CNM key terms

A five-part shorthand for obstetric history: Gravida (total pregnancies including the current one), Term births, Preterm births, Abortions (spontaneous or induced before 20 weeks), and Living children. It is recorded at the first prenatal visit and updated as pregnancy progresses.

A method for estimating the due date by adding 7 days to the first day of the last menstrual period and subtracting 3 months, adjusted for cycle length. It assumes a 28-day cycle with ovulation on day 14, so ultrasound dating is more accurate when available.

The distance in centimeters from the pubic symphysis to the top of the uterus, measured after about 20 weeks. Between 20 and 36 weeks it roughly matches gestational age in weeks; a difference of 3 cm or more prompts ultrasound evaluation.

A pregnancy-specific disorder of new hypertension after 20 weeks' gestation accompanied by proteinuria or evidence of maternal end-organ dysfunction such as thrombocytopenia, renal or liver impairment, or pulmonary edema. It can progress to eclampsia and HELLP syndrome.

Testing for glucose intolerance first recognized during pregnancy, usually a 1-hour 50-g glucose challenge followed by a 3-hour 100-g oral glucose tolerance test if the screen is elevated. Untreated gestational diabetes raises risks of macrosomia, preeclampsia, and neonatal hypoglycemia.

An ultrasound-based fetal assessment scoring fetal breathing, body movement, tone, and amniotic fluid volume, often combined with a nonstress test, for up to 10 points. Lower scores suggest fetal compromise and guide further testing or delivery.

An injection of anti-D antibodies given to Rh-negative, unsensitized pregnant people to prevent alloimmunization. It is offered around 28 weeks, within 72 hours after delivery of an Rh-positive infant, and after miscarriage, amniocentesis, or vaginal bleeding.

A scoring system rating cervical dilation, effacement, consistency, position, and fetal station to predict how easily labor can be induced. Higher scores indicate a favorable cervix; a low score usually prompts cervical ripening before induction.

The early part of the first stage of labor, from the onset of regular contractions until about 6 cm dilation, when cervical change is slower and contractions are typically less intense. Its duration varies widely and can last many hours, especially in a first labor.

Fluctuations in the fetal heart rate baseline that reflect an intact autonomic nervous system. Moderate variability (6 to 25 beats per minute) is reassuring; minimal, marked, or absent variability raises concern for hypoxia, fetal sleep, or medication effects.

A fetal heart rate pattern showing absent variability with recurrent late or variable decelerations, bradycardia, or a sinusoidal rhythm. It is abnormal and calls for immediate intrauterine resuscitation and preparation for expedited delivery.

Failure of the shoulders to deliver after the head, managed with maneuvers such as McRoberts position and suprapubic pressure. It is an obstetric emergency associated with brachial plexus injury and postpartum hemorrhage; fundal pressure should be avoided.

A planned attempt at vaginal birth in someone with a prior cesarean delivery. Success rates are roughly 60 to 80 percent; the main risk is uterine rupture, so it requires continuous monitoring in a setting prepared for emergency cesarean.

A graphic tool for plotting cervical dilation, fetal descent, contractions, and maternal and fetal vital signs over time in labor. It helps identify slow progress and prolonged labor so that referral or intervention happens promptly.

Artificial rupture of the fetal membranes with a sterile instrument to induce or augment labor or to place an internal monitor. It may shorten labor slightly but increases risk of cord prolapse and infection, so the fetal head should be well applied.

Blood loss of 1,000 mL or more, or any bleeding causing hemodynamic instability, within 24 hours of birth (primary) or up to 12 weeks (secondary). Uterine atony is the most common cause; care includes massage, uterotonics, and escalation as needed.

Vaginal discharge after birth made of blood, mucus, and uterine tissue. It progresses from red (rubra) to pink-brown (serosa) to white-yellow (alba) over about 4 to 6 weeks; foul odor or heavy bleeding suggests infection or hemorrhage.

The return of the uterus to its nonpregnant size, shape, and position after birth, occurring over about 6 weeks. The fundus descends roughly 1 cm per day; a boggy or high fundus may signal atony or retained placental tissue.

Infection of the uterine lining after delivery, typically causing fever, uterine tenderness, and foul-smelling lochia in the first days postpartum. Risk increases with cesarean birth, prolonged rupture of membranes, and long labor; treatment is broad-spectrum antibiotics.

