History of past and present pregnancy
Ask about the number of previous pregnancies and births (if any) the woman has had, and about the current pregnancy. Box 2.2 shows you how to record the number of pregnancies and/or the number of births, using the traditional terminology. Gestational age is the number of weeks the fetus has been in the uterus; the average number of weeks at full term is 40, calculated from the date when the woman's last normal menstrual period (LNMP) began.
Box 2.2 Gravidity and parity status
Gravidity is the total number of previous pregnancies, regardless of the outcome, including spontaneous miscarriage or abortion before 28 weeks of gestation.
- Gravida 1 or primigravida: first pregnancy
- Gravida 2: second pregnancy, etc.
- Multigravida: pregnant two or more times (number not specified)
Parity is the number of babies delivered either alive or dead after 28 weeks of gestation.
For women who can't tell you the exact number of gestational weeks, any delivery they think was after about 7 months (30 weeks) counts in the parity number.
- Nullipara or Para 0: no pregnancy reached 28 weeks
- Primipara or Para 1: one birth after 28 weeks
- Para 2: two births after 28 weeks
- Multipara: two or more births after 28 weeks (number not specified)
- Grand multipara: five or more births after 28 weeks.
A woman comes to your Health Post in labour at full term. She tells you that she has previously given birth to two live babies (both at the gestational age of 40 weeks), and one dead baby (stillbirth) at 32 weeks. She also had a spontaneous miscarriage at 26 weeks. Record the gravidity and parity of this woman.
She will be Gravida 5: she has had 2 live babies + 1 dead baby at 32 weeks + 1 miscarriage at 26 weeks + 1 current pregnancy. She will be Para 3: she has given birth to 2 live babies + 1 dead baby after 28 weeks.
Estimating the expected date of delivery
You should also ask when was the first day of her last normal menstrual period (LNMP). This will help you to calculate the expected date of delivery (EDD) and the gestational age of the fetus. Calculating the EDD and gestational age will help you to identify whether the labour is preterm, term or post-term. Often women do not recall their LNMP; in such cases it is useful to ask her when she first felt her baby's movement inside her (quickening or fetal kick). This occurs at approximately 18-20 weeks in primigravida mothers and 16-18 weeks in multigravidas.