
consults
with
Heather
Hurban,
medial
clinic was opened. The purpose
fine with putting her Kilimanjaro
assistant,
during
a
busy
day
at
the
of the clinic is to ensure that
climb on hold because she
Prenatal Clinic.
women without a family doctor
knows she and her husband have a much bigger
have access to prenatal care.
adventure ahead of them.
“We welcome women to visit early in their
The Prenatal Clinic and Well Baby Clinic
pregnancy to have their questions answered and
(Monday to Friday from 8 a.m. to 4 p.m.) and
tests completed,” says Dr. Jennifer McNaughton.
lactation consultant appointments (Monday and
“There are a lot of physical changes during
Thursday from 9 a.m. to 3 p.m.) can be made by
pregnancy and we want to be here to ensure both
calling 705-725-8796. All services are covered
mom and baby are safe.”
under OHIP and are located at 125 Bell Farm
The physicians at the clinic perform regular
prenatal check ups and are available to answer
Road in Barrie. Appointments should be booked
questions ranging from nutrition and exercise
in advance.
21 Essa Road 301 Blake St.
728-2823
728-2429
www.pharmasave.com
Sp e c i a l De l i v e r y
7
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Who
Dr. Shannon Causey, spends a moment
with new mom Lori Houle and her
newborn delivered by C-section.
will take care of me?
D
uring your pregnancy there will
be many professionals involved in
providing healthcare for you and
your baby - obstetricians, family
doctors, midwives and nurses – and one
thing you can be sure of is that you will
get consistent and exceptional care from
all of them.
To ensure the entire team of professionals
involved in your care are up to date with the
latest best practices, and working collaboratively
to keep the lines of communication between all
parties open, they - obstetricians, family doctors,
midwives and nurses – have embarked on a
three-year program entitled MoreOB.
“The care at RVH has always been
excellent, but this program will take us to the
next level. It will keep us on top of the latest
advances in obstetrical care and ensure effective
communication between all care providers and
the patient,” says Barb Leonard, RN Birthing Unit
and one of the co-chairs of the MoreOB Progam.
“Our ultimate mission is patient safety – at all
times.”
So who would be involved in your care?
Family doctors may provide prenatal care
up to 28 weeks if there are no concerns or
complications with your pregnancy. Five family
doctors at RVH still deliver babies and follow
Sp e c i a l De l i v e r y
their patients through the entire pregnancy and
delivery. All other family doctors will transfer your
care to one of seven obstetricians once you have
hit the 28-week mark.
At RVH there are eight midwives who are
members of the healthcare team. Midwives
provide care from the early stages of pregnancy
until six weeks after the birth.
If you do not have a family doctor, or your
family doctor does not provide prenatal care, the
Prenatal Walk-In Clinic will provide prenatal care
up until 28 weeks. Please contact (705) 725-8796
for an appointment.
You should see your family doctor or
obstetrician once a month until you are 28 weeks
and then every two weeks. At 36 weeks, your
visits should increase to once a week. If you
have specific concerns relating to your pregnancy,
please make sure you speak with your care
provider directly.
The Birthing Unit nurses provide one-on-one
care while you are in active labour. They will be
with you through the labour and delivery of your
baby. The obstetrician on-call for the day will
monitor your labour and attend the delivery of
your baby.
Following the delivery of your bundle of joy,
your obstetrician or midwife will monitor your
post-partum care while in hospital. As long as
continued on page 9
8
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continued from page 8 - Who
will take care of you
there are no complications you should expect
to be discharged from the hospital within 24
to 48 hours. There is usually one follow-up visit
with your care provider within two to six weeks
of delivery at which point your care will return to
your family doctor.
While in hospital, your newborn will be under
the care of your family doctor. If your family doctor
does not have hospital privileges, or you do not
have a family doctor, your newborn’s care will be
assigned to a group of physicians who provide
baby care at RVH.
After discharge your newborn will be followed
regularly by your family doctor. If you do not have
a family doctor, you can attend the Well Child
Health Clinic at the Barrie Community Health
Centre (705-734-9690 ext. 235) or the Well Baby
Clinic at 125 Bell Farm Road (705-725-8796).
continued from page 5 - RVH Celebrates your special delivery
In fact, the availability of specialized care at
Royal Victoria Hospital means most families don’t
need to leave the community to get the care
they may need. Expectant moms who still have a
family physician in another community may have
their care transferred to a Barrie obstetrician and
deliver their baby in the city where they live.
Our Birthing Triage Unit is a specialized area
for moms-to-be. All women who are experiencing
symptoms of labour or require a prenatal
assessment will come to the triage unit just
outside the Birthing Unit on the 4th floor. Our
Special Care Nursery, with its own neonatologist
and latest technology, allows us to care for our
tiniest patients close to home as well.
And to give parents peace of mind our
Birthing Unit, Obstetrics and Special Care Nursery
are all high security areas monitored with video
cameras. All patients and visitors must be buzzedin from the nursing station.
Just newly implemented is an Infant Security
System. All babies born at RVH will be given a
special electronic ankle band. If a baby is carried
within six feet of a door the system will sound an
alarm and automatically double-lock all doors.
The birth of a child is a magical time in your
life, with our caring approach and wide range of
sophisticated services, we are committed to not
only providing a memorable birth experience, but
giving your little one the best possible start in life.
Learn and Play
Daycare Centre
Limited Spaces for
infants available.
Call to reserve your
spot today!
Caring for infants
to Senior Kindergarten.
Providing exceptional daycare
in Barrie for over 21 years.
Call for information
7721-4905
21 4905
Limited spacing Full and part time available
Sp e c i a l De l i v e r y
9
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Exercise
in pregnancy
By Dr. Jaco Scheeres
anadians
are
encouraged to include
exercise as part of a
healthy lifestyle. Many
women enter pregnancy
with regular aerobic
and
strengthconditioning
activities already as
a part of their daily
lives. Other women
see pregnancy as
an
opportunity
to modify their
lifestyles to include
more
health-conscious
activities.
