What does prenatal care look like week by week in Quebec?

The short answer

In Quebec, prenatal care is arranged with a midwife, doctor or another qualified health-care professional, depending on your preferences, your circumstances and the services available nearby. There is no appointment scheduled for every single week that applies to everyone. Visits are usually spread out more at the beginning of pregnancy and become closer together as the due date approaches. Your care team may suggest a different schedule if you have specific needs.

Prenatal care gives you a chance to talk about your health and questions, consider tests at appropriate times, and prepare for the birth. The general milestones below come from a Quebec public-health guide. They can help you understand what may happen, but they are not a schedule to follow on your own. Your care team can explain which recommendations apply to you.

First, how pregnancy weeks are counted

Pregnancy is counted from the first day of your last menstrual period. So, when you are told you are “20 weeks pregnant,” 20 full weeks have passed since that date, even though fertilization happened later. Your estimated due date is just that—an estimate. An ultrasound done before 20 weeks can help refine it. (INSPQ — Duration of pregnancy and estimated due date)

It is normal for your estimated date to change after an ultrasound. Your app and your health record may also show a slightly different pregnancy day for a while. For your care, follow the dating confirmed by your team. Week-by-week milestones are approximate; they cannot predict exactly what is happening for every baby.

If you would like to see images of development during pregnancy, you can look at the Naître et grandir slideshow. For decisions about your care or a test, speak with your health-care professional.

The usual schedule for appointments

The schedule generally suggested by the INSPQ looks like this:

• During the first 11 weeks: one first appointment, usually between 8 and 11 weeks.
• From 12 to 30 weeks: an appointment every 4 to 6 weeks.
• From 31 to 36 weeks: an appointment every 2 or 3 weeks.
• From 37 weeks until the birth: an appointment once a week.

Your schedule may be different if your health or pregnancy calls for closer or otherwise different care. The schedule also does not mean that the same tests happen at every visit. The first appointment is usually longer. Your provider may ask about your health history, previous pregnancies, medications and allergies, habits and living circumstances. You can bring up concerns, accessibility needs or topics you would rather discuss privately.

At later appointments, your care team will check in about how the pregnancy is going. Depending on your visit, they may check your weight and blood pressure, listen to the baby’s heartbeat and, at around 20 weeks, measure the height of your uterus. You can ask why a test or check is being suggested, what it can tell you and what other options are available. (INSPQ — Prenatal care)

Tests that may be offered at different times

Some tests and samples are offered during particular stages of pregnancy. These are milestones to discuss with your care team, not a list of requirements that is the same for everyone.

• At the start of care: Blood tests and urine tests may check different aspects of your health and help plan your care. You can talk about prenatal screening tests and decide whether you want to take part.
• Between 11 and 13 weeks: A nuchal translucency ultrasound may be offered along with biochemical screening. Prenatal screening is a choice. A screening result estimates the chance of a condition; on its own, it does not confirm a diagnosis.
• Between 24 and 28 weeks: Screening for gestational diabetes is generally offered.
• Around 36 weeks: A vaginal and rectal swab may be offered to check for group B streptococcus.

An ultrasound may also help date the pregnancy and check on the baby’s development, including the baby’s organs, how many babies there are and the position of the placenta. The timing and number of ultrasounds may depend on your care. Ask your team what the scan is meant to check in your situation. The Quebec INSPQ page on prenatal care provides further information about these tests and general milestones.

Getting ready for appointments and finding support

You do not have to wait for your next appointment to write down a question. Keep a list in your phone or notebook of changes you want to mention, things you would like clarified, upcoming tests and information you want to share with your family. Before a test, you can ask what it involves, what the results may mean and when you can expect them. You can also ask for a second opinion or request access to your health record.

If you have not found a provider for your prenatal care, Quebec’s Ma grossesse service can help you find resources and access a health-care professional. Depending on your situation, a CLSC worker may also contact you. (Québec.ca — Ma grossesse service)

For a health question between appointments, call Info-Santé at 811. If it is an emergency, call 911. For questions about a medication, ask your pharmacist. These services do not replace your prenatal care team, but they can help direct you to support that fits your needs.

Your pregnancy may not follow the same path as a friend’s or as a schedule you found online. Use the milestones as a general guide, and let your care team plan the next steps with you. It can help to know when your next appointment is, which tests are being considered and who to contact if a question comes up.

Frequently asked questions

This article is for information; it does not replace advice from a health professional. In Québec, call Info-Santé 811 when in doubt (elsewhere in Canada, your provincial health line). In an emergency, call 911.

Sources

1. Service Ma grossesse (in French), Gouvernement du Québec
2. Your Guide to a Healthy Pregnancy, Agence de la santé publique du Canada