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First examination during pregnancy. Approximate schedule of examination during pregnancy. Power of attorney to attend childbirth

The first consultation with a gynecologist if you suspect pregnancy is a responsible event. Readers are interested to know how the first consultation is going. Read about it on the pages of our site.

The timing and purpose of getting a consultation

It is advisable to get a consultation two to four weeks after the last menstruation is delayed, that is, from 8 to 12 weeks of pregnancy. The consultation is designed to accurately and collect the information that has for further medical monitoring of the course of pregnancy.

He meets the pregnant woman, establishes contact with her, examines the medical history before pregnancy, performs a physical examination, requests all tests and prescribes additional tests. The doctor starts a pregnant woman's card and enters all the data there: the date of the last menstruation, what kind of pregnancy, what kind of childbirth, chronic diseases, etc. This allows the doctor to plan his further actions and predict the course of pregnancy to determine a possible negative situation in which it will be required help.

Physical examination

The first consultation during pregnancy includes a complete physical examination to assess the possible presence of disorders and disorders that may cause complications during pregnancy. For this purpose, the specialist examines the skin, mucous membranes, palpates the abdomen, listens to the heart and lungs. In addition, the doctor conducts a gynecological examination on a gynecological chair using special instruments. The external genitals, the vagina are examined, the uterus is palpated, its size is determined, which allows not only to establish the fact of pregnancy, but also to detect pathologies that can interfere with pregnancy. The doctor also examines the mammary glands of the pregnant woman.

Such a thorough visual examination is necessary to identify risk factors during pregnancy, and in the future, on repeat visits, such a thorough examination will no longer be necessary.

In conclusion, the gynecologist gives the first advice and recommendations. A woman should take them into account, since the first trimester of pregnancy is key, during which all precautions must be taken for the safety of the fetus - the exclusion of the use of drugs, radiation exposure, a contract with various harmful substances, etc.

Mandatory analyzes when registering

A woman can register for pregnancy not only in her antenatal clinic at the place of residence, but also in any specialized paid medical institution. The list of required analyzes is as follows:

  • , syphilis, hepatitis;
  • general and biochemical blood test;
  • and blood groups;
  • vaginal smear.

If there are indications, the doctor may prescribe additional tests:

  • for urogenital infections;
  • for hormones.

If it turns out that the husband of the pregnant woman has a positive Rh factor, and she herself is negative, she will have to be tested every two weeks for a blood test for antibodies.

The pregnant woman will also need to be examined by narrow specialists.

The content of the article:

The process of bearing a child is not only a joyful, but also a crucial period in a woman's life. Due to the hormonal changes taking place in her body, she becomes more sentimental and vulnerable. The slightest rudeness from the outside can provoke a nervous breakdown in the expectant mother. And when its source is the staff of the medical institution where she applied for the provision of the service, then it is doubly difficult for her to transfer. In order not to waste her nerves and avoid illegal situations, a pregnant woman should know her rights. In this article, we will consider in detail what rights a pregnant woman has, what difficulties she may face during pregnancy, childbirth and after the birth of a child.

What rights does a pregnant woman have?

A pregnant woman should familiarize herself with her rights in order to avoid possible complications in matters related to:

With the registration of the necessary medical documents;

With the choice of a antenatal clinic and a gynecologist according to a birth certificate;

This knowledge will make it possible to reasonably demand the observance of existing statutory rights.

Article 5 of the Federal Law No. 323-F3 (as amended on June 25, 2012) "On the fundamentals of the health of citizens in the Russian Federation" informs that the state acts as the guarantor of health protection for its citizens. Consequently, a pregnant woman has the right to count on the provision of emergency medical care to her:

In any corner of our country, regardless of where she lives;

If she does not have a passport, compulsory medical insurance policy, exchange card.

Important! In order to receive qualified state free medical care of a non-emergency nature, it is necessary to take care of the availability of the above documents.

Rights of a pregnant woman under the policy of compulsory health insurance

The document is issued free of charge to all people who have Russian citizenship on the basis of the Federal Law adopted on November 29, 2010, No. 326-F3 and informs about the following:

A woman with official employment is issued a document at the place of work. It doesn't matter where she works. It can be a public or private institution;

An unemployed woman receives a document at her place of residence. A certificate of the location of the insurance organization can be issued by: the administration of the municipality or the clinic. You can also independently contact a branch of any CHI fund.