In uncomplicated
pregnancies, women with or
without a previously sedentary
lifestyle should be encouraged
to participate in aerobic and
strength-conditioning exercises
as part of a healthy lifestyle.
Many women find that the
best time to initiate an exercise
program is in the second
trimester, when the nausea,
vomiting, and profound fatigue of
the first trimester have passed and
before the physical limitations of the
third trimester begin.
Women who have been exercising
prior to pregnancy may continue
their exercise regimens throughout
pregnancy using the guidelines
outlined below. When
starting an aerobic exercise
program,
previously
sedentary women should
begin with 15 minutes of
continuous exercise three times a
week, increasing gradually to 30-minute
sessions four times a week.
C
Sp e c i a l De l i v e r y
Measures of exercise intensity include the
“talk test” and a visual rating of perceived
exertion. As the term “talk test” implies, the
woman is exercising at a comfortable intensity
if she is able to maintain a conversation during
exercise. She should reduce the exercise intensity
if this is not possible.
In addition to exercise, other components of
a healthy lifestyle during pregnancy include good
nutrition and abstinence from smoking, alcohol,
and illicit drugs.
Women should stop exercising and seek
medical attention if they experience any of the
following symptoms: excessive shortness of
breath, chest pains, painful uterine contractions,
leakage of amniotic fluid or vaginal bleeding.
Reasonable goals of aerobic conditioning in
pregnancy would be to maintain a good fitness
level throughout pregnancy without trying to reach
peak fitness or train for an athletic competition.
Women should choose activities that will
minimize the risk of loss of balance and fetal
trauma. Brisk walking, stationary cycling, crosscountry skiing, swimming, or aquafit, are aerobic
exercises that cause less trauma to the joints and
ligaments and less bouncing up and down of the
centre of gravity than running or jogging. It is
suggested that a warm-up and cool-down period
be included in any exercise regimen.
Some women may experience symptomatic
hypotension from compression of the vena cava
by the pregnant uterus and should modify these
exercises to avoid the supine position after
approximately 16 weeks gestation.
Regular exercise is an important part of
maintaining a healthy lifestyle. This is no different
during pregnancy. Studies have shown that mild to
moderate level of exercise has no harmful effects
on a healthy pregnant woman or her baby.
In summary, mild to moderate levels of
exercise is recommended in a normal and healthy
pregnancy. If you have medical problems or
pregnancy complications, be sure to talk to your
doctor before starting an exercise program.
10
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Things to
avoid during
pregnancy!
By Dr. Enrique Reyes
Alcohol
It is well known that alcohol can damage the
unborn child, so the safest approach is to avoid it
altogether during pregnancy. However, a mother
who had an occasional drink before she realized
she was pregnant, likely has not put her baby at
risk. It is not clear how much alcohol consumption
will cause harm to the baby. Excessive amounts
ingested steadily could result in a low-weight baby
with a small head, facial and limb abnormalities,
mental retardation or behavioural problems. This
is known as fetal alcohol syndrome (FAS).
it is best to quit before you get pregnant. Plan to
smoke two cigarettes less each week until you are
down to only three a day. It may then be easier to
quit - which your baby will also appreciate after
birth.
Drug Abuse
Babies born to mothers who use illegal drugs
may show signs of addiction at birth, may be
irritable and fussy, and their ability to learn may
be impaired. A woman who is using illegal drugs
should stop before she gets pregnant. If she finds
herself pregnant while still using drugs, she should
discuss it with her physician as soon as possible,
to get the help and support needed to stop.
Smoking
The many chemicals inhaled when smoking
are known to affect the placenta and some
can affect the baby. Studies have clearly shown
that the function of the placenta is affected –
producing smaller babies, fetal distress, premature
labour and sometimes bleeding (in heavy smokers
and to a lesser extent in those who smoke less
than five cigarettes a day). If you are a smoker
Sp e c i a l De l i v e r y
If you need help
If you feel that you need some support in
the area of substance abuse please phone the
SOS Umbrella Program - a program designed for
pregnant women - ask for Kelly Wilkie 726-4224
ext. 2304.
11
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When
every
bite
counts!
But remember
you are not
eating for two!
By Jane Anne Sullivan,
Registered Dietitian
at Royal Victoria Hospital
W
hile it is not true that pregnant
women should eat enough
for two people, it is a good
idea to make every bite count
nutritionally.
Eating right is very important for many
reasons. It helps maintain a healthy weight; helps
meet an increased need for iron and prevents
anemia; provides needed energy and, believe it
or not, speeds up the recovery time after delivery.
Good nutrition is essential as it also helps prevent
common pregnancy problems like heartburn,
nausea, constipation and fatigue.
When you are pregnant, you need to pay
special attention to your intake of nutrients such
as calcium, vitamin D, iron, folic acid and essential
fatty acids.
Calcium and vitamin D are found in milk and
milk products. Three to four cups of low fat milk
per day can meet both calcium and vitamin D
requirements. Milk substitutes, such as cheese
and yogurt each day can meet the requirements
for calcium during your pregnancy, but not always
vitamin D unless these products are fortified.
continued on page 13
Sp e c i a l De l i v e r y
12
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continued from page 12
Folic acid is needed to support your body’s
expanding blood volume and the growth of the
tissues you need to support your baby. Folic acid
has been found to decrease the risk of neural tube
defects (i.e. spina bifida) in your baby. Folic acid can
be found in green leafy vegetables, whole grain
breads and cereals. Health Canada recommends,
“Women who could become pregnant and those
who are pregnant should take a multivitamin
containing 0.4 mg of folic acid every day.”
Iron is an important mineral in a new
mother’s diet as it is needed to support the
significant increase in the mother’s red blood cell
production. Canadian recommendations state
that adequate iron stores and a healthy diet can
provide sufficient iron to meet these increased
needs for iron, but most women
enter their pregnancy with
low to just adequate
iron stores. This is why
iron supplements are
usually recommended,
especially in the
second and third
trimesters.
