Diocese Of Metuchen Stm Chart - Pregnancy Symptoms Chart

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Name: __________________________________________ Address: ________________________________________________ Phone: _______________________
Chart# ____________
Month _____________
Year __________
Age ________
Cycle variation ______________
This cycle ___________ days.
Charting Key
Day of cycle
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
33
34
35
36
37
38
39
40
41
42
_________________
1
Menstrual flow
1 / = Slight
1
Abdominal pain
X = Moderate
= Heavy
1
Spotting
Symptoms
_______________
1
Breast fullness
2 D = Dry
W = Wet
1
Other
_______________
Day of month
3 Y = Yellow
2
O = Opaque,
Sensation
white,
3
Color
cloudy
Mucus
C = Clear
4
Consistency
_______________
1
Quantity
4 T = Tacky
5
St = Stretchy
Peak day
Sl = Slippery
Intercourse
_______________
5 Peak Day (P)
Low
High
Combined most
Firm
Soft
Cervix
fertile day. Can
only know this
Closed
Open
the day after it
6
Maximum change
occurs!
_______________
Day of cycle
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
33
34
35
36
37
38
39
40
41
42
6 Max. Change
99.0
Basal
(M) - Last day of
temperature
HSO. Can only
98.9
know this the day
98.8
after it occurs.
__________
98.7
7 Disturbances
Usual time ______________
98.6
include fatigue,
time change,
98.5
sickness, new
Oral
Other
98.4
thermometer,
use of alcohol,
98.3
medication,
98.2
emotional upset,
etc.
Cover line ______________
98.1
__________
98.0
Cover line:
97.9
Determined after
lower temp shifts
Phase 1 ends: ___________
97.8
to a new, higher,
sustained level.
97.7
Begin with day
Phase 3 begins: __________
97.6
prior to shift,
count back 6
97.5
days; add .1 to
97.4
highest temp in
those 6 days.
97.3
Draw line in
middle of box of
97.2
that temp to end
97.1
of chart.
97.0
7
Disturbances
Notes
Loving abstinence
Diocese of Metuchen – Office of Family Life <> 146 Metlars Lane <> Piscataway, NJ 08854 <> Ph: 732-562-1990 Ext. 1623

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