Maternity

A.1 What a Maternity doctor / nurse owns

A.2 What they cannot do

The Maternity shell is intentionally narrow — kiosk-style, like ICU:

• No sidebar, no global navigation, no dashboard.
• No access to lab, pharmacy, radiology, billing, HR, or admissions screens.
• No access to other wards (ICU, Emergency, Operations).
• No access to patients who are not on the maternity board.

Forbidden URLs land on the standard Forbidden page.

A.3 What the screen looks like

When a maternity doctor or nurse logs in:

┌─────────────────────────────────────────────────────────────────────────────┐
│ M  Mando · Maternity     [ Maternity ]            🔔   Dr. Yara Saleh ┄     │
├─────────────────────────────────────────────────────────────────────────────┤
│                                                                             │
│   Maternity                                          + Maternity Admission  │
│   3 mothers • 2 newborns • 1 premature                                      │
│                                                                             │
│   [ Mothers (3) ]  Newborns (2)  Premature (1)  Milk Bank                  │
│                                                                             │
│   ┌─ All ─ Pre-Labor ─ Early Labor ─ Active Labor ─ Delivery ─ Postpartum ─┐│
│   │  Maria Garcia    Dr. Yara S • G2P1 • 39w           [active-labor]      ││
│   │  EDD: 2026-05-04   Dilation: 7cm   Fetal HR: 142   BP: 118/76         ││
│   │  ─────────────────────  [Deliver] [+ Order] [Edit] [🗑]                 ││
│   └────────────────────────────────────────────────────────────────────────┘│
│                                                                             │
└─────────────────────────────────────────────────────────────────────────────┘

Top bar: brand → single static tab “Maternity” → notification bell → user pill → Sign out.

A.4 The day, end to end

1. Sign in. The system bounces them straight to /maternity. No dashboard intermediate step.
2. Read the board. Four tabs: Mothers, Newborns, Premature, Milk Bank. Mothers tab segments by labor stage.
3. Click the mother’s name. The chart popup opens with 12 cards: Pregnancy, Newborns, Vitals, Allergies, Conditions, Nursing Assess., Medications, Lab Orders, Imaging Orders, Results, Care Plans, Consents. Each card shows a count.
4. Click “Pregnancy”. Read-only snapshot: gravida/para, gestational weeks, EDD, LMP, labor status, dilation, fetal HR, contractions, BP, delivery type, baby status, Apgar, complications. The chart’s bottom hint reminds the user that editing the pregnancy record happens on the maternity board (Edit / Deliver / Add Baby).
5. Click “Newborns”. Lists every baby on this maternity case with weight, length, Apgar, blood type, bracelet colour + ID, premature / NICU badges, status.
6. Click “Vitals” → + Add. The form has eight chips: BP, HR, Temp, SpO2, RR, Wt, Pain, FetalHR. Click a chip → fields pre-fill → type the value → Save.
7. Click “Allergies / Conditions / Nursing Assess.” → + Add. Same flow. The Nursing Assess. dropdown includes maternity-specific types (Edinburgh, Bonding) alongside the general ones (Braden, Morse, Pain).
8. Place an order. Close the chart, click + Order on the row. Three tabs: Prescription, Lab, Imaging. Submit — Pharmacy / Lab / Radiology gets the alert; the maternity clinician sees nothing about who’s working on it until the result shows up under Results.
9. Deliver. When the mother is in stage 2, click Deliver on the row → a 2-step wizard. Step 1 picks the number of babies (single / twins / triplets). Step 2 collects per-baby data including NICU flag and incubator room. Submit creates the newborn records and pushes the mother to postpartum.
10. Register a late-arrival baby. If a baby is added later (paperwork, transfer), use Add Baby on the row.
11. Edit the maternity record. Click Edit on the row to open the 4-tab form: Pregnancy History → Antenatal Risk → Labor & Delivery → Postpartum. Switching tabs preserves whatever you’ve already typed (the form is one panel; tabs only toggle which slice is visible). Save once at the end of the visit — the labor-status, dilation, fetal-HR, and BP changes you’d otherwise update repeatedly during the shift are still on the same form, so the workflow has not changed.
12. Open Milk Bank. Click the Milk Bank tab on the top board. Sign-up flow: register donor → record screening → mark eligible → receive donation → pasteurize → mark available → dispense to a registered recipient. The dashboard’s Expiring (7d) tile is the one to watch — anything in the red number is at risk of being discarded.

A.5 The maternity admission form — 4 tabs

The form behind + Maternity Admission and Edit has grown from a single scrolling sheet to four named tabs. Everything is in one form — switching tabs is a CSS toggle, not a re-mount, so a half-typed value on tab 2 stays put when you click tab 3 and back.

A few field-level notes that bite people:

• Episiotomy + Perineal Tear are independent. A patient may have both, either, or neither; the form treats them as separate fields.
• Blood loss in mL drives the postpartum-haemorrhage flag (>500 mL vaginal / >1000 mL C-section). Currently visual-only — there is no red banner yet, just the number on the postpartum card.
• RhoGAM given only matters when the mother is Rh-negative. The form doesn’t enforce that — leave it unchecked for Rh-positive mothers.
• Discharge education complete gates the discharge summary in nurse handoff.

A.6 Milk Bank

The Milk Bank tab is the donor-mother programme — a separate workflow inside the same kiosk. Five sections in the left rail:

Server-side guardrails (you will see error toasts when you hit one):

• Receiving a donation from a donor with eligibility_status='ineligible' or 'deferred' is refused (HTTP 403).
• Dispensing from a donation that is not in available status is refused (HTTP 403). Pasteurise → mark available first.
• Dispensing more than what’s left in a batch is refused with the available-mL figure (HTTP 400).
• A donation drained to zero auto-flips to dispensed.
• Deleting a donor / recipient with rows on file soft-archives instead of hard-deleting so the audit trail survives.

Common pitfalls in the milk bank:

• “The donation isn’t appearing in the dispense dropdown.” The dispense dropdown only shows donations in status available. Mark it pasteurised → status available first.
• “The donor is eligible but the donation form rejects me.” Active flag is a separate switch from eligibility — make sure Active is on too.
• “Distributions show no donor.” A pooled / unspecified-batch distribution leaves the donor name empty; that’s by design when you can’t trace a specific batch.

A.7 Notifications

Inbound (the bell flashes):

• New maternity admission landed on the wing — fired by Reception/Admissions Officer at admit time.
• Stat lab or imaging result finalised on one of their mothers (planned).
• Blood-bank cross-match approval (when the blood-bank workflow is wired in).

Outbound (they create them implicitly):

• Placing a Lab order → Laboratory.
• Placing an Imaging order → Radiology.
• New prescription → MAR / pharmacy queue.
• Delivery completion → Records / billing (for room downgrades, postpartum charges).

A.8 Common pitfalls

• “I want to change the EDD on the Pregnancy card.” That card is a snapshot. Close the chart, click Edit on the mother’s row to open the maternity form. Save there.
• “Why doesn’t the Newborn list update after I deliver?” It does — but you have to close and re-open the chart, or click All categories → Newborns again. The card-grid count refreshes when you go back to it.
• “I’m trying to add a baby but the form rejects me.” The mother record must already exist. Use Deliver the first time (creates babies via the wizard) or Add Baby for additional ones. Both buttons are on the mother’s row.
• “The patient I’m looking for isn’t here.” They aren’t admitted to Maternity. Reception admits patients with admission_type = maternity — until that happens, the patient won’t appear on this board.
• “I tried to open the lab page and got Forbidden.” Correct — maternity staff place orders but never browse lab/pharmacy/radiology. Use + Order on the row.