Mom-to-be 

First visit to antenatal clinic. Rules for registration in an antenatal clinic

So, you have the first doubts that you will be able to spend the next vacation only with your husband, because some very specific symptoms indicate that soon there will be three of you in the family. Where to look for confirmation of your secret hopes, if not in the antenatal clinic? What awaits you there during your first visit?

Why do you need a female consultation?

The antenatal clinic should be attended by all pregnant women; expectant mothers who have not been seen by a doctor during pregnancy are sent for childbirth to observational departments of maternity hospitals or to specialized infectious maternity hospitals.

It is definitely worth noting that a pregnant woman can register and attend the consultation that is closest to her home, or be guided in her choice by other reasons, but regardless of the place of permanent or temporary registration. For registration in antenatal clinic it is necessary to provide a passport and (or) a certificate of registration at the place of stay, an insurance policy of a mandatory health insurance(if any). In the future, you may need other documents, about which expectant mother will be informed additionally.

When is the best time to contact an antenatal clinic?

Most often, a visit to the antenatal clinic is scheduled after the menstruation according to the individual calendar has not come, but home test gave for pregnancy positive result... Nevertheless, there is still some uncertainty that I really want to quickly resolve. However, it is unlikely that such short term an obstetrician-gynecologist in a antenatal clinic can absolutely accurately confirm the fact of pregnancy, despite the examination. It is best to wait a couple of weeks, and then the doctor can really confirm the fact of pregnancy. Optimal term for a visit - 6-9 weeks of pregnancy, i.e. about 2-5 weeks after the date of the expected, but not coming menstruation.

It is also not worth delaying the first visit to the consultation, because early diagnosis pregnancy will allow not only with maximum precision determine the date of delivery, but also complete all necessary examinations and decide in time possible problems, conduct preventive actions according to the gestational age.

How does the reception begin?

Based on the conversation with the woman who came to the reception, the obstetrician-gynecologist starts an individual card of the pregnant woman. Such cards are then laid out according to the days or weeks of the appointment of the next appearance of the pregnant woman. What information is displayed on the map?

General anamnesis

  1. Full Name.
  2. Year of birth. The age of the expectant mother is very important for the doctor, because early or late pregnancy proceed in different ways.
  3. Family status. The question of whether a woman is married or not is not a tribute to curiosity: it is important for a doctor to know psychological attitude pregnant woman and the ability to help at home.
  4. Bad habits, age and health of the husband. This point should not be surprising, because the health of the child also depends on the health of the future dad.
  5. The spouses' professions and the specifics of their work. Harmful conditions the production in which the future parents work should be known to the doctor in order to draw the attention of the expectant mother to their possible negative effects during pregnancy.
  6. Hereditary diseases, transferred in childhood and in mature age general and gynecological diseases, blood transfusions, operations (therefore, it is advisable to recall them beforehand by talking with the parents). If the family had hereditary diseases, you may be prescribed a series of tests at the genetic counseling center. In the presence of chronic diseases the doctor will prescribe special examinations and visits to other specialists.
  7. Contact with infectious patients, travel abroad, especially to countries with a tropical climate, within the last 6 months. Some infections have a long incubation period (the time when there are no manifestations of the disease yet, but the infection is already developing in the body), that is, they do not appear immediately, so the doctor needs to know whether and when there was contact in order to check and prevent complications in time. because the infection can have its detrimental influence not only on the baby, but also on the fetus, provoking fetal malformations or termination of pregnancy.
  8. The course and outcome of previous pregnancies and childbirth (their number, number of abortions, gestosis, miscarriage of previous pregnancies, surgical intervention in childbirth, birth trauma, flow postpartum period, hypoxia and malformations of the fetus and newborn, stillbirth). These data will make it possible to predict the course of this pregnancy, to timely prevent this or that disease.
  9. Features of menstrual, sexual functions. A detailed anamnesis will allow the doctor to analyze the condition of the expectant mother, to make a forecast regarding the well-being of the course of this pregnancy.

