Pregnancy Records: What to Track Week by Week

A pregnancy generates more medical documentation than most non-hospitalised episodes of care. Nine months of visits, scans, blood work, weight tracking, symptoms. A well-organised record makes each visit efficient, catches problems earlier, and produces a complete file for the delivery. It also becomes the foundation for the baby's health record.

The trimester structure

• Trimester: First · Weeks: 1-12 · Standard visits: Booking visit (8-12 weeks), NT scan (11-13 weeks)
• Trimester: Second · Weeks: 13-27 · Standard visits: Monthly visits, anomaly scan (18-22 weeks), GTT (24-28 weeks)
• Trimester: Third · Weeks: 28-40 · Standard visits: Bi-weekly then weekly, growth scans, birth planning

First trimester — what to record

• Last menstrual period date (anchors due date).
• Symptoms and their severity — nausea, fatigue, breast tenderness.
• Weight at booking visit.
• Blood pressure baseline.
• Booking blood work: CBC, blood group, HIV, syphilis, hepatitis B, thyroid, HbA1c or fasting glucose.
• Ultrasound reports — dating scan, NT scan.
• Any bleeding, cramping, or concerning symptom with dates.
• Vitamins started (folic acid, iron).

Second trimester — what to record

• Weight monthly.
• BP at each visit.
• Fetal movements from ~18-20 weeks (first-time mothers) or earlier (subsequent).
• Anomaly scan report — full images if possible.
• GTT result (gestational diabetes screening).
• Any specific symptoms — reflux, back pain, contractions.
• Any exposure — infections, medications taken.
• Vaccine record (Tdap in second trimester typically).

Third trimester — what to record

• BP at every visit; kick counts daily.
• Growth scan measurements.
• Any signs of pre-eclampsia (headache, vision changes, swelling).
• Any contractions timed.
• Birth plan preferences.
• Hospital pre-registration details.
• Nursery preparation status.
• Postpartum care plan discussed.

The specific tests worth tracking closely

• Haemoglobin — trend across pregnancy; iron supplementation adjusted based on.
• Fasting glucose or GTT — gestational diabetes affects delivery and long-term health.
• Blood pressure — trend detects early pre-eclampsia.
• Weight gain — total 10-12 kg typical for normal-weight women; less for overweight, more for underweight.
• Fetal growth measurements — trending, not just single value.
• Fetal movements — kick counts from 28 weeks.

Symptoms that always warrant call

• Any vaginal bleeding.
• Severe headache, especially with visual changes.
• Sudden severe abdominal pain.
• Decreased fetal movement.
• Fluid leaking from vagina.
• Regular contractions before 37 weeks.
• Fever.
• Severe swelling of face and hands (not just ankles).

The birth plan document

• Preferences on pain management.
• Who attends the delivery.
• Interventions you're comfortable with and reluctant about.
• Cord clamping preferences.
• Immediate skin-to-skin, breastfeeding initiation.
• Newborn procedures (vitamin K, initial vaccines).
• Any religious or cultural considerations.
• Emergency contacts.

Preparing the newborn's record

• Set up baby's profile before delivery.
• Immediately record birth details: weight, length, head circumference, gestational age at birth, APGAR, blood group.
• Discharge summary — most important single document.
• Newborn screening results (hearing test, metabolic screen if done).
• First vaccinations.
• Feeding pattern establishment.

Postnatal weeks

• Own weight, BP, mood, breastfeeding.
• Baby's weight, feeding, sleep, elimination.
• Own postnatal check at 6 weeks.
• Baby's growth check and vaccinations.
• Any postpartum depression symptoms — screen at 4-6 weeks.

A well-maintained pregnancy record is worth the specific work. It reduces every subsequent visit's time, catches deviations early, and becomes the reference for family planning discussions in the future.

References

• ACOG — antenatal care
• FOGSI — pregnancy care guidelines India
• ICMR — antenatal care standards