Chapter 7: Learning a pregnant woman’s health history
Measuring the womb
With practice, a midwife can feel the size of the woman’s womb to know how long
a woman has been pregnant. Use this method when:
• the woman does not remember when her last
monthly bleeding started.
• the last monthly bleeding was unusually
light or heavy.
• her monthly bleeding is not regular.
• the woman was breastfeeding and not
bleeding regularly when she got
There are two ways to measure the womb. During the first 12 weeks (3 months)
of pregnancy you can do a bimanual exam to feel the womb from inside the
vagina (see page 384). After 3 months you can measure the womb from the
outside (see page 130).
Using a sonogram
A sonogram (or ultrasound) machine takes a picture of the baby inside the womb
by using sound waves (see page 434). A sonogram done in the first 3 months of
pregnancy is usually an accurate tool for showing how far along the pregnancy is.
Sonograms are probably not dangerous for the baby, but they are expensive, and
they are rarely necessary.
How old is she?
Pregnancy can cause problems for women of any age. But very young women and
much older women tend to have more problems.
Girls who become pregnant before they are 17 years old may not
have finished growing themselves. A girl’s pelvis might not be
grown enough to give birth normally. Girls are more likely to have
other problems too — like pre-eclampsia, long labors, and babies
born too early. Girls who get pregnant when they are very young
can be wonderful and caring mothers, but many of them will need extra
advice and support.
Older mothers also may have more problems in pregnancy and birth.
It may be safer for older women and very young women to give birth
in a well-equipped medical center rather than at home.
How many children has she had?
Women who have had 1 or 2 babies and whose children were born alive and
healthy usually have the fewest problems giving birth.
A Book for Midwives (2010)