Preconception and prenatal health are the foundation for the lifelong health of the child. They include a very wide range of factors such as healthy eating, appropriate exercise, healthy relationships, stress management and coping, safety at work, avoiding toxins such as alcohol, tobacco smoke, lead etc. Prenatal education has the potential to increase knowledge and improve health behaviours prior to pregnancy, during pregnancy and postpartum, including social support, and access to key prenatal information and supports, ultimately improving health outcomes.

This online tool responds to the need identified by the No Time to Wait report to provide women, their partners and service providers with consistent evidence-informed preconception, prenatal and postpartum information across a wide range of prenatal education opportunities (e.g. classes, drop-ins, online, etc.).

According to Public Health Ontario’s report Addressing Obesity in Children and Youth, specific preconception and prenatal factors have been associated with childhood obesity, including maternal smoking, maternal gestational diabetes and maternal weight. Women may be an unhealthy weight during pregnancy because they enter pregnancy with a low or high BMI, or because they exceed or do not meet recommended weight gain recommendations during pregnancy. If a mother is overweight before pregnancy or gains excessive weight during pregnancy, she is more likely to have gestational diabetes and a large baby. Babies with high birth weights are more likely to be heavier in childhood. This is a concern for a large proportion of pregnant women – 40% to 50% gain more than the recommended amount during pregnancy.


This tool is for Ontario service providers who share universal prenatal information (prenatal educators, midwives, nurses, physicians etc.) and includes key messages to provide to clients, as well as supporting evidence to guide service providers. The tool consists of 25 topics, covering the areas of pre-conception, pregnancy, labour, birth, newborn and postpartum . It will assist in the provision of consistent evidence-informed key messages about preconception, prenatal and postpartum health by service providers in Ontario.

Definition of Prenatal Education

The definition of prenatal education for this tool includes in person and online prenatal education. It includes:

  • Traditional prenatal education classes (designed and advertised for the general public)
  • Group prenatal education courses offered through a health care provider practice (e.g. midwifery clinic prenatal program)
  • Registered and non-registered groups (such as drop in groups at a Parent Resource Centre, teen programs, the Canada Prenatal Nutrition Program)
  • One-on-one prenatal education through a population-wide program (for example, telephone advice, Healthy Babies Healthy Children prenatal home visiting)
  • General universal prenatal information provided by a health care provider
  • Brochures, handouts and resources
  • Online courses, apps, websites

It does NOT include individualized prenatal medical advice or care provided by health care providers e.g. doctors, midwives, nurse practitioners or specialized health programs.

Development of This Tool

Development of this tool involved a number of preliminary activities, including the following:

  • A literature review.
  • Surveys of organizations providing prenatal education services in Ontario.
  • A survey of Ontario women (and their partners) who were planning a pregnancy, currently pregnant or recently pregnant.
  • A needs assessment of Ontario prenatal education providers.
  • An examination of data from the Ontario Better Outcome Registry and Network (BORN) related to prenatal education in Ontario.

Detailed information can be found in the following report:

The development processes for the tool content and design included:

  • An advisory group
  • Researchers/writers
  • Expert reviewers
  • Field testing with prenatal information providers


We would like to thank the following groups of people involved in the development of this tool.

