Inspection

The uterus should change shape from round and globular to long and ovoid as pregnancy progresses, though this may be difficult to visually appreciate in a multi-parous woman. The midwife may also notice a saucer shape depression in the abdomen around the area of the umbilicus indicating the fetus is in an occipito-posterior (OP) position. The umbilicus may protrude as pregnancy advances. Stretch marks (Striae gravidarum) may be seen, older ones being a silver colour and new ones being red/pink/purple in colour. A brown line known as the linea nigra may also be visible. This line runs from the umbilicus down to the symphysis pubis.

Scars will indicate previous obstetric or abdominal surgery and the history of these should be investigated. Be careful not to confuse old scarring with elastic marks made from clothing (particularly previous Caesarean section scars).