General and special obstetric objective research

After the survey, a few more medical manipulations, the data of which is entered into an individual card. It:

  1. Measurements of anthropometric data (height, weight). For this, the doctor's office has a scale and a height measuring device. The ratio of height and weight will reveal the features of the proportions and approximately calculate the weight that a woman can normally add during nine months of pregnancy;
  2. Measurement blood pressure... The fact is that during pregnancy, pressure can increase or decrease, so it is important to know its baseline indicators;
  3. Temperature measurement. It should be borne in mind that at the beginning of pregnancy, the temperature may be slightly increased - up to 37.5 ° C, this is due to the action of pregnancy hormones. A significant increase in temperature suggests the presence of any infectious disease;
  4. Determination of the size of the pelvis using a special device. This is very important stage survey. The fact is that anatomically the bony pelvis and the lining it soft tissue there is nothing more than the birth canal through which the child moves before birth. Therefore, it is very important to know if the birth canal is not narrow for the baby. This circumstance determines the possibility of childbirth through the natural birth canal;
  5. Vaginal examination of the uterus and ovaries will allow the doctor to correlate the size of the uterus with the estimated (by date last menstruation) by the gestational age, and will also provide an opportunity to assess the condition of the vagina, cervix and ovaries. Then, by palpation (probing) the abdomen with special obstetric techniques, the doctor determines the condition of the anterior abdominal wall(elasticity, condition of rectus muscles, round ligaments), size and tone of the uterus. During the examination, the doctor will also take a swab from the vagina to determine the degree of cleanliness of the vagina (usually the laboratory examines the smear for the presence of gonococci, Trichomonas and Candida fungi that cause thrush), if necessary, they can be taken special analyzes and other sexually transmitted infections.

In addition, the doctor pays attention to appearance pregnant woman: her physique, features skeletal system, mammary glands and nipples, the doctor examines the skin and visible mucous membranes.

Directions for analyzes
After general and special obstetric examination the doctor will prescribe a referral for the following tests:

  1. clinical analyzes of blood and urine;
  2. biochemical analysis blood;
  3. determination of blood group and Rh factor;
  4. a blood test for the presence of pathogens in the body of diseases such as syphilis (Wasserman reaction - RW), hepatitis B and C and AIDS.

at the first appointment, the pregnant woman will be referred to specialists who will need to be visited within a few days after the visit to the antenatal clinic. This is a therapist, ophthalmologist, dentist, otolaryngologist, if necessary, an endocrinologist and other specialists (in the case when the obstetrician-gynecologist assumes the presence of any chronic diseases).

Survey results

According to the results of the survey in the antenatal clinic, special group pregnant women with increased risk complications for the mother and fetus. These are those women who have obstetric and gynecological diseases, for example, with miscarriage of a previous pregnancy, uterine myoma, or extragenital diseases - these include bronchial asthma, diabetes, heart disease. Such pregnant women are under special supervision: they are recommended to attend antenatal clinics more often than others, depending on their condition, characteristics of the disease and other reasons.

Pregnant women of this group are examined additionally in outpatient or in specialized obstetric and other medical institutions... 70 days after the birth of a child, women, except those who have last pregnancy or childbirth was accompanied by severe complications, relieve from dispensary observation.

If you came to the antenatal clinic for the first time at 6-9 weeks of pregnancy, then next visit you will be assigned in 3-4 weeks. Further, in the second trimester of pregnancy, you will need to visit the doctor every 2 weeks, and in the third trimester - from 28 weeks - once every 7-10 days. If complications arise during pregnancy, then the doctor will need to come more often.

It is best to register with an antenatal clinic before 12 weeks. In this way, the management of your pregnancy will be more complete. Earlier, you will undergo the first tests, ultrasound, in case of complications, it will be possible to identify them earlier. In addition, women registered with early dates(just before 12 weeks) get paid lump sum... Although tiny - about 500 rubles, it will not be superfluous. In any case, the first time in the antenatal clinic often does not have to appear - once every 2-3 weeks.

Step 2

Usually, women are observed in the antenatal clinic to which they are registered, in the same way your local obstetrician-gynecologist is appointed.
However, if you are registered in one city / district, region, and live in another, then just take the certificate from the place of actual residence and be monitored in the medical facility where it is convenient for you. Moreover, you have the right to choose any medical institution of this profile in the city.
You can also choose a doctor on your own, for this just write an application addressed to the head of the LCD or any other specialized medical center.
When registering, be sure to present your passport, medical policy OMS and SNILS.

Step 3

At the first appointment, the doctor will send you for an ultrasound scan, and when its results are ready, the antenatal clinic will keep a history of pregnancy, which will be kept in the doctor's office until childbirth and an exchange card (it is also a dispensary book of a pregnant woman), which will be stored with you. Both of these documents will contain information about all changes during pregnancy, the results of all tests and ultrasound, examinations of other specialists. You must have an exchange card upon admission to the hospital.

