Prenatal Record - National Archives and Records Administration

R~PRODUCTI\~ HISTORY (Con't.) C3-2
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Item #3. "Liveborn"
If a pregnancy lasted less than 20 weeks, there is little probability that the
child was born alive. For pregnancies of this or longer duration, however,
you should make special effort to distinguish between cases in which the
gravida was told that the child was stillborn, those in which it was born
alive but immediately expired, and those cases in which the gravida was not
told or cannot recall whether the child was l~ve born or not.
Item #4. "D & C"
Make sure the gravida understands the question and write "yes" or "no" in the
space.
Item #5. "Sex"
Attempt to determine the sex for all children, whether live or stillborn,
at any gestational age.
Item #6. "Name of Child"
For all children born alive, record the first name.
Item #7. "Comolications of Pregnancy"
The following types of complications should be noted:
1. Difficulties during pregnancy, such as chronic or infectious disease,
bleeding, high blood pressure, and albumin in the urine.
2. Difficulties during labor, such as bleeding, prolonged or difficult labor,
or retained placenta.
J, Difficulties after labor, such as post-partum infection or excessive
bleeding.
If the patient reports any such complications, record her answer as
completely as possible. If there were difficulties during pregnancy, attempt
to date them as "early" (first trimester) 1 ''middle" (second trimester) 1 or
"late" (third trimester).
Item #8. "Induced Labor"
Write "yes" in this box if labor was induced by the patient, a physician,
or by arr,y other person, using any drug or procedure. Write "no", if labor
started without any interference. If labor was induced, ask "why?" and see
t::,at the answe:r: is noted under i tern #7 •
Item #9. "Duration of Labor"
This should not inclu~~ the third stage. It is expected that the duration
of "labor" as reported by the gravida will, in nearly all cases, approximate
the duration of the tirst two stages.
February 1959
(For Forms in Use April 1961)
II.A.33
OB-2
Reproduced at the National Archives