The presence of a medical policy for a pregnant woman guarantees that she will receive free medical services at the place of actual residence, and not only at the place of registration (polyclinic, women's consultation, dentistry, emergency room, dermatoveneric dispensary). This is fixed in an extra liner attached to the medical pole. At your request, you can choose any area and attach to it. When you move, you can easily change medical institutions, for this you need to come to any branch of your insurance company and change the insert. You can also change or leave one of the medical institutions of a certain area, but for this you need a written confirmation from the head physician of this institution. For example, you have moved from one area to another and want to change all medical facilities except the antenatal clinic, because you like your doctor and you are ready to go to him. You must get written confirmation from your doctor and the head physician of the antenatal clinic that they will guide you further.

Rules for registering a pregnant woman in an antenatal clinic

A citizen carrying a child can be registered at her own request at any time convenient for her. This is legally enshrined in an official document approved by the Order of the Ministry of Health of Russia on November 1, 2011, No. 572n.
It states that the main function of medical control of a woman during the period of bearing a child is to prevent and early diagnosis of alleged pathologies:

During pregnancy;

During labor activity;

In the postpartum period;

In the condition of newborn children.

That is, there are no time limits for registration, but there are a number of advantages for early registration.

The advantages of registering for up to 12 weeks are:

In receiving a lump sum payment - an allowance for registration up to 12 weeks of pregnancy, from February 1, 2019, its size is 628 rubles 47 kopecks (Article 10 of the Federal Law of 05/19/1995 No. 81-F3);

In the design and subsequent receipt of an exchange card for a pregnant woman, containing full information about the course of pregnancy, the physical condition of the woman and the fetus. Early registration will allow not to miss any deviations in the state of the female body and fetus, as well as to pass all examinations and tests on time.

What rights does an exchange card give to a pregnant woman?

An exchange card for a pregnant woman is an official medical document that records:

The health status of a pregnant woman (anamnesis of life and illnesses);

Data on all the nuances of the current pregnancy;

The results of the studies, analyzes and examinations carried out by specialists of a narrow focus.

Based on the procedure for providing medical care in the field of "Obstetrics and Gynecology", approved by the order of the Ministry of Health of Russia on 01.11.2012 No. 572n, pregnant women during the entire period of pregnancy should be examined by the following medical specialists:

A local gynecologist (seven or more times);

Therapist (twice);

Dentist (twice);

Otorhinolaryngologist (once);

Ophthalmologist (once);

In the presence of pregnancy pathologies, examinations by other narrow-profile doctors are prescribed.
In addition, such pregnancies will be constantly supervised by the required specialists.

Some pregnant women do not want to visit antenatal clinics on a regular basis, citing their good health. They have the right to do so. In such situations, the doctor informs them about all possible negative consequences in the correct form and in no case forces the pregnant woman to forcibly visit the antenatal clinic. Threats not to issue an exchange card in this case are illegal.

If a woman expecting a child is faced with rudeness and rudeness on the part of the medical staff, then she has every right to complain to the administration of this institution (to the head of the department and the chief doctor of the antenatal clinic). In case of refusal to consider the complaint, a pregnant woman has the right to contact the higher health authorities.

To receive an exchange card in the hands of a pregnant woman, you must twice visit the local doctor - gynecologist, who:

Conduct an initial medical examination;

Write out a referral for the delivery of the necessary tests;

He will enter the data of the test results into the document and give it to the pregnant woman in her arms.

Some time ago, a doctor could issue a document to a pregnant woman only at 28 weeks of pregnancy. The basis for this was the Order of the Ministry of Health of the USSR of June 12, 1986 No. 848 "On the approval of methodological documents for the definition of concepts related to the perinatal period, and for maintaining primary medical records in obstetric institutions" (as amended on December 4, 1992).

You should know that at present, an exchange card can be issued at the request of a citizen, on the first day of her visit to the local gynecologist for registration. The doctor creates an individual pregnant woman's card, which is kept in the antenatal clinic and an exchange card for the pregnant woman, which is handed out. To receive an exchange card, a pregnant woman must have the following documents with her:

Passport of a citizen of the Russian Federation;
- compulsory medical insurance policy;
- SNILS (green pension insurance card).

An exchange card is a visiting card of a pregnant woman, which must always be with her.

A pregnant woman has the right to:

Pass the required tests;

Undergo an examination by specialists and the necessary medical procedures;

Receive for personal use an exchange card with recorded data on the results of analyzes and conclusions of specialists of narrow specialization;

Choose the place where the birth process will take place on your own.

Delivery of paid tests in the direction of a district doctor - gynecologist is a gross violation of a citizen's right to receive free medical services. All the required tests and examinations for admission to the "clean" maternity hospital are carried out free of charge. All paid procedures and tests can be performed only at the request of the pregnant woman.

A pregnant woman is legally entitled to:

Systematically undergo examination by a gynecologist;

At least three times during the period of bearing a child, undergo an ultrasound examination (ultrasound) at 11-14, 18-21, and 30-34 weeks;

Undergo a medical examination with narrowly specialized doctors;

Complete basic studies.

