The "E" is for Ectopic Pregnancies. The "M" is for any Multiple Births (twins?) At OHSU we use this, here is an example. G (Gravida)5 P (Para) 3 T (Term)3 P (Preterm SOB 1 (SOB is Spontaneous Abortion, a miscarriage) TAB 1 (TAB is Therapeutic or Medically Indicated Abortion) A 2 (Abortions, all together) E (Ectopic Pregnancies) 0 M (Multiple Births) 1 Living 3 So, the above mentioned patient has been pregnant five times, has had three live births, one miscarriage, one medically induced abortion, one set of twins and one other pregnancy that was carried to term and delivered. A lot of it seems repetetive but thats just the way our charting program has it in the chart. We still just say, "Shes a G5 P3" in the end after al of that. :chuckle Hope this helps! :loveya: