The obstetric examination is distinct from other examinations in that you, the clinician, are trying to assess the health of two individuals – the mother and the fetus – simultaneously. From the initial history, you should be able to judge the health of the pregnancy, any risk factors that need to be addressed, and any concerns from the parents. The history is an opportunity for you to find out how much the parents know about pregnancy, labour and delivery and if they have any preferences to which these events are carried out. A carefully taken history will also direct your attention to specific signs during the examination. As such, it is important that you develop a concise and systematic method of taking the history and carrying out the examination so that you do not miss any important information. This article focuses primarily on the examination.
Pregnancy is a sensitive issue, especially for the primigravida’s. Therefore, extra care is needed when you approach a pregnant woman. Always obtain expressed informed consent before examining her and have a chaperone accompany you throughout the examination. A walk-through of what you will be doing is a good way of reassuring the patient and allows the examination to go on smoothly. It is also important to let your patient know that if the examination is too painful, she can stop at any time she wants. Finally, before you begin, you should always wash your hands, especially at an OSCE station.