Health
Canada recommends,
“Pregnant
women
should also ensure that their
multivitamin contains 16-20
gm of iron.” Iron should be
taken with juice or water and
apart from meals and other
mineral supplements.
Essential Fatty Acids
(EFA’s) are an important part of
the pregnant woman’s diet. Linoleic
acid and a-linolenic acid are essential fatty
acids. These fats are important for the proper fetal
neural and visual development of your baby. You
may not have adequate amounts of these EFAs if
you eat foods that are high in saturated fats or
hydrogenated fats, which are commonly found in
commercial bakery products, fried foods and many
other convenience foods.
Also, women who greatly restrict their intake
of fat may also have a low intake of EFA’s. Foods
that have large amounts of EFA’s include most
common vegetable oils (canola and soybean),
margarines and salad dressings made from
non-hydrogenated oils such as canola, olive
and soybean. Corn, sunflower and peanut oils,
some nuts and peanuts are also good sources.
Marine fatty fish such as salmon, mackerel and
sardines are good sources of fatty acids. Current
recommendations are that all women should eat
at least 150grams of fish each week. Check the
Health Canada website for recommendations on
fish intake and mercury found in various types of
fish.
Weight Gain During Pregnancy
Pregnancy isn’t the time to cut back on
calories or “go on a diet”. A healthy weight gain
during your pregnancy can help to give your baby
a healthy start to life. It can also reduce the risks
of complications in your pregnancy as well as
improve your health in the future.
Weight gain can vary depending on your prepregnancy Body Mass Index. In 2009, Health
Canada adopted new recommendations for total
weight gain during pregnancy. If
your pre-pregnancy BMI is in
the normal range (18.5-24.9)
the recommended total
weight gain is in the range
of 11.5-16 kg. If your prepregnancy BMI rates you as
underweight or overweight,
be sure to consult with
your doctor. Try for a slow
and steady weight gain,
but remember that all
women gain at different
rates. Find out your prepregnancy BMI and your
recommended weight gain
at
www.healthcanada.
gc.ca/pregnancy-calculator
and talk to your health care
provider.
During pregnancy, women should
eat a balanced, healthy diet. The
average woman requires 2200 calories per day
to maintain adequate nutrition. Health Canada
recommends women in their first trimester do not
need to increase their calorie intake but need to
choose foods that are more nutritious. Then in
your second and third trimester you may need an
extra 350-400 calories per day to gain the weight
you need to for your pregnancy. In addition, it is
recommended that you increase your complex
carbohydrates (such as rice, pasta and potatoes)
to make up 30 to 40 per cent of your total caloric
intake. Remember to eat “twice as healthy” NOT
“twice as much”. Be sure to follow the Canada’s
Food Guide recommendations.
Often just
including two to three extra Food Guide servings
each day is all the extra calories you require for
adequate weight gain.
continued on page 14
Sp e c i a l De l i v e r y
13
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continued from page 13
Food Cravings
As many as 85 per cent of pregnant women
report craving foods or combinations of foods
they never would have eaten prior to pregnancy.
Sweets, fruits and fruit juices, salty or spicy foods
and hard or chewy foods rank high on their lists.
If the foods you crave are healthy choices, your
best bet is to follow your body’s signals. If the
foods you crave are not healthy choices, you
need to find an alternative food choice to satisfy
those cravings. Some women feel the urge to eat
nonfood items such as laundry starch. If you feel
this urge, do not give in and talk to your doctor.
Artificial Sweeteners
The sweeteners cyclamate and saccharin
are not recommended for use during pregnancy.
Foods or beverages containing other sweeteners
are not recommended during pregnancy if they
take the place of more nutritious foods. If you
do choose to use foods or beverages containing
sweeteners, aspartame (Equal or NutraSweet) and
sucralose ‘Splenda’ may be taken in moderation
as a substitute for sugar or honey. You should
not have more than four packages of these
sweeteners or two cans of diet beverages in a
day.
Vegetarian Diets
If you are a lacto-ovo vegetarian (one who
eats dairy and egg products) you can obtain all
the nutrients you need to produce a healthy baby
if you follow Canada’s Food Guide to Healthy
Eating. If you are a vegan (one who avoids
foods of all animal origin), you must pay special
attention to getting enough of the nutrients
normally found in animal products - for example,
vitamin D, calcium, and vitamin B12, iron and
protein. You can ask to see a dietitian for help in
finding alternative sources of these nutrients.
Caffeine
Cut down on your intake of caffeinecontaining foods or beverages such as tea, coffee,
cola or chocolate. For example, consume no more
than 300 mg of caffeine per day, the equivalent of
three to four cups of coffee.
Herbs
At this time there is not enough scientific
information about the safety of various herbs and
herbal products to recommend their general use
during pregnancy and lactation.
momstown is for neighbourhood
moms wanting to connect for
support, conversation and
just plain fun!
barrie.momstown.ca
neighbourhood moms connected
email address: info.barrie@momstown.ca
• 30 momstown events monthly • member privileges • interactive message board
Sp e c i a l De l i v e r y
14
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Midwives
offer yet
another choice!
M
idwives have been regulated in
the province of Ontario since
1994, and Barrie Midwives
have been a part of the
obstetrical team at RVH since that time
as well. Our clinic is close to the hospital in the
medical building at 1 Quarry Ridge Road, Suite
303. Midwifery care is free in Ontario. Like nurses
and doctors, midwives are paid by the Ministry
of Health. Your midwife will provide complete
prenatal, birth and postpartum care for you and
your newborn until your baby is six weeks old.
As specialists in normal birth, midwives are
trained to detect situations that may require
additional care. When needed, midwives
collaborate with physician and nursing colleagues
as necessary. If a woman or newborn needs
specialized medical care, their care is transferred to
the appropriate provider, typically an obstetrician
or a paediatrician.
At our clinic, you will be cared for by a small
team of midwives. This means that you are likely
to know the midwife who delivers your baby.
Partners and children are welcome to attend and
participate at appointments.
In order to practice in Ontario, midwives
complete a four-year university degree at
McMaster, Ryerson or Laurentian universities.
