Chart — Maternal-Newborn
Gravida-Para-GTPAL Chart
A visual quick-reference guide to obstetric history notation — Gravida, Para, and GTPAL — with clear definitions for each letter, rules for counting, and multiple worked clinical examples to master this NCLEX-essential skill.
Educational use only. Obstetric history notation conventions may vary slightly by institution. This chart reflects commonly accepted definitions used in nursing education and NCLEX preparation. This material supports nursing education and exam review. It is not medical advice and is not a substitute for clinical judgment, institutional policy, or medical direction. Always follow facility protocols and current provider orders.
GTPAL — Letter-by-Letter Reference
| Letter | Term | What It Counts | Key Rule |
|---|---|---|---|
| G | Gravida | Every pregnancy ever, including the current one | Count ALL pregnancies regardless of outcome or duration. Multiple gestation = 1 G. |
| T | Term | Pregnancies delivered at ≥37 0/7 weeks | Counts deliveries, not infants. Twin delivery at term = T1, not T2. |
| P | Preterm | Pregnancies delivered at 20 0/7 – 36 6/7 weeks | Counts deliveries. Twin delivery at 32 wks = P1, not P2. |
| A | Abortus | Pregnancy losses before 20 weeks (spontaneous or induced) | Includes miscarriages AND elective terminations. Ectopic pregnancies often counted here. |
| L | Living | Number of children currently alive | Counts actual living children, not deliveries. A stillbirth at term adds T+1 but L stays the same. |
Essential Rules
GTPAL = T + P + A (always)
G always equals the sum of T + P + A + current pregnancy (if pregnant). This is a useful check.
Multiple gestation = 1 delivery
Twins or triplets count as one pregnancy (G+1) and one delivery (T or P +1) but each living infant adds to L.
Stillbirth ≥20 wks counts as Para
A stillbirth at term increases T by 1 because it was delivered at ≥37 weeks — but does NOT increase L.
G/P vs. GTPAL
G = total pregnancies. P in G/P notation = total deliveries at ≥20 wks = T+P from GTPAL. Not the same P.
Worked Examples
Example 1 — First Pregnancy
Scenario: A woman is pregnant for the first time and has never delivered.
G1 T0 P0 A0 L0
Reasoning: This is her first pregnancy (G=1). No prior deliveries or losses. No living children yet.
Example 2 — One Term Delivery, One Miscarriage, Currently Pregnant
Scenario: A woman had one term vaginal delivery (child alive, age 3), one spontaneous abortion at 8 weeks, and is now pregnant again.
G3 T1 P0 A1 L1
Reasoning: 3 total pregnancies (term delivery + SAB + current). T=1 (term delivery). P=0 (no preterm). A=1 (SAB at 8 wks). L=1 (one living child).
Example 3 — Twins, Term Delivery, Elective Abortion
Scenario: A woman delivered twins at 39 weeks (both alive, now age 5), had one term singleton delivery (child alive, age 2), and had one elective termination. Not currently pregnant.
G3 T2 P0 A1 L3
Reasoning: 3 pregnancies total (twins + singleton + termination). Twin delivery at 39 wks = T1 (one delivery). Singleton at term = T1. T=2 total. A=1 (elective). L=3 (2 twins + 1 singleton).
Example 4 — Preterm Delivery, Stillbirth, Currently Pregnant
Scenario: A woman had one preterm delivery at 34 weeks (infant alive), one stillbirth at 38 weeks, and is now pregnant again.
G3 T1 P1 A0 L1
Reasoning: 3 pregnancies total. Preterm (34 wks) = P1. Stillbirth at 38 wks = T1 (term delivery, even though fetal death) — but L does NOT increase. L=1 only (the surviving preterm infant).
Example 5 — Cesarean Delivery, Ectopic Pregnancy
Scenario: A woman had one cesarean delivery at term (child alive), one ectopic pregnancy (treated), and is not currently pregnant.
G2 T1 P0 A1 L1
Reasoning: Cesarean vs vaginal delivery does NOT change GTPAL — route of delivery is irrelevant. Ectopic = A1 (ended before viability). Term CS delivery = T1. L=1.
NCLEX Pearls
- Gravida always counts the current pregnancy — a first-time pregnant woman is G1 P0, not G0
- Para (in G/P notation) = T + P from GTPAL — never confuse with the P in GTPAL (which is only preterm)
- Multiple gestation = 1 G, 1 T or P depending on gestational age at delivery; L increases by number of living infants
- Cesarean delivery does not change GTPAL — route of delivery is irrelevant
- A stillbirth at ≥20 weeks increases Para (T or P) but does NOT increase L
- Ectopic pregnancy is typically counted as A (abortus) — ends before viability
Related Resources
Standards & sources
Fact-checked Jun 20, 2026This page is written to align with ACOG Obstetric Terminology Standards. It is an educational summary, not a citation of any single document — always verify specific doses, values, and protocols against current guidelines and your facility policy. How we source content →