Signs of Previous Pregnancy
Midwives need to observe during History taking for clues of the woman having been
pregnant previously. Women may hide pregnancy for personal reasons. Some of the reasons and signs are:

• Fear: New partner, single/unmarried = stigma, unplanned/unwanted and laughed for not spacing between pregnancies.
• Breasts: Flabby, prominent nipple and persistent pigmentation of areola
• Abdomen: stretched muscles, loose skin and old striea, easy to palpate fetal parts
• Vulva perineum: pigmentation persists, gaping of labia and vaginal introitus, torn hymen, scarrying perineum
• Vagina: Lax and roomy with signs of Cystocele/Rectocele
• Cervix: On speculum external OS is with a Transverse Slit and admit finger.

Problems of Abnormal Pregnancy
• Abortion - threatened = positive pregnant test, passed out = negative pregnant test, missed
• Ectopic – urine positive if tubal or ruptured
• Hydatidiform mole – urine positive in high dilatation.

Basis For Diagnosing Pregnancy
I. What the woman experiences.
II. Signs and symptoms found on assessment.
III. Investigations carried out to confirm pregnancy.

The above are based on physiological changes occurring in the woman’s body due to hormonal changes, both level and type and the development of the embryo and its appendages.