Prenatal Record - National Archives and Records Administration

REPRODUCTIVE HISTORY
(For Form OB-2, Dated 1-59)
Instructions for Interviewer
On this form is to be recorded what the gravida knows about her previous
pregnancies. The only source of information for OB-2 is to be an interview
with the gravida.
All information about previous pregnancies that you may obtain from
hospital records, abstracts, etc., should be made available to the
obstetrician, who will record it on OB-9.
Disregard item #19, "Informant," since in all cases the informant will be the
gravida herself.
If the gravida has had more than 5 pregnancies, use additional sheets.
Note this at the bottom of the first sheet and renumber the pregnancies on
the next.
With the exception of item #19, for each pregnancy all items should have
some notation. This notation should consist of the answer called for, or
one of the following:
None - if no complications or abnormalities.
UNK - if the answer cannot be determined.
NA - if the item is not applicable.
Unless otherwise instructed, write all dates numerically in the order month,
day, and year, such as 2/24/59.
Iwin Pregnancies:
Use a separate column for each child. Correct the pregnancy numbers printed
at the top. For the seeond child, leave blank items # 2, 4, 7, a, 9, 12,
14, and 15.
Item #1. "Date of Termination G!t' Pregnancy"
Record the month, day amd year. If the gravida is in doubt about the exact
date, record the most prebable date.
Item #2. "Gestation"
The length of gestation should be given in weeks from the LMP to the termination
of pregnancy (corrected to the nearest whole week). The average as
determined in this mannw is 40 weeks.
If the gravida reports a duration in months, multiply the number of months by
4 1/3 to get the number of weeks. Thus, a 4 month gestation is equal to
17 1/3 weeks, which should be recorded as 17. (If, however, the gravida
reports "9 months," she probably means term, or 40 weeks.)
If the gravida reports a delivery as "three weeks early" or 11 2 weeks late,"
add or subtract this nuaber or weeks from 40.
Reproduced at the National Archives
II.A.32
February 1959
(For Forms in Use April 1961)
OB-2