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What does a GP referral mean?


In BC, referrals are generally made between physicians on your behalf.  An official consult request is sent, usually by a family doctor to another doctor who offers a specific service. They also forward any pertinent health information, lab tests, and investigations.   A family doctor or GP who does not offer maternity care can refer you to one that does.  Some GPs take care of you for the fist two trimesters then refer you on in the third trimester; some refer earlier.  At Terra, we have no preference.  If you do not have a family doctor and want to see a Terra physician that only accepts GP referrals, a walk-in clinic doctor can make the referral for you.


What does self-referral mean?


Some Terra physicians can see you for your pregnancy even without a GP referral.  All you need to do is call that physician's office and request to see that specific doctor for prenatal care.  Some Terra physicians work together in the same office.   Please let the front desk staff know which doctor you want to see.


What if I do not have MSP coverage?


MSP, or the Medical Services Plan of BC, provides healthcare coverage for eligible residents of BC.  If you are a resident of Canada but are from a province other than BC, then you are still covered and eligible to receive our services.  


Patients who are eligible to be covered under MSP but are still waiting for it, will have to pay for visits and tests privately until their coverage is active. We follow the BCMA fee guide for non-insured services.


Non-Canadian patients are a little more complicated.  Information about fees and a waiver can be obtained at the physician's office.   




Who will I see for my prenatal visits?


The Terra physician who accepts you for prenatal care will be primarily responsible for seeing you for all of your prenatal visits.  However, in offices that are shared by two or three Terra physicians, it is common for us to cover for each other if someone is away, sick or a particular day is more convenient for you.


Who will be there when I go to the hospital?  


There is a Terra physician on call, 24 hours a day, 7 days a week.  We typically have 24 hour long shifts, from 6pm today to 6pm tomorrow.  We believe that having a healthy work-life balance is essential in practicing good medicine.  Also, we feel that having someone dedicated solely to hospital calls is essential for safe and comprehensive care.  


Although 6pm is usually when our shift ends, it is not uncommon for a Terra physician to stay on a little longer if your birth is imminent. We do not like missing the best part of our job!!


How do I get help if I have concerns in the middle of the night, on weekends, or on holidays?


As above, there is a Terra physician on call, 24 hours a day, 7 days a week.  Part of our job is to be available for telephone advice if you have urgent concerns about the pregnancy.  Your Terra physician will let you know how to contact us.  Please schedule a clinic visit for non-urgent concerns.


My baby is due.  When do I go to the hospital?


In general, only women in active labor are admitted to the hospital.  Active labor means that your cervix has reached 4 cm dilatation, there are regular contractions, and these contractions continue to dilate your cervix at an expected rate.  If you are too early in your labor and there are no safety concerns, you will be discharged home.


It takes a while for first time moms to reach the active stage of labor.  We encourage you to stay at home as long as you can. We can provide you with advice regarding comfort measures while you are at home.  We usually talk about the "5-2-1 rule" where we encourage you to call us once you are having contractions 5 minutes apart, lasting up to 2 minutes long, for at least 1 hour, and strong enough that you cannot talk through them.


Labor and delivery is generally faster for your subsequent babies.  Let the Terra physician on call know you've started to contract, and she can help you decide when to head to the hospital.


Other reasons to head to the hospital are significant pain, significant bleeding, or decreased movement of your baby.  

If you think your water has broken, you should call the Terra physician immediately and she will make a plan with you as to when to come in.  


Click on the button to see a handout about early labor.  Click on the link to access this handout in Chinese, Vietnamese or Punjabi.








How long do I usually stay in the hospital after I give birth?


Healthy women who have uncomplicated vaginal deliveries typically stay for 24 hours.  Those who have a Caesarian section typically stay for 2 to 3 days.  


Women who have complications that need closer or longer monitoring will stay until we feel it is safe for them to go home.


Other issues, like significant breastfeeding difficulties, babies with significant weight loss or significant jaundice also require longer hospital stays.


When do I have to see my doctor after I give birth?


Follow-up visits are discussed with you prior to sending you home.  How quickly and how often you see your doctor after will depend on your health and your baby's health.  We typically see your baby in the first week to make sure he or she is gaining weight appropriately.  We will also see you for a 6 week post-partum visit where we tackle topics like returning to regular exercise and activities, resuming sexual relations, and contraception.  


How long will this bleeding last?


It is normal for you to have some bleeding after giving birth.  It usually starts out like a regular period, then gets lighter and lighter.  It typically lasts about 4 weeks, and sometimes lasts up to 6 weeks.  As long as the pattern is that of bleeding that is lighter and lighter, it is ok.  If there is suddenly an increase in bleeding, foul-smelling discharge, fever, chills and other concerning symptoms, you should see your doctor immediately.  


I suddenly have fever, chills and part of my breast is red and tender.  What is happening?


Mastitis is a localized, painful imflammation of the breast in breastfeeding women.  It is not uncommon; it happens in 2 to 10% of breastfeeding moms.  Risk factors include prolonged engorgement, cracked nipples, and poor milk drainage. Organisms that are found on your skin gain access to the stagnant milk and cause the infection.


Initial steps to take are to take ibuprofen or tylenol, use a warm compress over the red area, massage it gently and empty your breast as often and as completely as possible.  Keep breastfeeding and/or pumping.  If this does not resolve fairly quickly, see your doctor as you will need antibiotics.  We do not want the infection to get worse, and form an abscess or pus in your breast.  The antibiotics we choose are safe in brestfeeding.


I have pumped some breastmilk.  How long can I keep it?


Frozen breastmilk can be kept for 6-12 months.  Thaw frozen breastmilk in the fridge, DO NOT microwave it.  It usually takes 12 hours to thaw.  You can keep  breastmilk in the fridge for 24 hours.  Once you take it out, and feed it to your baby, throw away any unused portion.  Do not refreeze thawed milk.



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