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To assess a policy of women holding and thus having constant access to their own obstetric records, 290 women attending a peripheral consultant clinic in Newbury, West Berkshire. were randomly allocated to hold either their full case notes, or the more usual co-operation card. Women holding their full records were significantly more likely to feel in control of their antenatal care (rate ratio 1.45; 95% confidence interval 1.08-1.95) and to feel it was easier to talk to doctors and midwives (rate ratio 1.73; 95% confidence interval 1-1&2-59). No other beneficial effects were detected. Asked about their preferences for any subsequent pregnancies, women holding their own records in the index pregnancy were more likely to say they would prefer to hold the same kind of record again in a subsequent pregnancy than were women holding a co-operation card (rate ratio 1.56; 95% confidence interval 1.34-1.81). There was no evidence of negative effects. In particular, women holding their case notes did not feel more anxious than co-operation card holders. The policy of women holding their notes resulted in savings in clerical time, without evidence of an increase in the rate of lost notes.The present system of shared maternity care in the United Kingdom is characterized by multiple contacts between women and a variety of staff. This situation has spawned a number of parallel medical records systems. At a minimum these include those of hospital staff, the woman's general practitioner and the community midwife. This duplication may be wasteful of scarce

In conversation, speakers occasionally use figurative expressions such as “had a good innings,” “take with a pinch of salt,” or “come to the end of her tether.” This article investigates WHERE in conversation such expressions are used, in terms of their sequential distribution. One clear distributional pattern is found: Figurative expressions occur regularly in topic transition sequences, and specifically in the turn where a topic is summarized, thereby initiating the closing of a topic. The paper discusses some of the distinctive features of the topic termination/transition sequences with which figurative closings are associated, particularly participants' orientation to their moving to new topics. Finally, the interactional use of figurative expressions is considered in the context of instances where their use fails to secure topical closure, manifesting some conflict (disaffiliation, etc.) between the participants. (Figurative expressions, idioms, conversation, topic)

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