Charts & Due Dates

So we had a momma pregnant with her first baby come to the hospital in labor last Wednesday. In one of her earliest prenatal visits she had been estimated to be 37 weeks pregnant (this was in March!). At one of the next visits there was a notation “wrong dates” and then the dates of her prenatal visits seemed to make sense. However, on June 25^th she was 37 weeks and 5 days pregnant and 10 days later she was 37 weeks and 0 days pregnant! This miracle momma had managed to be in her 37^th week of pregnancy on three different weeks during her pregnancy! Inaccurate dating is the norm here as it is rare to keep track of menstrual cycles, get early prenatal care and/or have access to ultrasound for dating. This can be problematic when women present in preterm labor. Or more accurately when we do not know what “term” is for a particular woman. In VCH we do have access to tocolytics to stop preterm labor and to steroids to help a premature fetus mature their lungs. (at least they have some stock of these drugs at the moment).

So far I have only seen one chart with a prenatal hemoglobin written down. Then again it is a good thing when a woman has had prenatal care at all.

A hard reality is the hand written question on most of the charts that reads “Domestic violence? Yes/No Then, Current partner? Yes/No” some shifts 75 % of women’s charts read Yes/Yes. I am not sure if the charts without this question mean that the woman has no history of abuse or more likely no one asked the question. DV is obviously a huge problem here. There are posters around town and at one local restaurant all employees wear black on Thursdays to support violence free families. So much for the happiest place on earth status…