|
Does pt have menses?
|
LMP
|
|
Length of menses
|
Frequency of menses
|
|
History of abnormal pap smear?
|
Details and outcome of abnormal pap:
|
|
Number of pregnancies:
|
Number of vaginal deliveries:
|
|
Number of c sections:
|
Reason for c sections:
|
|
Number of miscarriages:
|
Number of stillbirths:
|
|
Number of abortions:
|
Number of ectopic pregnancies:
|
|
Problems with pregnancies or deliveries:
|
History of postpartum depression?
|