Step 4

In addition to the gynecologist, you will need to visit a therapist, dentist, ENT, ophthalmologist, register with the children's clinic at the place of residence (immediately take there photocopies of the passport, policy, SNILS and a thick notebook - the baby's future medical card).
In addition, you will have to go through a considerable number of tests - regular blood and urine tests, biochemical blood tests, tests for herpes, hepatitis B and C, HIV, rubella, toxoplasmosis. You will pass some tests directly in the antenatal clinic, some in separate laboratories. Among the analyzes there are paid and free

Step 5

During the examination, the doctor will usually weigh you, measure the volume of the pelvis with a special compass, and measure the circumference of the abdomen. If necessary, he will examine in a chair. For every appointment, be sure to bring a diaper with you (you can buy disposable, but it is more economical to have a cloth one) and shoe covers (they can also be replaced with slippers).
If you are lucky, the LCD will give you vitamins for pregnant women and folic acid several times.

Step 6

At 30 weeks, the women's consultation is obliged to write you sick leave for pregnancy and childbirth, as well as a birth certificate, consisting of 4 coupons. The 1st coupon remains in the consultation, the 2nd is taken to the maternity hospital, and the 3rd and 4th - to the children's clinic (for serving the child in the first and second half of life). But you will still be monitored by a doctor until the birth. In addition, from this time it is quite possible to choose a maternity hospital and a doctor who will take over your childbirth and, along the way, be observed with him.

Every pregnant woman in mandatory you need to register with the antenatal clinic. This is necessary both to maintain the health of the expectant mother, and to avoid problems with registration in the maternity hospital and obtaining medical certificates.

Legislation Russian Federation provides free medical diagnosis and monitoring of pregnant women. These activities are carried out in women's advisory centers(antenatal clinics). Women's clinics can work on the basis of a polyclinic or be separate institutions. In our country, they exist in both designated forms.

At the same time, antenatal clinics can work on a free and commercial basis. Free services for pregnant women are most often provided by state antenatal clinics, and consultations established on a commercial basis, although they charge a certain fee, claim more. high level providing medical services pregnant women.

Every woman needs to know that during pregnancy she definitely needs to register with an antenatal clinic as early as possible. The fact is that it is in antenatal clinics that they will be able to give advice on proper nutrition during pregnancy, to identify the features of the course of pregnancy and to prevent some of the negative phenomena that may accompany the period of pregnancy. A pregnant woman needs regular check-ups medical professionals as well as in medical consultations... In addition, birth certificates and other documents that will be needed upon admission to the maternity hospital are issued to women precisely in antenatal clinics.

Apart from what has been said, antenatal clinics issue medical certificates for pregnant women that they will need to be provided at work or in any other institutions (for example, in a registry office). This is primarily about the document "certificate of pregnancy". The need for such a certificate for pregnant women is due to the fact that a pregnant woman in Russia has whole line special rights associated with both labor activity and with other aspects of life. A pregnancy certificate can also be obtained in the examination room, however, the women's consultation draws up medical certificates based on a more serious examination. I must say that a pregnancy certificate is not the only one medical document, which is drawn up in the antenatal clinic. In it, you can get other medical certificates, which does not make sense to list in this article. However, a pregnancy certificate is issued to every woman registered with an antenatal clinic.

It is advisable that the antenatal clinic, where the pregnant woman registers, and which she will regularly attend, was located at the place of registration. This, first of all, will allow the woman herself to get to the consultation faster and easier. In the same time Russian legislation does not exclude the possibility that a pregnant woman was assigned to an antenatal clinic in another district or city. Women's clinics in the Russian Federation can also provide services to women who live in other states, but the scope of such services is limited.

Consider the features of registration in an antenatal clinic for different categories women.

If the pregnant woman is a citizen of the Russian Federation and lives in the area to which the women's consultation belongs, then registration will not bring any difficulties. A pregnant woman should come to the antenatal clinic with a passport and a compulsory health insurance policy. In rare cases, workers in antenatal clinics also require a pension insurance policy with them.

In the event that a woman is registered at one address, but lives in a different area (for example, with her husband at the place of his registration or in a rented apartment), she can register with the antenatal clinic of the area where she lives. True, it will be necessary to confirm that the pregnant woman is in some way connected with the area to which the female consultation she has chosen belongs. We are talking about providing the consultation with documents on renting an apartment and a passport of the owner of the apartment with a residence permit. Or it can be a marriage certificate and a husband's passport with a residence permit, etc.

If before that the woman was registered in another antenatal clinic, about the removal of the pregnant woman from the register, and sometimes an extract from her medical record.

For women who came from other cities and have a temporary registration, in addition to a passport and a policy of compulsory health insurance, it is necessary to present a certificate of temporary registration to the antenatal clinic. The absence of temporary registration under the law does not prohibit a woman from receiving medical assistance however, in practice, this will be extremely difficult.