Sp e c i a l De l i v e r y
Their well-rounded curriculum includes studying
normal pregnancy, labour and newborn care, as
well as emergency skills. Internationally-trained
midwives access a bridging program offered
through Ryerson University and must complete
provincial examinations prior to practicing in
the province of Ontario. We are committed to
providing safe, research-based care for pregnant
women and new babies.
Together with your midwife, you can choose to
have your baby in the hospital or at home. Beyond
information provided during appointments, we
offer a homebirth night where a woman and
her support people can speak with previous
homebirth clients, ask questions, and look at the
emergency equipment midwives bring.
Whether the birth was at home or in the
hospital, midwives visit women in their own
homes in the first week after the baby is born
to monitor the health of the newborn and the
mother, and provide dedicated support for infant
feeding and care. When your care is completed,
you and your baby return to the care of your
family physician.
The Barrie Midwives provide safe care, free
care, and excellent care to clients and their babies.
Call us at (705) 727-7660 or visit our website at
www.barriemidwives.com
15
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How
will
Iif I’mknow
really in labour
L
abour is the multi-stage process that
causes the cervix to dilate so that
the baby can move through the birth
canal.
While it seems a straightforward process,
it can sometimes fool women. Such is the case
with Braxton Hicks contractions – which are false
contractions.
“While they do occur during the later weeks
of pregnancy and are a tightening of the uterine
wall, they are not as regular or intense as true
labour contractions,” said Dr. Vincent Wu, Chief of
Obstetrics, RVH.
He suggests a walk around the house or a
warm bath in order to relieve false labour pains.
So, when should a pregnant woman come to
hospital?
“If you are having regular contractions every
four to five minutes for at least two to three hours;
if your water breaks; if you experience vaginal
bleeding or haven’t felt fetal movement for a day,
come to the hospital,” said Dr. Wu. “The key is to
try to admit women to hospital when they are in
active labour.”
Wu suggests women should have a bag
packed and be ready to go to the hospital at 37 to
38 weeks.
A woman in the active phase of labour will
usually dilate one centimetre every hour, although
some women, especially women who have had
other children, may progress more quickly. This
is the stage where the contractions will be the
most intense and close together. Women should
try to stay relaxed, says Wu, and try not to eat or
drink too much as this can cause vomiting during
labour and delivery.
Not all women go into labour at the same
stage in their pregnancy. Premature labour can
Sp e c i a l De l i v e r y
occur before the baby reaches its 37th week of
gestation. The same rules apply to premature
labour as with full-term labour.
Usually the guide regarding contractions is
that they should be so intense they stop a woman
from talking mid-sentence. If a woman is unsure
about the status of her labour, she should come
to the hospital to be assessed in the Birthing
Triage Unit. Once it has been determined that
active labour is indeed taking place, the expectant
mother will be admitted to RVH’s Birthing Unit.
While in the Birthing Unit there are many
comfort measures to choose from. Some women
may choose to have a warm shower, or soak in
the whirlpool tub to relax. This may help to speed
up the labour process. Other comfort measures
are also made available such as hot packs for
back labour and the birthing ball. This will be the
time when pain management techniques, learned
in prenatal classes will come in very handy.
As the labour progresses, so too will the
intensity of the contractions. It is at this point
that a woman can choose which method of
pain management she wishes to use, such as
nitrous oxide (laughing gas), an epidural or pain
relieving medications given by an injection or
intravenously
If labour is not progressing, a woman
may have her labour induced. Sometimes just
breaking the woman’s water will bring on labour.
If that is not effective, a catheter can be inserted
to dilate the cervix, a prostaglandin gel can make
the cervix favorable for labour or the patient can
be put on an oxytocin (PIT) drip.
If labour is failing to progress and there are
concerns about the health of the baby or mother,
the doctor may recommend a caesarean section.
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People
Care
exceptional
exceptional
Sp e c i a l De l i v e r y
17
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Give your
baby the
best
start
B
Christine Gannon, Resource Nurse
on the obstetrics floor, assists Andrea
Walker with the breastfeeding of her
newborn Dwayne Roger Walker Jr.
in life!
reastfeeding is natural and human
milk is specifically designed for
human infants. RVH Obstetrical staff
support moms to make informed
choices related to breastfeeding and offer
educational support to women regardless
of the decision they make about feeding
their baby.
The World Health Organization (WHO)
recommends exclusive breastfeeding for a
minimum of six months. Health Canada is aligned
with the recommendations by WHO. Breastfeeding
provides optimal nutritional, immunological
and emotional benefits for the growth and
development of infants.
Breastfeeding, while not new, is something
that every newly breastfeeding woman must
learn. At RVH, obstetrical staff have specialized
courses in breastfeeding so that they can help
to teach and support moms through the process.
continued on page 19
Sp e c i a l De l i v e r y
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continued from page 18
Staff will assist moms to obtain a comfortable
position for breastfeeding, a proper latch, and
how to observe for feeding cues and signs of
effective breastfeeding.
When a mom first starts breastfeeding, she
should plan on feeding eight to 12 times per
day for at least seven to ten days. The first milk,
the colostrums, is rich with nutrients, protein and
antibodies the baby needs. In three to five days
the transitional milk starts coming in, making the
breasts feel more full and heavy.
Babies who are breastfeeding well will have
slow and shallow sucks at the start of the feed.
As the milk starts to flow, the sucking should
become deep and slow. There should be a pause
during the suck when the baby’s mouth opens the
widest. It is at this point, that the baby is drinking
breast milk. There should be 10 to 20 minutes of
this deep and slow type of sucking at each feed.
Sometimes mothers will worry that their babies
are not getting enough milk. The nurses will teach
new parents about weight gain, the number of
wet/soiled diapers to be expected and the cues
that indicate the baby is feeding well.
Sp e c i a l De l i v e r y
19
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What
about the
pain?
Dr. Paul Webber administers an
epidural to a labouring mom.
