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Help. I can't seem to grasp the definition of "para."

2961 Views 7 Replies 6 Participants Last post by  MamaTaraX
I wrote it on my ALACE exam as "referring to the number of times a woman has given birth." The midwife marked it as incorrect.

Now, I'm going back and reading and researching and please tell me if I have this correct: it's the number of times a woman has delivered a baby, whether or not the baby was at full term or survives. However, there seems to be some dissent among the "age" of the baby for a woman to be considered a para -- 20w gestation vs age of viability.

So, a woman who had twins during her first pregnancy is a gravida 2, para 1?

A woman who gives birth to a stillborn at 21w is a para 1?

A woman who has an abortion at 19 weeks is not a para?

Please help, I'm a bit confused.
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I understood "para" to be derived from the Latin "parturere" (and variations) which means to give birth. The Latin proverb I use to remember it is
"Parturient montes, nascetur ridiculus mus" meaning "mountains have labored and a silly mouse has been born" (We did all this work and have diddly squat to show for it... could be the motto of the transportation authority, but I digress!)

I understood "gravida" to refer to number of pregnancies, thus a mother of twins would be gravida 1 (one pregnancy) para 2 (birthed two babies)?

Color me confused as well.

that's why some providers use the following TPALM in addition to GP...

T: Term Pregnancies
P: Preterm Pregnancies
A: Abortions - either therapeutic or spontaneous
L: Living Children
M: Multiple pregnancies (a twin would count as ONE here, as it is one pregnancy)

But, in reference to a woman who has been only pregnant one time with twins, her Gravida is 1, her Para is 1. She has been pregnant once and given birth once (though she may have given birth to two or three babies).

Sometimes using the GP with the TPALM further expands the definition of a woman's childbearing history.

Hope that helps.
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Gratzi. Yeah, I figured there is a more definite scale at this point; I'm just answering q's for ALACE so that I'm relatively knowledgable (although I think now I'm a bit more confused than ever!)
Now, I'm confused. I understand Gravida and Para don't reflex multiple births. Whether it was single, twins or quads.... She'd still be G1P1.

But, the TPALM thing is confusing me, because I see different definitions in different sources.

According to Varney's and Holistic Midwifery, when using TPALM:
term babies (not pregnancies or births)
pre-term babies
living children
mulitiple births

So, a mom who has twins that were born at term would be a G1P1 using gravida and para. Or if using TPALM, she'd be G1 P20021

Other sources (online) say it's term/preterm births (regardless of how many babies). So the same woman would be G1 P10021.

My copy of William's Obstetrics is loaned out now... so I'm not sure what that text has to say.

Which one is right?
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Cori, that could be right that it's just about the babies, not about the pregnancies (the TP...). I should look it up.
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I have never been able to remember TPALM, it drives me batty.
You know what's funny? On forms I fill out, there are "P" and "G" spots and I *always* fill them out backwards! I don't know why that is

Namaste, Tara
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