Everything said in the previous paragraph also applies to women who came from other states and who want to be observed in the antenatal clinic during their stay in the Russian Federation. Note that the policy of compulsory health insurance, in its absence, is issued to all citizens on the basis of a residence permit, temporary registration or employment contract.

Even in the absence of registration, residence permit and insurance policy, a pregnant woman can count on free medical care in case of emergency. When the state is normalized further treatment acquires a paid character.

No one would argue that, in any case, medical advice plays a big role in normal flow pregnancy. Therefore, every woman should take care to register in a timely manner with one or another antenatal clinic.

FORMS OF MEDICAL REFERENCES:

Conclusion on professional suitability by order 302n Medical books - obtaining, renewing, attestation
Passage of fluorography with registration of a medical certificate Vaccination card (form 063 / y)
Form 027 / y (extract from the patient's medical record) Form 076 / u-04 (health resort card for children)
Form 072 / u-04 (health resort card for adults)

What documents the expectant mother will need in each of the periods of pregnancy: from registration to discharge from the hospital.

Related materials:

When registering with a antenatal clinic

By law, a pregnant woman with a compulsory medical insurance policy can be observed in any antenatal clinic in the territory of the Russian Federation. In order to register with the antenatal clinic of your choice, you will need the following documents:

  • application for attachment to the name of the head of the antenatal clinic (or the chief physician of the polyclinic);
  • valid (not expired);
  • photocopy of significant pages of the passport;
  • if you were observed in another antenatal clinic, you need an extract from the outpatient observation card and a certificate of deregistration from the previous antenatal clinic.

If you are denied registration due to the lack of registration at the place of stay or for other reasons, you can do the following:

  • call the phones " Hotline»The district or city administration of the Ministry of Health;
  • write an application addressed to the chief physician of the clinic or the head of the antenatal clinic with a request to register you for pregnancy, in accordance with "", as well as article 41 of the Constitution of the Russian Federation. Be sure to register the application with the secretary. Refusal to you must be given in writing;
  • call the insurance company that issued you the compulsory medical insurance policy (the phone number is indicated in the policy), the department for the protection of the rights of the insured. Ask the department staff to help you solve the problem;
  • write a complaint to the health department, referring to the above laws;
  • file a claim with district court... In parallel, write a petition for urgent consideration of the claim, in view of the fact that there is a direct threat to life and health (Articles 145 and 146 of the Criminal Code of the Russian Federation). Attach a written refusal from the antenatal clinic for registration to the case.

During pregnancy

If you come to the antenatal clinic before 12 weeks, you are entitled to benefits for women registered with medical institutions in the early stages of pregnancy. To get it, take a certificate from the doctor and attach it to the application that must be submitted to the authorities. social protection population.

The application is written in any form, for example: "I ask you to calculate benefits for early pregnancy. A certificate from the antenatal clinic is attached."

It is very important to settle the relationship with the employer on time during pregnancy. It is better to notify him of pregnancy as early as possible - and not orally, but officially. So that in a controversial situation the boss could not invisibly slap his eyes: "Wow! And I did not know that she was pregnant!"

Therefore, you need to take a certificate in the form 084-U from the antenatal clinic and take it to the personnel department. There she will be registered and given a registration number. If the situation at work is tense, you can make a copy of the certificate, on which the head of the HR department must sign, date and mark the registration. This will give you additional guarantees.

After that, not only will they not be able to fire you, but they will also be obliged to do everything possible for your safety and comfort. In particular, Articles 254, 255 and 259 state that you are entitled to:

  • transfer to lighter and less harmful work;
  • part-time work with full wages;
  • the ability not to go on business trips, not to go out to work on holidays or weekends, on the second or third shift (at night). Do not work overtime;
  • payment for working time spent on treatment and medical examination;
  • maternity leave;
  • responsible attitude on the part of the employer in relation to the pregnant employee.

If the employer cannot find a suitable one for you easy work, he is obliged to release you from work during the "search" - with the preservation of wages. If no suitable job is found, your paid stay at home is extended until the end of your pregnancy.

As for medical supervision- list required analyzes and research is determined by the instructions of the Ministry of Health. If you do not want to undergo any examination, write a written refusal from it. In this case, the doctor has no right to insist.

Also during pregnancy, you have the right to free medicines for which the Fund allocates social insurance... You are supposed to:

  • folic acid;
  • potassium iodite;
  • multivitamins;
  • multivitamins + multiminerals;
  • iron preparations;
  • iron preparations + folic acid;
  • vitamin E;
  • calcium carbonate.

Documents that should always be with you

Every time you leave the house - even for five minutes to the nearest store - a pregnant woman should, just in case, take it with her. required package documents. They may be needed if, for some reason, you suddenly have to be in the hospital earlier than the expected date.