Department of Anesthesia, RVH
H
aving a baby is an exciting
event, but it may be painful.
Labour, and the amount of pain
felt, differs between women
and between pregnancies.
Things that affect the pain you may feel are:
fear/anxiety, the size/position of the baby, the
strength and frequency of the contractions,
earlier birth experiences, your position and
ability to move around during labour.
usually used when you have a medical condition
which prevents you from having an epidural.
b) Inhaled gas: Nitrous oxide (laughing gas)
is an anesthetic gas that you breathe through
a mask during each contraction. It is released
from the mask when you hold it firmly on your
face and breathe deeply. The gas works almost
instantaneously, and stops working three to five
minutes after you stop breathing it in. Between
contractions you take the mask away from your
face. You will likely feel slightly dizzy while
breathing nitrous oxide, but it is safe for you
and your baby because its effects wear off so
quickly. Nitrous oxide is only a weak pain killer,
but works mainly by making you less awake
and less aware of the pain. It is usually used
only in the latter stages of labour or when you
are pushing, if you have not previously received
an effective form of pain relief.
Medications
a) Injections: Demerol, which is a narcotic, is
most often used. Your nurse injects it, along with
an anti-nausea drug, into your thigh, bottom, or
arm. It works within 10-30 minutes and lasts
about two to four hours. A small amount of
Demerol may also be put through your IV. The IV
portion works a little faster but it doesn’t last as
long. No matter which way Demerol is given, it
is absorbed by your blood stream and can make
you and your baby sleepy. Because of this,
Demerol is usually used early in labour, and not
when you are close to delivering. Another form
of injected medication sometimes used for pain
relief during labour at RVH is PCA Remifentanil.
This refers to Patient Controlled Analgesia (pain
relief) using remifentanil, a narcotic drug with a
very short duration of action. This drug is given
by a continuous intravenous infusion, plus
extra doses that you can give yourself into your
intravenous tubing by pressing a button if you
need additional pain relief. PCA Remifentanil is
Regional Anesthetic Techniques:
Epidural, Spinal, or a combination of both.
Pain is greatly reduced if the nerve impulses
carrying the sensation of pain from the uterus
and birth canal are blocked before they travel
up the spinal cord. This can be achieved using
an epidural, a spinal, or a combination of both.
Before inserting the epidural or spinal needle,
the anesthesiologist will inject some local
anesthetic just under the skin on your back.
This will feel like a bee sting. After that, most
people only feel some pressure as the rest of
continued on page 21
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20
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continued from page 20
Spinal:
When the anesthesiologist performs a
spinal, a much smaller needle is used to put the
medicine directly into the fluid that is around
your spinal cord.
No tube is left in, so it is a “one shot”
injection.
A spinal starts to work faster than an
epidural, but only lasts for about an hour and
a half. If your labour is expected to be longer
than this, the anesthesiologist may also insert
an epidural catheter at the same time. This is
called a CSE (combined
spinal/epidural).
Then,
when the spinal wears off,
medication is given through
the epidural catheter as
described above.
Side effects from a
spinal or an epidural
are usually minor and
can be easily managed.
Serious
complications
are extremely rare. These
should be discussed with
the anesthesiologist, and
you should have your
questions answered before
you have an epidural or a
spinal.
the procedure is done. The medications that are
injected into your back should not make you
sleepy or have any significant effect on your
baby.
Your pain will be reduced and your legs may
feel slightly heavy. It is not always possible
to get rid of all the pain because your baby’s
position can affect the amount of pain you feel
and the anatomy of your back can affect how
the medication spreads around your spinal
cord. Most women, though, will experience
significant pain relief and will be able to rest
well.
Epidural:
Most commonly used for
labour and vaginal delivery.
A specially designed
needle is placed into the
tissue layer surrounding
your spinal fluid.
A long, thin tube called an
epidural catheter is then
inserted through this needle
and then the needle is
removed.
The epidural catheter
is taped to your back
and stays there until it is
removed after delivery.
An initial dose of the
medication is given through
the epidural catheter.
It takes 10-15 minutes
before you start to feel more comfortable.
An electronically controlled pump is then
used to give you a continuous infusion of the
epidural medication for the rest of your labour.
Back tattoos:
In recent years, it has
become more and more
common to see pregnant women with tattoos
on their lower back. Initially, there were
concerns among anesthesiologists that tattoo
dye could be carried by epidural needles into
the area around the spinal cord and lead to
irritation or injury. More recent research does
not support this belief. Therefore, if you have
a large lower back tattoo and the only way
to perform an epidural is to insert the needle
through the tattoo, we now consider that it is
safe to do so. Our current practice is to make a
small nick in the tattooed skin before inserting
the epidural needle (this is painless since the
skin is frozen first with some local anesthetic).
This technique eliminates the possibility of any
dye (or a tiny skin fragment containing dye)
being carried down into the epidural space by
the epidural needle. If you have a lower back
tattoo, it is no longer necessary for you to see
an anesthesiologist before your delivery to
discuss whether you can have an epidural.
Patient Controlled
Epidural Analgesia (PCEA):
PCEA allows you to push a button and
give yourself an extra dose of medication
once in a while, if you require it. The pump is
programmed to set the appropriate amount
of baseline infusion, the amount of each extra
dose, and how often you can give yourself an
extra dose. This system gives you some control
over how much medication you receive.
PCEA technique provides excellent pain relief,
but has minimal effects on muscle strength.
Therefore, your legs usually remain strong, you
are able to move in bed, you maintain control
over bladder function, and you keep your ability
to push when it is time to deliver.
Sp e c i a l De l i v e r y
21
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News hound has
T
met his
match
v personality Rob Cooper is wellknown as a hard news reporter who
doesn’t take ‘no comment’ for an
answer.
He is used to working hard and playing hard,
but now he’s met his match.
An eight pound, two ounce little boy named
Maxwell has spun this hard-nosed news hound’s
world upside down. In fact, the infant managed
to change some things in Rob’s world no one else
had been able to - and that was even before he
was conceived.
