## How to measure fundal height using the ﬁnger method

If the top of the uterus is below the bellybutton, measure how many fingers below the bellybutton it is. If the top of the uterus is above the bellybutton, measure how many fingers above the bellybutton it is.

Figure 10.2 Measuring fundal height using the finger method. The woman is lying on her back. Each line represents the width of two fingers.

Look carefully at Figure 10.2. If the baby is growing normally, by how many finger-widths should the uterus rise in the second trimester (3-6 months of pregnancy, or 15-27 completed weeks of gestation)?

Figure 10.3 Fundal height at 7 months' gestation.

How many fingers above the bellybutton should the top of the uterus be at 7 months' gestation?

How do you explain the position of the dotted line at 9 months in Figure 10.2, which is below the line showing fundal height at 81/2 to 9 months?

Look at the diagrams in Figure 10.4 (a) and (b). How many weeks pregnant is the woman in each case, based on the finger method of measuring fundal height shown in Figure 10.2?

Figure 10.4 (a) and (b) How many months of pregnancy do you think each of these diagrams shows?

When you measure fundal height at every antenatal visit, write down the number of fingers you used to measure the height of the uterus on the woman's antenatal record card. Put a '+' (plus) sign in front of the number if the top of the uterus is above the bellybutton. Put a '-' (minus) sign in front of the number if the top of the uterus is below the bellybutton.

How would you record the measurements shown in Figure 10.4(a) and (b)?

## Limitations of the finger method

You need to be aware that the finger method for estimating gestational age (the number of weeks/months of pregnancy) has some limitations that affect its accuracy.

Look at your own hands. Can you suggest why the finger method might give a different estimate of gestational age if two different health workers used this method to measure the same woman's fundal height?