  • you will need a passport upon admission to the hospital. Instead of a Russian passport, you can present a foreign passport. After you have determined your blood type, you can ask the staff of the antenatal clinic to enter it in your passport;
  • compulsory medical insurance policy, confirming your right to receive free medical care in the amount of existing compulsory medical insurance programs throughout the Russian Federation.
  • exchange card according to the form No. 113 / y, which the doctor will get for you when registering with the antenatal clinic. It records all the data regarding the course of pregnancy:
  1. past illnesses;
  2. features of the course of previous pregnancies, childbirth, the postpartum period;
  3. abortion;
  4. premature birth;
  5. last normal period;
  6. gestational age at the first visit to the consultation;
  7. number of visits;
  8. the first movement of the fetus;
  9. pelvis size, height, weight (weight);
  10. fetal position, presenting part, palpitations;
  11. blood group and Rh factor;
  12. Rh-belonging to the husband's blood;
  13. analyzes: blood, urine, vaginal contents (smear), feces;
  14. weight gain during pregnancy.

After 28 weeks of pregnancy, an exchange card is issued to you. An exchange card must be provided upon admission to the hospital. If a woman does not have this card with her, or does not indicate the results of tests for syphilis, AIDS, hepatitis, etc., then she can be sent to the so-called "dirty maternity hospital" - that is, a specialized observational maternity hospital where women who are ill with various infectious diseases as well as unexamined women in labor who are considered conditionally infected.

Hospital discharges. If you were hospitalized during your pregnancy, you will be given an extract stating the diagnosis, briefly describing the course of the disease or complications of pregnancy, as well as the examination and treatment performed. This information can be useful to doctors maternity hospital.

A birth certificate issued to women for a period of 30 weeks (if multiple pregnancy- 28 weeks) in the antenatal clinic. At premature birth it can be issued at an earlier date upon receipt of information about the delivery from the maternity hospital. The birth certificate is accompanied by a memo containing information on the rights and obligations of women within the framework of the "Birth Certificate" program.

The generic certificate consists of six parts:

1) Spine generic certificate... Designed to confirm the issuance of a generic certificate. Remains in the medical institution that issued the birth certificate.

2) Coupon No. 1 of the generic certificate. Designed to pay for medical services provided to a woman by an antenatal clinic during pregnancy. Transferred from the antenatal clinic to the regional branch of the Social Insurance Fund for subsequent payment.

3) Coupon No. 2 of the generic certificate. Designed to pay for medical care provided by the maternity hospital to women during childbirth and postpartum period... Transferred from the hospital to the regional branch of the Social Insurance Fund for subsequent payment.

4) A birth certificate, which confirms the provision of medical care to a woman during pregnancy and childbirth by health care institutions. A birth certificate (without coupons) is issued to a woman upon discharge from a maternity hospital.

5) Coupon No. 3 -1 of the generic certificate. It is intended to pay health care institutions for services for the first six months of the child's dispensary observation.

6) Coupon No. 3 -2 of the generic certificate. It is intended to pay health care institutions for services for the second six months of the child's dispensary observation.

All citizens of the Russian Federation, as well as foreign citizens and stateless persons legally residing in the territory of Russia - that is, having a residence permit or a temporary residence permit, have the right to receive a generic certificate.

A birth certificate is issued to a woman only if she has identity documents. If a woman is under the age of fourteen, a birth certificate is issued upon presentation of a birth certificate.

If a Russian citizen does not have a registration mark for her place of residence or place of stay, compulsory medical insurance policy, insurance number of an individual personal account, a generic certificate is still issued to her, but at the same time it indicates the reason for the absence of the above documents.

However, even if a woman does not have a birth certificate, she will still receive medical assistance.

In the maternity hospital

Many women who enter a maternity hospital, especially a free ward, feel completely helpless. The main thing that experts advise to always remember is that you have only rights in the maternity hospital, and doctors who take delivery have only responsibilities.

  • At the beginning of childbirth, a woman can go to any maternity hospital, regardless of the place of registration, as well as regardless of whether she has a compulsory medical insurance policy and exchange card from the antenatal clinic (in the absence of an exchange card, a woman who has already begun childbirth is sent to the infectious diseases department);
  • Change the doctor at any time if the doctor does not suit you;
  • Refuse to take any medication or obstetric benefits;
  • Refuse any paid procedures;
  • At any time, leave the maternity hospital on receipt and take the child with you.

Doctors are required to:

  • provide medical assistance in full within the framework of compulsory health insurance;
  • provide full information any applied research and treatment method;
  • establish the procedure for visiting relatives;
  • if the mother wishes to provide her joint stay with child.