It all began when the reporter entered a bank
looking for financial advice and left with a soul
mate. Even before Rob and Judy Cooper settled
into marital bliss they discussed having children,
something they both wanted. However, there
was a problem, Rob was a smoker and neither of
them wanted their child subjected to second-hand
smoke. No children, until no cigarettes - Rob had
to make some changes.
“I definitely had to grow up and I definitely
wanted to quit smoking. That was really important
for both of us,” says Rob.
So, with the help of medication and the desire
for a child motivating him, Rob kicked the habit
within a very short period of time.
In an equally short period of time the couple
continued on page 23
Sp e c i a l De l i v e r y
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Maxwell’s first bath
A cuddle with Mom
Welcome Maxwell Leonard Cooper
Already dressing
like dad
replied, “How far along am I?”
The pharmacist, with a look of concern on
his face, asked, “You didn’t pee on the strip, did
you?”
Rob assured him that indeed his wife had and
that the pharmacist was not sitting on a breaking
news story.
When Rob got home he confirmed the exciting
news with Judy and the couple was so overjoyed
they started to cry. And clean their house.
“Almost instantly I began looking around the
house and saying, “That’s got to go and that’s got
to go.”
Fast forward nine months to December 7,
2010. Judy and Rob Cooper are gowned-up and
continued from page 22
was expecting their first child. However, Rob,
ever the skeptic, didn’t think they could have
conceived so quickly. As any good reporter would,
he questioned the validity of the over-the-counter
pregnancy test.
“Judy came to me and said, ‘I think I’m pregnant,’
and I immediately said, ‘No you are not.”
So Rob went to the source to find out. He took
the test strip, jumped in the car and drove to the
closest pharmacy to have it verified.
“It was actually quite a funny moment. I
showed the strip to the pharmacist and asked
him what it meant. He replied, ‘It means you are
pregnant sir.”
Catching on to the hilarity of the situation Rob
continued on page 24
Sp e c i a l De l i v e r y
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The Cooper Family
continued from page 23
ready for a scheduled C-section with RVH’s Dr.
Shannon Causey.
At 1:38 p.m. the event they had worried about,
celebrated and wished for, happened – their son
Maxwell Leonard Cooper made his debut.
And that’s when Rob lost it.
“The doctor brought him around the corner
and as soon as I saw him I just bawled. I couldn’t
believe how emotional I was. There was Judy
hooked up to all these wires and she’d just had
a C-section and she was the one comforting me,”
say Rob. “I always wanted a child I just never
thought I would have one and I guess that was
what was so overwhelming for me.”
Judy’s recovery from the C-Section was
textbook as she waited the regular six weeks
before attempting any heavy lifting. She says the
actual procedure wasn’t what she expected.
“I was a little nervous going in, but it was
actually great,” says Judy. “It felt a little weird. I
was surprised that I could feel the pushing and
Sp e c i a l De l i v e r y
the pulling, but it wasn’t painful in the least.”
After her hospital stay of three days, the
Coopers were able to take Maxwell home and
begin their new life.
“Rob is a great hands-on Dad. He actually
changed the first diaper,” says Judy.
Was Rob fully prepared for fatherhood? Not
on your life. But was he thrilled? You bet.
“I asked as many questions as I could about
parenting to as many people as possible. They all
said be prepared to cope with the lack of sleep.
Well, before I was married I could stay up all night,
no problem – I was like a vampire. But very quickly
I learned they were right. It is different when you
are trying to sleep and are woken up every three
hours,” says Rob. “So I suggest new parents
prepare themselves for that, enjoy every moment,
love your child and have fun.”
And to the new fathers he adds, “try to get
some of the parental leave from your wife.”
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Special care
for
special
babies
Skating champion Jennifer Robinson
holds her daughter Reese McKenna
in Royal Victoria Hospital’s
Special Care Nursery.
T
he birth of a new baby is an exciting
time for everyone involved. Some
newborns however, require just a
little extra care, particularly those
who arrive earlier than planned, or those
that have medical issues. That is when the
experts in Royal Victoria Hospital’s Special
Care Nursery (SCN) take over.
Parents often feel apprehensive when their
newborn is taken to the Special Care Nursery, but
there is no need to be alarmed if your baby spends
time in the neonatal unit.
“It is normal for parents to feel apprehensive
or anxious when their child is admitted to the
Special Care Nursery. Parents should realize the
staff involved in the care of their infants are highly
qualified,” says Dr. Vincent Ho, neonatologist for
the Special Care Nursery.
That SCN team consists of nurses, two
neonatologists, six paediatricians, an occupational
therapist, social worker, physiotherapist and
respiratory therapists. The Special Care Nursery
currently has an Advanced Level II rating according
to provincial standards, meaning it is equipped to
provide intensive critical care for infants as early
as 32 weeks gestational age.
The neonatal nurses attend all caesarean
section deliveries, and if the baby is well, this new
bundle of joy will remain with mom and significant
other in the recovery room. All babies go through
a transition period adjusting to life outside the
womb, and those born by caesarean section may
not always make this change right away.
Therefore, they may have to be admitted to
the Special Care Nursery for some short-term
observation, helping them to adjust to the outside
world.
Sp e c i a l De l i v e r y
While RVH’s tiniest patients rest in climate
controlled incubators or specially-designed cribs,
family members are encouraged to participate
in their care. This could mean changing diapers,
breastfeeding or feeding through a tube inserted
in the nose.
“The vision of the Special Care Nursery is
to encourage family-centered care. This means
having both parents involved in the care and
decision making for their newborn baby,” says Dr.
Ho. “We recognize that being physically separated
from your baby is stressful to the family as a whole
and the staff in the Special Care Nursery will make
your baby’s stay as easy as possible.”
We are very pleased to be enrolled in a
pilot project in conjunction with The Hospital for
Sick Children and the Remote Retinopathy of
Prematurity Screening Project. Retinopathy of
prematurity (ROP) is a disorder that can cause
blindness in premature infants. Having the exams
performed at RVH means the baby does not have
to be transferred to The Hospital for Sick Children
in Toronto each time.
