There is significant evidence that women carrying their pregnancy care documentation is successful in promoting communication and increased satisfaction for women and care providers.
"Women-held antenatal records are one means by which women can feel better informed, more involved in, and exercise control over, their maternity care."
"Carrying one's records during pregnancy was associated with an increased likelihood of feeling in control during pregnancy" [2, 3]. "Further, women reported that a woman-held record made it easier for them to talk to their doctors and midwives" .
In 1997 a Randomised Controlled Trial conducted at the St George Hospital, Sydney  reported that:
These documents have been introduced to a number of other hospitals in Australia and to the whole state of South Australia. Known document users are listed below and URL Links are provided where available:
A number of Recommendations from the report of the Inquiry into obstetric and gynaecological services at King Edward Memorial Hospital 1990 - 2004 were in the area of improved communication between health professionals, the woman and her family. In particular recommendation 5.20.56 is that a woman-held pregnancy record be introduced.
|5.20.24||KEMH is to develop and implement guidelines to ensure that the standard of clinical care planning is improved. The guidelines are to include contingency planning and require statements of rationale for any unusual plan, or any change of plan.|
|5.20.25||All patients (except healthy women at low obstetric risk) are to have written care plans that have been approved by an experienced registrar or a consultant. Any changes to these care plans are to be approved by a consultant and the approval is to be documented.|
|5.20.35||Women are to be provided with written information concerning treatment options and, where possible, given sufficient time to review the information.|
|5.20.37||It needs to be recognised that when a woman withholds consent for an important and medically indicated treatment, this may represent a communication breakdown. The responsible consultant is to be informed and he or she is to review the circumstances with the woman and her family.|
|5.20.39||The Hospital is to take steps to enhance continuity of care for child-bearing women.|
KEMH is to conduct regular workshops with medical, midwifery, nursing and allied health staff with particular emphasis on:
|5.20.41||A woman is not to be discussed by clinicians in her presence or within her hearing without including the woman in the conversation.|
|5.20.48||KEMH is to develop and implement a policy to ensure that a woman and her family is included in clinical decision-making related to her or her baby. Changes to clinical status, along with options for care, are to be discussed with the woman.|
|5.20.50||KEMH is to improve its standard of documentation. Patient clinical files, in particular, are to be of sufficient quality and detail so that the documentation adequately informs other professionals taking over care of a woman and/or a baby.|
|5.20.52||The same standard of documentation and care planning is to be required from consultants as from other staff. This standard is to apply equally for public and private patients in KEMH.|
|5.20.53||KEMH is to develop and implement a standard organisational format for the patient clinical files used in the Hospital.|
|5.20.54||Integrated progress notes are to be used by clinicians and allied health professionals involved in the care of women and/or babies.|
|5.20.56||KEMH is to introduce a hand held (patient-held) antenatal record for public and private patients.|