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Histories do repeat – Taking a good history in early pregnancy

The diagnosis of a new pregnancy in General Practice is an ideal opportunity to ask many things you might not normally discuss with patients. It is interesting how few women know medical information about their partner, for example, and it is easy to forget to ask about hereditary diseases that affect the man’s side of the family.

The doctor should also ask about any problems in other relatives that the patient or partner is aware of. Certain medical conditions that affect the woman’s parents (such as type 2 diabetes, heart disease, hypertension, thyroid disease, mental illness) are suddenly also very relevant to the pregnant patient. Good doctors will specifically tailor common hereditary diseases to the patient’s origins (e.g. as cystic fibrosis, thalassaemia and sickle cell traits). It is much easier and safer to identify and manage these conditions if, or when, they are diagnosed early.

Finally, do not assume that every mother-to-be is happy to be pregnant; for a large number of reasons, some women and/or their partners are not. Domestic violence is not asked enough about in General Practice. It is necessary to specifically ask the patient about the risk of physical and psychological harm as pregnancy makes the woman more vulnerable. History taking is not just the science of medicine; it is also the art of medicine/. We must empower, rather than worry, the mother-to-be.