Since May 2010, 27 babies have had this
test. During the examinations, RVH staff are in
communication with a Neonatal Ophthalmologist
from The Hospital for Sick Children via video
conference. The images are viewed live, and from
the video, image stills are transferred securely by
our ICT department to Toronto. A full report is
received at RVH within 24 hours of the exam.
After discharge, babies should be followed
up by the family doctor for routine care, and if
required, a paediatrician may be consulted for
follow-up in RVH’s neonatal follow-up clinic.
25
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January 2011
September 2009
RVH
is in the
labour phase
of its own “special delivery”
T
he staff of Royal Victoria Hospital
truly consider it a privilege to play a
role in the delivery of your bundle of
joy. Whether it is through prenatal
care, labour and delivery assistance, to
infant hearing screening, we know the
health of your baby is paramount to you.
We congratulate you on expanding your
family and we want to share our exciting news
with you.
RVH is “expecting” as well. We are well into
the labour phase of our own special delivery, the
Phase 1 Expansion Project, which includes the
Simcoe Muskoka Regional Cancer Centre.
It’s hard to believe that almost two years ago
the expansion project was just a very big hole in
the ground. From the day the first shovel of dirt
was turned in March of 2009, everyone involved
have kept the project on track, keeping in mind
both aesthetics and patient safety.
“Progress on this project has been truly
remarkable and given the explosive population
growth of our region, completion can’t come soon
enough,” says Janice Skot, RVH President and
CEO. “The Province of Ontario has demonstrated
its understanding of the growing need of our
community by investing in this critically important
project. We also greatly appreciate the outstanding
support of this project from our municipal partners
– the City of Barrie, $52.5 million; County of
Simcoe, $20 million and the District of Muskoka,
$3 million. The community has also been very
continued on page 27
Sp e c i a l De l i v e r y
26
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continued from page 26
supportive of this project with $35 million raised
through the ‘I Believe” Capital Campaign. This
is the largest capital project in Simcoe Muskoka
history, and begins a new chapter in Royal Victoria
Hospital’s proud history.”
Much research and planning has gone into
the Phase 1 Expansion Project
to ensure not only is it able to
provide safe, quality patient
care, but does so in a bright
and healing environment. But
much thought has also gone into
selecting the fixtures, furniture
and features of the hospital to
make it a soothing and healing
place. For example patient rooms
will be painted with soothing
colours, motifs and patterns
based on the four seasons.
Most rooms have either a view
of a lush green courtyard, green
garden or a view of Little Lake
and the forests that surround it.
Glass walkways from unit to unit
ensure patients enjoy their pleasant surroundings
without being disturbed by unnecessary traffic.
At RVH quality care is our top priority, so
special attention has also been paid to enhancing
safety throughout the building with items such
as nightlights in patient washrooms, non-slip
flooring, the addition of 150 more clinical ‘handsfree’ hand washing sinks, patient lifts over each
bed, and more dedicated isolation rooms. All of
these features add up to improved and enhanced
patient and staff safety. The expansion doubles
the size of the hospital, adding another 440,000
additional square feet.
“The Simcoe Muskoka Regional Cancer
Centre, and in fact the entire hospital, will feature
state-of-the-art technology. The cancer centre
will feature four radiation treatment suites, as
well as 34 chemotherapy treatment spaces, all
overlooking gardens and Little Lake,” says Garth
Matheson, Vice President, Regional Cancer and
Clinical Services. “From the new automated
laboratory and the addition of new MRI and CT
machines, to the interventional
radiology suites and digital
mammography units, the
patient who enters our facility
can do so knowing they have
access to the most advanced
technology in healthcare”
It is true that when you or
someone you love is sick,
suddenly all that matters
is your ability to get the
healthcare you need. So, as
you anxiously await the arrival
of the newest member of your
family, RVH’s gift to you is our
commitment to bring you and
your family quality healthcare,
close to home.
What does the
expansion project include:
•
•
•
•
•
The Simcoe Muskoka Regional Cancer Centre
Capacity for 165 additional inpatient beds
A dedicated Coronary Care Unit
An Emergency Department that
will triple in size
An expanded Diagnostic Imaging Department
includes space for a second MRI unit and
three Interventional Radiology suites
• A fully-automated Laboratory
• Two new Smart Operating Rooms - which are
larger and more technologically advanced
than existing suites for complex surgeries
• classes
• trendy gifts
• natural products
• cloth diapers
12 Commerce Park Dr. Barrie • 705-735-4302
www.serenitybirthstudio.ca
Sp e c i a l De l i v e r y
27
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Taking care of
children
O
wen Lapshinoff isn’t having a
great day.
The eight-year old Midhurst boy is at
Royal Victoria Hospital for his monthly
infusion of a life-saving treatment which boosts
his weakened immune system.
Owen has a primary immune disorder which
simply means his body is unable to fight bacteria
which cause infections. For four years now he’s
been coming to RVH to receive this treatment,
and he knows the drill. But, some days there are
other places a young boy would rather be than
hooked up to intravenous and lying in a hospital
bed for hours at a time.
Yet, it is these hours spent at RVH that enable
Owen to do the more enjoyable things boys like to
do - skiing, jiu jitsu and swimming.
“I feel so grateful to have access to such an
amazing medical facility so close to home,” says
Owen’s mom, Christy Allen. “Less time travelling
to Toronto for this treatment means more time
living life with Owen.”
Owen is just one of more than 3,000 children
from Simcoe Muskoka who each year use the
services of RVH’s Child and Youth Outpatient
Services and that number is expected to rise.
Barrie is experiencing a baby boom. In fact,
according to Statistics Canada, the city has the
fastest-growing youth population in Canada. Last
year, almost 2,200 babies made their debut at the
Tara Cooper adjusts
her daughter Hannah’s
hearing aid during a visit
to RVH’s Child and Youth
Outpatient Clinics.
facility which is why RVH is dedicated to providing
services to meet the needs of its youngest patients
and their families.