A mood disorder with persistent sadness, loss of interest, guilt, sleep disturbance, and sometimes thoughts of self-harm arising in the weeks to months after birth. Screening tools such as the Edinburgh Postnatal Depression Scale prompt referral and treatment.

A 0-to-10 score assigned at 1 and 5 minutes after birth, rating heart rate, respiratory effort, muscle tone, reflex irritability, and color. It describes the newborn's condition and response to resuscitation but does not by itself diagnose asphyxia.

Waiting roughly 30 to 60 seconds or longer after birth before clamping the umbilical cord, allowing placental transfusion. It improves iron stores and circulatory stability, especially in preterm infants, but may slightly increase the risk of jaundice.

Elevated bilirubin in a newborn causing jaundice, from immature conjugation or from hemolysis, breastfeeding, or other causes. Treatment thresholds depend on age in hours and risk factors and may include phototherapy or exchange transfusion.

Tests done before hospital discharge, usually a heel-stick blood sample plus pulse oximetry, to detect treatable conditions such as congenital hypothyroidism, sickle cell disease, and critical congenital heart disease. Abnormal results require prompt follow-up.

An intramuscular dose of vitamin K given to newborns shortly after birth to prevent vitamin K deficiency bleeding, a rare but serious cause of intracranial hemorrhage. Parents may decline after discussion, and the conversation is documented.

Placing the naked newborn prone on the parent's bare chest with a blanket over both, which supports warmth, breastfeeding initiation, and bonding. It is a first-line strategy for preventing neonatal hypothermia.

Testing with cervical cytology, HPV testing, or both to detect precancerous changes. Screening generally begins at age 21 or 25 and repeats at intervals set by age and test type; abnormal results lead to colposcopy or closer follow-up.

Vaccines recommended for adults based on age, pregnancy status, health conditions, and risk, including influenza, Tdap, and COVID-19. In pregnancy, Tdap and influenza vaccination protect both the pregnant person and the newborn.

Persistently elevated blood pressure, generally 130/80 mm Hg or higher on repeated readings, classified by stage. Management combines lifestyle change with medication chosen according to overall cardiovascular risk and comorbidities.

Intrauterine devices and the contraceptive implant, which provide highly effective, reversible birth control without requiring daily action. They are appropriate for most people, including adolescents and those who have never given birth.

Methods used to prevent pregnancy after unprotected intercourse, including copper IUD placement (most effective) and oral regimens such as levonorgestrel or ulipristal. Effectiveness depends on timing and body weight, and these methods do not disrupt an established pregnancy.

A classification system for abnormal uterine bleeding: Polyp, Adenomyosis, Leiomyoma, Malignancy and hyperplasia, Coagulopathy, Ovulatory dysfunction, Endometrial, Iatrogenic, and Not otherwise classified. It organizes evaluation and treatment planning.

Infection of the upper genital tract, often from chlamydia or gonorrhea, presenting with pelvic pain, discharge, and sometimes fever. Empiric antibiotics are started when suspicion is high to prevent infertility, ectopic pregnancy, and chronic pelvic pain.

A disruption of vaginal flora with loss of lactobacilli and overgrowth of anaerobes, causing thin gray discharge with a fishy odor and clue cells on microscopy. It is treated with metronidazole or clindamycin and is linked to preterm birth.

A process of explaining a proposed intervention's benefits, risks, alternatives, and the option to decline, then confirming the person's voluntary agreement. It requires decision-making capacity and should be documented in the record.

The range of clinical activities a midwife is legally and professionally authorized to perform, defined by state law, licensure, and education. It may cover prescriptive authority, hospital privileges, and independent or collaborative practice arrangements.

A legal duty for clinicians to report specified conditions to authorities, such as suspected child or elder abuse, certain communicable diseases, and some perinatal substance use. Requirements vary by state, and patients should be told when possible.

A collaborative process in which the clinician presents evidence-based options and the patient's values and preferences guide the choice. It supports autonomy and is especially useful for screening decisions, birth plans, and contraception counseling.

A U.S. federal law setting national standards for protecting health information through its Privacy and Security Rules. It governs when patient information may be shared, requires safeguards, and mandates notification for certain breaches.