NHS & private maternity care

Maternity notes explained

6 min read

Your handheld notes are used by midwives to keep track of your health and your baby’s development throughout pregnancy – but these records can sometimes be tricky to decipher. We guide you through how to understand your maternity notes.

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What are maternity notes?

Your maternity notes, or handheld notes, come in a thick booklet which you’ll be given at the booking appointment when you’re around 8-12 weeks pregnant. It contains information about your health, family history, scans, antenatal appointments and preferences for the birth.

Every time you have an antenatal appointment or receive maternity care at a hospital, records of your and your baby’s health will be written down in your notes.

Why are maternity notes important?

Your handheld notes allow health professionals to get up to speed with your pregnancy and your medical history quickly, so you can receive emergency maternity care anywhere in the UK if you should need it.

Most NHS trusts don’t have digital maternity records, and those that do are specific to the trust you’re in, so your handheld notes are the only written record of all the information about you and your baby’s health that you can take with you wherever you go.

As well as bringing the maternity notes to every antenatal appointment and if you need to visit triage in the maternity unit, you’re also encouraged to carry the booklet with you in your day-to-day life and if you go on holiday, in case you need emergency care at a different hospital to the one you’re booked in with.

What’s included in the maternity notes?

When you first receive your notes, you may be surprised by just how much is covered in the booklet.

  • Your medical information and history: The notes will have details of who your next of kin is, your medical and mental health history, any previous pregnancies and births you’ve been through, the family medical history of both you and your baby’s father and your named midwife or midwifery team.
  • Pregnancy planner: You’ll have a personal plan drawn up in your notes covering how many routine antenatal appointments you’ll have and who with, scans you’ll be invited to and screening tests and immunisations you’re offered based on your health and medical history.
  • Antenatal appointments and other interactions with health professionals: Your notes contain detailed records of any midwife or doctors appointments you have in your pregnancy, as well as any visits you make to maternity triage. Read more about what happens at antenatal appointments.
  • Labour and birth: From as early as your booking appointment, your maternity notes will have information about where you’re planning to give birth. There’s also a birth plan with information about what could happen during labour and choices you can make for the birth which you should have a chance to talk through with your midwife in your third trimester. Here’s some more information about what to think about when choosing where to give birth and writing a birth plan.

 

Understanding maternity notes abbreviations

When you have your antenatal appointments, your midwife or doctor will often write details about your health or observations about your baby as abbreviations in your notes, and it can seem a little cryptic if you haven’t seen these before. Here’s a quick run-through of some of the codes you may come across as you look through your notes.

Your pregnancy

When your baby’s due and whether you’ve been pregnant or given birth before can all impact your maternity care needs.

  • LMP: last menstrual period, used to calculate your due date before your dating scan
  • EDD: Expected due date
  • How many weeks pregnant you are: for example, 16+4 (16 weeks and four days pregnant)
  • Gravida, or G: whether you’ve been pregnant before
  • Primigravida: pregnant for the first time
  • Multigravida: you’ve been pregnant before
  • Parity, or P: how many times you’ve given birth before
  • Nulliparous: never given birth before
  • Primipara or primip: have given birth to one baby before
  • Multipara or multip: have had two or more babies before.

Your health

Your blood pressure and urine samples will be tested throughout your pregnancy, and other tests like blood checks will also be done occasionally to make sure the pregnancy’s progressing as expected.

  • NAD: no abnormality detected (your urine test was normal)
  • Tr (trace): small amount of protein or glucose was found in your urine
  • +, ++, +++: greater amounts of protein or glucose have been found in your urine, this can be a symptom of pre-eclampsia or gestational diabetes
  • BP: blood pressure – if your blood pressure’s higher than usual it could be a sign of pre-eclampsia or pregnancy-induced hypertension
  • Oed: swelling (oedema) can also be a symptom of pre-eclampsia
  • Hb: haemoglobin – if your iron level’s too low you might need treatment for anaemia
  • VE: vaginal examination – sometimes done in pregnancy to check whether your cervix has started to efface and dilate
  • FH: fundal height (how many centimetres there are between the top of your pelvic floor to the top of your uterus), it indicates whether your baby’s growth is on track.

Your baby’s heart rate and movements

A doppler or stethoscope will be used to record and measure your baby’s heart rate, and your midwife or doctor will ask you whether you’re feeling any movements.

  • FHH, or H: foetal heart rate heard, this will be accompanied with beats per minutes (BPM)
  • FHNH, or NH: foetal heart rate not heard. This isn’t unusual in the first and sometimes second trimester, but your midwife may like you to come for an extra check-up
  • FMF: foetal movements felt
  • FMNF: foetal movements not felt. Many women don’t start to feel movements until 20 to 24 weeks.

Your baby’s position in the womb

Your midwife will palpate (feel) your tummy to see which position your baby’s in throughout pregnancy and ahead of the birth.

  • Ceph, C or Vx: cephalic (head down)
  • B or Br: breech (head up with their bum or feet in your pelvis)
  • T or Tr: transverse (lying across your belly)
  • L or Long: vertical
  • O or Obl: oblique or diagonally
  • OA: Occiput Anterior (head down, facing your back)
  • OP: Occiput Posterior (head down, facing your front)
  • OL: Occiput Lateral (head down, facing your side)
  • L or R: written in front of OA, OP or OL it indicates which side of your body your baby is lying on.

Whether your baby’s engaged in your pelvis

The midwife or doctor will also check how much of the baby’s head is in your pelvis (how engaged they are).

  • 5/5, NE, NEng, Not Eng or ‘free’: your baby’s head is above your pelvis
  • 4/5: your baby is sitting on the brim of your pelvis
  • 3/5: the head is lower but still mostly above the brim
  • 2/5: your baby’s engaged and mostly below the brim
  • 1/5 or 0/5: your baby’s head is deeply engaged and hardly palpable from above.

Your maternity notes during and after the birth

It’s important to bring your maternity notes with you when you go into labour or go to the hospital for an induction or planned c-section, so your midwife or doctor can refer to them during the birth.

In the final weeks of pregnancy, it can be a good idea to keep the notes in or next to your hospital bag so you or your birth partner remember to take them with you.

After the birth, your pregnancy notes will be filed alongside notes made by your health professionals during the birth and at your postnatal appointments.

If you want to read your notes at a later date, you can request to get a copy from the hospital.

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