This year those young patients experienced a
change in scenery when all the child and youth
clinics were relocated within an easily accessible
and child-friendly space on the first floor of the
hospital.
“We consciously moved all the child and
youth clinics to the first floor, right near the
front entrance, for convenience and to enhance
patient safety. Some of these children are really
susceptible to infection and having the clinic close
to the main entrance, means they don’t have to
walk through inpatient units to get where they’re
going, which is critical for those children who are
medically fragile or have multiple disabilities,”
says Karen Fleming, Program Director, Women
and Children’s Program.
Dr. Brian Kuzik applauds this move as he
believes this model of outpatient paediatric care
is the way of the future.
Kuzik is a paediatric researcher, holds
academic positions as an assistant professor of
paediatrics at both the University of Toronto and
Queen’s University in Kingston and one of the
very experienced paediatricians who work in the
clinic.
“This new clinic is absolutely and unequivocally
critical to developing a children’s program. The
continued on page 29
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28
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continued from page 28
trend is to move away from inpatient care and
paediatric diabetes, asthma, feeding and
toward outpatient care, especially when dealing
swallowing, neonatal follow-up, early intervention,
with more complex health issues. Essentially what
weight management, Down syndrome, mental
we have created here is
health, Infant Hearing,
one-stop shopping for
audiology and hearing
families,” says Dr. Kuzik.
aid dispensing, and the
With families coming
RSV (Respiratory Syncitial
to RVH from as far away as
Virus)
Immunization
Parry Sound, Bracebridge,
Clinic.
Huntsville, Collingwood,
This spring the Complex
Midland/Penetang
and
Care Clinic is expected to
Owen Sound, it just made
open and offer services
sense for them to see all
for children with multiple
the medical professionals in
disabilities and who are
one spot instead of several
medically fragile. RVH’s
different
appointments
preschool Speech and
in many different places,
Language, Occupational
says Dr. Kuzik. Even having
Therapy and Blind Low
to register on one floor
Vision early intervention
of the hospital and wait
services are offered
on a different floor for
in various community
Owen Lapshinoff receives
an appointment can be
locations.
his life-saving treatment
frustrating, especially for
For young patients like
in a special room located
parents of children with
Owen, who must make
at RVH’s Child and Youth
multiple disabilities.
frequent visits to RVH and
Outpatient Clinics.
The space, which
often need the expertise
officially opened in October 2010, is home to
of a multi-disciplinary team involved in their care,
child and youth clinics for: conscious sedation,
this new outpatient clinic is a godsend.
• Local, live out nannies fully screened
• Full-time, part-time, temporary or
occasional
• Returning to work, on a shift schedule
or just need extra help
• Special needs children catered to
• Trial dates available
Requiring assistance
with newborns,
multiples, or toddlers
in the home.
We have trained
personnel available.
Consider a trial,
call us today!
www.simcoenannysolutions.com
Barrie, ON ph: 705.797.8473
Fax: 705.733.0265
Sp e c i a l De l i v e r y
29
www. r v h . o n . c a
Contact Numbers New Parents May Need
Royal Victoria Hospital
Main Switchboard . ..........705-728-9802
Automated Attendant Line . .... 705-728-9090
(requires extension numbers)
Diabetes Education Centre . .... 705-739-5652
Fertility Clinic .......................... 705-728-7784
Health Library ............................... ext. 42631
Imaging Services (bookings) . ........ ext. 43500
Nutrition Counseling . ................... ext. 44436
Patient Accounts ..................... 705-739-5607
Patient Representative .................. ext. 44510
Pre-admission Bookings . .............. ext. 47466
Obstetrical Information Line . ........ ext. 46444
Paediatric Asthma Clinic ............... ext. 46280
Paediatric Outpatient Services ....... ext. 47463
Preschool Speech and
Infant Hearing ....................... 705-739-5696
Telephone Device
for the Deaf (TDD) .................. 705-739-5618
La Leche League...................1-800-665-4324
Motherrisk
Alcohol and Substance
Use Helpline - ......................1-877-327-4636
Nausea and Vomiting of
Pregnancy Helpline - . ..........1-800-436-8477
HIV and HIV Treatment
in Pregnancy - .....................1-888-246-5840
Motherisk’s Home Line - ....... (416) 813-6780
Breastfeeding Place... ext. 813 705-721-7520
Midwives ................................ 705-727-7660
Prenatal Clinic ........................ 705-725-8796
Simcoe County Health Unit...... 705-721-7520
Telehealth . ..........................1-866-797-0000
............................... TTY : 1-866-797-0007
Women and Children’s Shelter.705-728-6300
Barrie Pregnancy
Resource Centre...................... 705-739-7280
Dr. Andrew Browning is one
of seven RVH obstetricians.
Obstetricians
Bologna, John T., M.D.
(705) 728-5311
Browning, Andrew D., M.D.
(705) 728-5311
Causey, Shannon, MD
(705) 737-2347
Moreau, Jan P., M.D
(705) 737-2450
Reyes, Enrique G., M.D.
(705) 737-5038
Scheeres, Jan J., M.D.
(705) 739-7611
Wu, Vincent, M.D.
(705) 728-5311
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2 Locations To Serve You Better
35 Mapleview Dr. W.
Molson Park and Highway 400
705-728-9122
Sp e c i a l De l i v e r y
31
400 Bayﬁeld Street
Bayﬁeld Street and Livingstone
705-728-2833
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GRC
Georgian
Radiology
Consultants
nsity
Bone poDinetm
ent
By Ap
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g
Proudly servin
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Simcoe County
Since 1972
Georgian Radiology
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BARRIE LOCATIONS
Appointment Bookings
726-7442
5 Quarry Ridge Road (Suite 105) .......................735-2166
190 Cundles Road East (Suite 205) ....................722-8036
121 Wellington Street West (Suites 114-115) ....726-4531
480 Huronia Road (Suite 101) ............................739-1028
Our Bone Mineral Density Service
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is fully accredited
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Sp e c i a l De l i v e r y
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