One pregnancy, one episode, one named lead

The antenatal register with risk flags and a named lead on every woman, the surveillance alert that says which patient and what to do, and the labour, postnatal and perinatal mental health records that sit on the same episode.

1 A pregnancy is an episode, not a series of appointments

Maternity care runs from booking through labour to the postnatal period, and the thing that has to survive all of it is one episode with one lead professional on it. commvita holds the antenatal register, the labour record, the postnatal record and the perinatal mental health caseload as parts of the same episode.

Every row carries the estimated delivery date, gestation in weeks and days, parity, and the flags that change what care looks like: gestational diabetes, a previous caesarean, pre-eclampsia risk, fetal growth restriction, a planned VBAC, a twin pregnancy. The lead is named — a midwife where midwife-led care is right, an obstetric consultant where it isn’t. Nobody has to work out who is responsible from the notes.

2 The alert that names the patient and the action

Most systems can tell you a risk exists. The useful version tells you which woman, what to do and how often.

The surveillance banner sits above the register and says one patient carries pre-eclampsia risk flags, needs blood pressure monitoring every two weeks from 28 weeks, and needs aspirin 150mg documented. That last word matters. It isn’t asking whether aspirin was prescribed; it’s asking whether the record shows it, because at a maternity investigation the record is what exists.

3 Where the rest of it goes

The other tabs carry labour and birth, the postnatal period, the perinatal mental health caseload, the pathway alerts and the service analytics. The counters at the top say how many episodes are open, how many need obstetric input and how many are on the labour ward right now.

Perinatal mental health has its own screen too, and it’s covered in the specialist mental health explainer. The point of having it here as well is that a woman with an EPDS score of 15 at 28 weeks is the same woman as the one on the antenatal register, and a service that treats those as two people misses the thing that matters.

Where it lives in commvita