Click Here to Download Printable PDF Version: Maternity Care Midwives Paging Instructions

PAGER: (807) 624-1260

Pager use is for current clients only who have had their initial appointment.


The operator will need to know your TEAM COLOUR, NAME, PHONE NUMBER, and whether your concern is URGENT or NON-URGENT.

Green Team: Sandra Shymko, Amy Borges, Chantal Dube, Margaret Flietstra
Blue Team: Mojgan Dostar, Carey Murphy, Colleen Johnston, Tori Glena

For URGENT concerns, please call the pager. A midwife will return your call within 15 minutes. Examples: vaginal bleeding, decreased fetal movement

For NON-URGENT concerns, please call the office during working hours (M-Th 9:30-4:30, F 9-1), or the pager on evenings or weekends. A midwife will return your call within 2h. Examples: signs of a bladder infection, medication safety for colds

After you page your midwife, please keep your phone nearby and stay off the line until your call is returned. Your midwife will call from a blocked number. If you have not heard back in the allowed timeframe, first check your messages then re-page.

Below is a list of examples of when to page to page your midwife, but is not a complete list. If you are worried for any reason, please contact your midwife


  • If you are going to the ER for any If you are 20 weeks pregnant, your midwife needs to listen to the fetal heart rate and confirm you are not in labour before you are assessed in the ER.
  • Fever above 38.0°C (100.4°F)
  • Severe abdominal pain
  • Severe nausea and vomiting, and you can’t keep fluids or food down for 24h
  • Vaginal bleeding
  • Signs your water has broken
  • Decreased fetal movement after 24 weeks
  • Active labour (strong, regular contractions less than 5 minutes apart)
  • Regular, rhythmic abdominal cramping with a constant low, dull backache
  • Constant frontal headache (forehead or temples) that doesn’t go away with Tylenol, rest, and drinking water
  • Vision changes (blurry, seeing stars or spots)
  • Signs of a bladder infection: Burning or pain with peeing, blood in your urine, concentrated or cloudy urine, or feel like you can’t fully empty your bladder
  • Changes in vaginal discharge (bad smell, yellow/green, cottage-cheese texture) and/or vaginal itching or irritation
  • Hot, red, swollen lump in one breast, intense breast pain, fever, and/or flu-like symptoms
  • Swelling in one leg, calf skin that is red in one spot or warm to the touch, calf pain not caused by activity
  • Redness, swelling, warmth, pus, discharge, or pain at the C-section incision site
  • Abnormal bleeding after baby: soaking a pad within an hour, bleeding like a faucet, passing more than one fist-sized clot, or are feeling dizzy, tired, confused, have cold/clammy skin, and/or racing heart rate.
  • Mental health concerns


  • Poor feeding, lethargy, and you can’t wake your baby to feed.
  • Armpit temperature above 37.5°C (99.5°F) or below 36.5°C (97.7°F).
  • Rapid breathing (more than 60 breaths every minute) for longer than 10 minutes (and your baby is not crying, being active or overdressed).
  • Difficulty breathing – nasal flaring and grunting that lasts longer than a few minutes, skin that seems to be pulling in sharply around the ribs or base of the throat when he or she breathes, or skin colour changes.
  • High-pitched crying almost all the time
  • Limp tone and not interacting when awake.
  • Repeated, projectile vomiting (more forceful than spitting up) or bright green vomit
  • No wet diaper in a 24-hour period.
  • Jaundice (skin and the whites of the eyes are yellow) that is worsening


  • Vaginal bleeding
    • Mucosy blood-tinged discharge called bloody show is normal in labour.
    • Page with any continuous, bright red, or period-like bleeding.
  • Your water breaks
    • Feel or hear a “pop” inside your vagina, feel a large gush or continuous leak of fluid from your vagina, and soak a pad within an hour
    • Make note of the time, amount, colour, smell, and your GBS status.
    • Put a pad on and monitor the amount of fluid. Bring your pad(s) with you when you meet your midwife.
    • Do not put anything in your vagina (no fingers, tampons, or sex).
    • Do not take baths (showers are okay).
  • Active labour – Strong, regular contractions that require coping
    • First baby: Contractions every 2-3 minutes, lasting at least 60 seconds, and the pattern has been going on for 2 hours
    • You’ve already had a vaginal birth: Contractions every 7-10 minutes, lasting at least 60 seconds, with moderate to strong intensity, and the pattern has been going on for 1 hour
  • Decreased fetal movement
    • Babies will move even in labour. If you are having difficulty feeling your baby move, do a “fetal kick count.” Lie on your left side with your hands on your belly. Count fetal movements (e.g., hiccups, kicks, rolling movements, flutters). Page if you don’t get 6 movements in 2 hours or less.


Irregular in length and/or intensity, or only regular pattern for short time periods

Unpredictable lengths (less than 30 seconds or up to 2 mins).

Mild intensity, stay the same intensity level, or become weaker then disappear. They may restart later.

Do not have a distinct beginning, middle, end, then a break

Do not increase in length, rhythm, regularity, or intensity over time

Felt in the front of the abdomen, in one specific area, or are menstrual-like

Stop with changes in activity level or position changes

Triggered by activity, dehydration, sex, full bladder, touching your belly, or your baby’s movement

Come in regular intervals

Last 60-90 seconds, and become longer over time

Have a distinct beginning, middle, end, then a break.

Increase in length, rhythm, regularity, or intensity over time

Start midback, wrap around the abdomen towards the middle, and radiate down the legs

Continue or become stronger with position changes or movement


  • Rest! If your labour starts at night, sleep as much as you can. If it starts in the day, try to lie down and take naps.
  • Take 100 mg dimenhydrinate (Gravol) and 1000 mg acetaminophen (= 2 Extra-Strength Tylenol) every 6-8 hours for discomfort and rest.
  • Eat a good meal. Choose high-carbohydrate, easily digested food. Labour is a marathon! You will need the energy but will likely not have an appetite in active labour. Do not avoid eating because you’re scared to vomit. Try toast with jam, pancakes, cereals, pasta, fruit juice, coconut water, tea with sugar or honey, or gelatin desserts.
  • Drink plenty of fluids. Empty your bladder often.
  • Try distracting and restful activities: take a warm bath or shower, go for a walk, get a massage, listen to music, slow dance, watch a movie, prepare a meal together (make a birthday cake for baby, or freezer meals for after), etc. If your partner is unable to distract you, have them help you cope instead.
  • Create an environment that makes you comfortable (tidy, music, fire in the fireplace, favourite scents, etc.)
  • Try different positions, find a rhythmic movement and slow breathing

Comfort in Labour (Penny Simkin)



Feel or hear a “pop” inside your vagina

Have wet underwear

Feel a large gush of fluid that you can’t stop

Feel a slow, steady trickle of fluid from your vagina

Continue to leak fluid and soak a pad within an hour

Fluid increases with position changes or stairs

Feel a gush of fluid with coughing or sneezing

Usually clear or straw-coloured

Green or yellow – this is a sign your baby has had a bowel movement called meconium in the water

Contain streaks of blood and mucous

Have little white flecks in it

Sweet or like bleach

May be odourless

Does not smell like urine (ammonia)

A bad or foul smell may be a sign of infection


  • Download a free “Contraction Timer” app on your phone. We like the “Freya – Surge Timer” App ($3.99) that coaches you through contractions with simple breathing techniques and helps you to relax in between surges with a mix of positive affirmations, calming visualizations, guided meditations and gentle music
  • Ignore your contractions as long as you can. Start timing your contractions when they are strong enough that coping is required (you must use breathing or relaxation techniques, are bracing yourself on surfaces, and are unable to talk through contractions).