Advisory Committee
  • Gillian Alton, Phd, Epidemiologist
  • Rita Barbieri, RD, Dietitians of Canada/EatRight Ontario
  • Donna Caputo, RN, BScN, PHN, Algoma Public Health
  • Sharon Dore, RN, Phd, SOGC, Associate Clinical Professor, Dept. of Obs Gyn and School of Nursing, McMasterUniversity
  • Caroline Edwards, RN, PHN, Family Health-Parenting Team, Peel Region
  • Joanne Enders, RN,PHN, Region of Waterloo Public Health, OPHA Reproductive Health Workgroup
  • Merle Ling, RN,  CCCE,  CAPPA Canada Faculty, CBE trainer and Birth Doula
  • Stephanie MacDonald, LC, Six Nations Birthing Centre
  • Patricia Mousmanis MD CCFP FCFP, OntarioCollege of Family Physicians
  • Angela Murphy, RN, Perinatal Coordinator, ConestogaCollege
  • Peggy Neil, RN, Family and Youth Outreach Nurse, Prince Edward Family Health Team
  • Fern Santos, RN, Healthy Families Manager, Toronto Public Health
  • Lia Swanson, RN, Manager Reproductive Health Program, Niagara Region Public Health
  • Jasmin Tecson, RM, Regional Coordinator (South East Region), Association of Ontario Midwives
  • Anna Thurairatnam, Senior Project Manager, Provincial Council for Maternal and Child Health
  • Julie Toole, RM, Policy Analyst, Association of Ontario Midwives
  • Nancy E. Watters, RN,BScN, MScN, NursingFacultyUniversity of Ottawa, Registered Nurses Association of Ontario, Maternal-Child Nurses’ Interest Group
Writers and Editors
  • Debbie Aylward RN, BScN, MScN, Perinatal Consultant
  • Leigh Baetz-Craft, RN, BScN, MScN, IBCLC
  • Rita Barbieri, RD
  • Leslie Borne , MSc, PhD
  • Arnita Findlay, MT
  • Cathie Logan, RN, PHN
  • Anne Meloche, BA, Psy PPCC
  • Dorothy Misek, RN, PHN
  • Sara Mohammed
  • Wendy Moulsdale, RN(EC), MN, NNP-BC, Education Lead, PAIL Network
  • Harriet Nwachuckwu, MPH
  • Angela O’Grady, BScH, BScN, RN, MPH
  • Michelle Suarly RN, BScN, BAH, MPH (candidate), Ontario Public Health Association Reproductive Health Workgroup
  • Nancy Watters, RN,BScN, MScN
  • Louise White, RN, BScN, IBCLC, CCE
BFI Reviewer
  • Marina Green RN MSN IBCLC BCC BFI Assessor
Expert Reviewers
  • Helen Ames, RN, BScN, PHN, Reproductive Health Program, Peterborough County City Health Unit
  • Leigh Baetz-Craft, RN, BScN, MScN, IBCLC, Maternal-Child Nurses’ Interest Group, Registered Nurses Association of Ontario
  • Kathy Banks, PhD, MSN, RN, CAPWHN Treasurer, Assistant Professor, College of Nursing , University of Calgary in Qatar
  • Rita Barbieri, RD, Dietitians of Canada/EatRight Ontario
  • Tracey Borland, MSc,  Ontario Tobacco Research Unit
  • Leslie Born, MSc, PhD
  • Donna Caputo, RN, BScN, PHN, Algoma Public Health
  • Virginia Collins
  • Jocelyn Cook, PhD, MBA, Scientific Director, The Society of Obstetricians and Gynaecologists of Canada
  • E. Laura Cruz, MSc, MD, CCFP, Dip Sport Med, Lecturer, Dept Family and Comm Med, Univ of Toronto, Medical Director, LiveActive Sport Medicine Health and Performance, President, Canadian Academy of Sport and Exercise Medicine (2016-2017)
  • Ariel Dalfen, MD, FRCP(C), Head, Perinatal Mental Health Program,Department of Psychiatry, Mount Sinai Hospital, Assistant Professor, Department of Psychiatry, University of Toronto
  • Kim Dart, RN, MSN, PNC, IBCLC
  • Michael Dickinson, MD, Vice President, Canadian Paediatric Society
  • Sharon Dore, RN, Phd, SOGC, Associate Clinical Professor, Dept. of Obs Gyn and School of Nursing, McMaster University
  • Laura Doull, RN, PNC(C), BScN, MSc, Regional Educator, Practice and Education, Women & Babies and Children’s Health Programs, Niagara Region Public Health
  • Rosa Dragonetti, MSc, Project Director, Nicotine Dependence Service, CAMH
  • Joanne Enders, RN, PHN, Region of Waterloo Public Health, OPHA Reproductive Health Workgroup
  • Pamela Fuselli, MSc, VP, Knowledge Transfer & Stakeholder Relations Parachute Canada
  • Larissa Gadsby, RN, MScN
  • Catherine Gallant, FRCP(C)
