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Department of Family and Community Medicine and St. Michael’s Academic Family Health Team

Services: Pre-natal care - When should I call my provider?

Who to call

For your regular prenatal office visits: call your own doctor

For all other concerns:

  • During regular office hours, call your own doctor first
  • After office hours, or if your own doctor is unavailable, contact the doctor on-call.

The number for the doctor on-call is 416-864-5431

If you think you’re in labour or are over 20 weeks along in your pregnancy, you can also call maternal triage at the hospital: 416- 864-5252

What to say

“I’m pregnant and I’m a patient of Dr. _______________. I need to speak with the family medicine resident on-call.”

When should I call?

Regardless of appointment times, you need to call us if you experience any of the following:

+ Cramping

Lower belly or back pain (especially if it feels like your periods) may mean contractions of the womb. Most women who have these symptoms end up with normal pregnancies, but they all need to be examined by one of our obstetrical providers. If you have not yet had an ultrasound during your pregnancy, it is important you consult your provider the same day.

+ Bleeding

Spotting from the vagina (red or dark brown in colour) can happen normally after Pap testing, after sex or even with physical exercise. Always mention vaginal bleeding to your health care provider. If you’re bleeding like a heavy period, you need to be seen by your provider the same day. There are many non-urgent reasons which could be causing your bleeding, but it is important to first be seen by a medical professional in this context.

+ Contractions

There are many reasons to feel belly pains in pregnancy, not least of which is an ever larger, heavier womb with a kicking baby inside of it. Contractions, however, tend to have a waxing and waning quality, tend to be felt at the front lower belly and at the lower back, and tend to feel similar to the cramping during your periods.
Review any pain in your belly with your healthcare provider to see if they could be contractions. If these pains do not get worse into stronger and/or more often pains it is something to bring up at your regular appointments, and may be normal during this stage of pregnancy. If however, the pains come along with bleeding from the vagina, are increasing, getting longer in length, or happening more often, do not wait for your next appointment and call your nearest obstetrical hospital to be seen.

+ Swelling of the face, headaches, blurry vision, high blood pressure

During the second and third trimester of pregnancy it is possible to develop preeclampsia. This usually starts with increased blood pressure, headache, blurred vision, swelling of the face or even seizures. If you are having a headache, this is common during pregnancy and does not necessarily mean you have preeclampsia. It is important to mention the headaches to your doctor or nurse practitioner, who will be checking your blood pressure and for other signs of this disease. If you are having severe headache, blurred vision, high blood pressure or increasing swelling of the face it is important to see a professional the same day.

+ Fetal movements

As your pregnancy grows beyond 26 weeks, the baby’s movements change. They feel different and come less often than before. If you notice that the baby's movements are less that their normal for that time of day: lay down, drink a sweet drink and count all the movements you feel. If you count six or more within two hours you can be reassured. If you get to two hours without counting six movements, call maternal triage at St. Michael's Hospital (416-864-5252).  If you are at all worried, call the resident on-call for family practice to review the details with them.

+ Breaking the waters

This happens when the balloon of liquid around the baby breaks. The liquid pours into the vagina and then into your underwear. This can happen as a large fluid gush from the vagina, which is unmistakable and has inspired many Hollywood films. However, if the hole in the ‘balloon’ is very small, the leaking from the vagina will be very little and may be hard to notice. If your underwear feels wetter than usual (ex. as though someone keeps pouring water over it) change your underwear, dry yourself off and check again in one to two hours. If you again notice wet underwear you should call maternal triage (416-864-5252) to be checked.
It doesn’t matter if it is a large or a small leak.  If you think you’ve broken your waters you should call us to be checked. The answering service pages the resident who will get back to you right away.

Information the on-call resident will need:

  • Your name
  • Your family doctor
  • Your resident doctor (if any)
  • Your situation
  • The resident gives all this information to the doctor on-call, who will call you right back.