Questions in a pregnancy health history
Did she have heavy bleeding before or after the birth?
If she bled a lot in a past pregnancy or birth, it is likely to happen again. Ask her to
tell you as much as she can remember about her bleeding. Did she need medical
help? Was she anemic? Was she too weak to stand? The answers to these questions
will help you prepare for what may happen at this birth. If possible, a woman who
bled heavily before should have her babies in a medical center. Be ready to treat
her for heavy bleeding after the birth. (See page 224.)
Did she have any problems with the placenta?
If the woman’s placenta did not come out easily in a
past birth (see page 227), she may have the same
problem again. Be ready to treat her for bleeding. It
is better if she gives birth in or near a medical center.
Did she have a fever or infection of the womb during or after the birth?
This birth may be fine, but she has more risk of infection than other women. Be
sure to check her for signs of vaginal infection (see Chapter 18).
Was she very sad (depressed) after the birth?
If a woman became depressed after a past birth, it may
happen again. Be prepared to help if this happens (see
Did the baby get sick or die
before, during, or after the birth?
Find out if the baby was sick or died. If some of her
babies died, she may have a problem in her blood called
Rh incompatibility (see page 504). Or the deaths could have
had other causes. Check the mother for high blood pressure
(see page 122), diabetes (see page 115), anemia (see page 116), malnutrition (see
page 117), and illness. These can all cause death in babies. Get medical advice.
Did her baby have birth defects?
• Some birth defects run in the family. Ask about the type of birth defect and if
anyone else in her or the baby’s father’s family has that birth defect. The next
baby may have the same problems.
• Some defects are caused by illnesses like herpes or rubella. If the woman had
herpes or rubella in a past pregnancy, it probably will not cause birth defects
in this pregnancy. Pregnant women should avoid people who are sick.
• Some birth defects are caused by exposure to toxic chemicals, drugs, or
medicines. (See pages 45 to 47.)
• Some birth defects are caused by poor nutrition. (See pages 33 to 39.)
• Some birth defects just happen — no one knows why.
See page 266 to learn more about birth defects.
A Book for Midwives (2010)