  • Lisa Graves,  MD, CCFP, FCFP, Associate Professor,  University of Toronto, Department of Family and Community Medicine
  • Karine Hebert, BA, Chair, Board of Directors, Baby’s Breath
  • Debra Kaye, RN, MScN, Maternal Child Nurses’ Interest Group, Registered Nurses’ Association of Ontario
  • Grace Kuipers, Cessation Learning & Development Lead, field support, program training and consultation centre, Prevention and cancer control, cancer care ontario
  • Chaya Kulkarni, Director, Infant Mental Health Promotion (IMHP), The Hospital for Sick Children
  • Tom Leibson, Motherisk, The Hospital for Sick Children
  • Julie Mather, Executive Director, Ontario Women’s Health Network
  • Michelle Matola, PhD, FACSM,  Director, R. Samuel McLaughlin Foundation- Exercise and Pregnancy Lab, The University of Western Ontario
  • Jennifer McCrea, RD, Nutrition Advisor, Office of Nutrition Policy and Promotion
  • Diane Meschino, MD FRCPC, Founder Reproductive Life Stages Programme, Director Women’s Mental Health Centre of Education and Training, Assistant Professor, University of Toronto Department of Psychiatry
  • Catriona Mill, RN, PHN, Ontario Public Health Reproductive Workgroup Chair
  • Nadia Minian PhD, Project Scientist Nicotine Dependence Service, CAMH
  • Kristina Niedra, Project Manager, Toronto East General Hospital
  • Alice Ordean, MD, CCFP, MHSc, FCFP, Associate Professor, Department of Family & Community Medicine, Medical Director, Toronto Centre for Substance Use in Pregnancy, St. Joseph’s Health Centre
  • Michelle Ponti, MD FRCPC, Community Pediatrician
  • Joel Ray MD MSc FRCPC Full Professor and Clinician-Scientist
    Departments of Medicine, Health Policy Management and Evaluation, and Obstetrics and Gynecology St. Michael’s Hospital, University of Toronto, Toronto, Canada
  • Dawna Royall, PEN, author, journal editor, Dietitians of Canada
  • Brian Russell, Father Involvement Initiative
  • Susan Santiago, Motherisk (retired)
  • Moumita Sarkar
  • Lindsay Siple, BA, MHS candidate,  Projects Leader, Ophea, PARC
  • Deanna Stirling, RN, BScN, PHN, Reproductive Health Team, Prenatal Health, Middlesex-London Health Unit
  • Kelly Stone, Executive Director,Canadian Association of Family Resource Programs (FRP Canada)
  • Jasmin Tecson, RM, Regional Coordinator (South East Region), Association of Ontario Midwives
  • Deanna Telner, MD, MEd, CCFP, FCFP, Clinical Lead, Centre for Effective Practice
  • Evelyn Vaccari, MHSc, RD, Ontario Society of Nutrition Professionals in Public Health
  • Jeanell Vanbesien, RN, BScN, PHN, Halton Region Public Health
  • Pat Vanderkooy, MSc, RD, Public Affairs Manager, Dietitians of Canada
  • Robin C Williams, MD, President , Canadian Pediatric Society
  • Andrea Witzke, Pregnancy and Infant Loss
  • Linda Yenssen, RN, BScN

Best Start Resource Centre also thanks the many other service providers across Ontario who provided input on this tool.

Best Start Resource Centre Project Lead
  • Matthuschka Sheedy, RN, BNSc, ICCE

The concept for this tool is based on “Le portail d’information prénatale” from L’Institut National de Santé Publique Quebec (INSPQ), who generously authorized us to translate and adapt some of the content on their website for use by our writers to guide our work. Topics translated and adapted, but not checked by the INSPQ, are limited to the following: adjusting to parenthood, alcohol, breastfeeding, diet and weight gain, domestic violence, drugs, mental health, perinatal death and grieving, physical activity and wellbeing, preventive and health-care, products and services, and smoking. These topics were authored by the following: Sylvie Lévesque, Julie Poissant, Marie-Josée Tardif, Renée Cyr, Marie-Josée Santerre, Cécile Fortin, Alessandra Chan, Pascale Tremblay, Émilie Côté and Michèle Tremblay.

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