Improvements in antenatal care have included changes to traditional practices in order to
improve womens’ experience of antenatal care and the clinical outcomes of maternity
care. One such change has been giving women their own clinical case notes to carry
throughout their pregnancy in order to enable women to participate in the decision
making regarding their health care, and to improve the availability of the records when
needed.
Key messages
 Women who carry their own case notes probably feel more in control and involved
in decision making about their care, and want to carry their notes again in subsequent
pregnancies.
 Women’s satisfaction with antenatal care and the number of assisted deliveries may
increase when women carry their own case notes.
 Women carrying their own case notes during pregnancy may not lead to any changes
in smoking cessation, availability of complete antenatal records at the time of
delivery, loss of case notes, or breastfeeding initiation.
 These findings are based on a few small trials in high-income countries. Factors
which should be considered in applying the findings of this review in LMIC settings
include:
- Access to and utilisation of antenatal care;
- Literacy rates of women and care providers may be a factor which could influence
the impact of the intervention;
- Support by health professionals and others of women’s rights to be involved in
decision making about clinical care during pregnancy.