If a pregnant woman refuses to regularly attend an antenatal clinic, then she can receive an exchange card only after passing a number of tests, namely:

Clinical blood test;

General urine analysis;

Blood for hepatitis B, C;

A smear for cleanliness of the vagina.

And visits to the ophthalmologist, otolaryngologist and dentist. Further, you will need to undergo a medical examination by a general practitioner, who will draw up a general opinion on the current state of health of a woman carrying a child. Based on these data, the district doctor - gynecologist will fill out the exchange card of the pregnant woman and give it to her. The presence of this document gives a pregnant woman the opportunity to give birth in any maternity hospital in her locality, if there are no health problems of the pregnant woman or the fetus.

The best time frame for obtaining an exchange card if you do not regularly visit a gynecologist is
from 23 to 35 weeks of pregnancy, since the results of the examination and analyzes will not lose their relevance.

But it is advisable to regularly see a gynecologist, since selective results of the study cannot give a complete picture of your health and the course of pregnancy, which in the future can lead to problems in childbirth.

Important! If you do not like your gynecologist, you can refuse him and by law you must be offered another doctor. To do this, in writing, you must contact the chief doctor of the antenatal clinic.

What rights does a pregnant woman have without an exchange card?

In the absence of an exchange card, you will have to give birth in the observational department of a medical institution or at home. If a woman expecting a baby for some reason does not have an exchange card, then it is not accepted to give birth to a "clean" maternity hospital, even if she comes there on her own, she will be sent by ambulance to the maternity hospital, which has an infectious disease department. If childbirth has already begun, then they will be admitted to the emergency department, and then anyway, the woman in labor with the baby will be transported to the infectious diseases department. The only way to stay in this hospital is if they have a free box (isolated room), which is unlikely.

You should not be afraid of infectious departments of maternity hospitals, they have much stricter sanitary measures in comparison with ordinary maternity hospitals, but minus the partner births and visits are impossible. Relatives can see the child only on the day of discharge.

The official document SanPiN 2.1.3.2630-10, approved by the Resolution of the Chief State Sanitary Doctor of the Russian Federation of 05/18/2010 N 58, reflects the basic requirements for the placement of a certain category of citizens in infectious diseases wards, these include:

Lack of documentary data confirming the passage of a medical examination by the woman in labor;

Body temperature exceeding 37.6 ° C, not accompanied by characteristic clinical manifestations;

Symptoms of infectious diseases;

The acute form of the course of chronic inflammatory diseases, such as: cystitis; pyelonephritis; bronchitis; pneumonia and the like;

Inflammatory and respiratory diseases occurring in an acute form (flu; tonsillitis; ARVI, etc.);

Sexually transmitted diseases (syphilis, gonorrhea);

HIV infection;

Herpetic infection;

Viral hepatitis B, C, D;

Inflammatory diseases of the pulmonary system (tuberculosis). If there are no specialized maternity hospitals in the village for women in labor with an open form of tuberculosis, then they are placed in an isolation ward or box of the infectious (observational) department. Further, after they have given birth to a child, they are transferred to a specialized medical institution (inpatient department of an anti-tuberculosis dispensary);

Medical and social indications for termination of pregnancy, starting from twenty weeks;

Frozen pregnancy, as a result of which the death of the fetus is ascertained;

Revealed pathologies of the child's development in the womb, which require surgical intervention;

Childbirth that took place outside the walls of a medical institution, the time interval is a day after them.

The above document spells out the rules for transferring pregnant women, women in labor, parturient women from ordinary inpatient obstetric departments to the observation department. These categories include women who have experienced complications such as:

At the time of childbirth or immediately after it, the body temperature rises sharply. It reaches 38 ° C or more. If, after measuring it three times within three hours, the indicators remain in place;

High body temperature that lasts for more than 24 hours;

Extragenital infectious diseases that do not require sending a woman to a special hospital. These include: angina; herpes; ARVI, etc.

Based on the information provided, each woman will be able to determine how right the gynecologist-obstetrician is, recommending her childbirth not in an ordinary maternity hospital, but in the observational department.

Rights of a pregnant woman under a birth certificate

Unlike an exchange card, which a woman can get by visiting a gynecologist only 2 times, a birth certificate is issued if a woman has been registered for at least 12 weeks and regularly visited a gynecologist. If the pregnant woman has not appeared for more than 3 months at the reception, then the women's consultation may refuse to issue her a birth certificate.

The birth certificate gives a pregnant woman the right to choose:

Any antenatal clinic within the Russian Federation;

Any maternity hospital within the Russian Federation;

Any gynecologist leading a pregnancy;

Any doctor attending childbirth.

It was created to protect a pregnant woman and a woman in labor from poor quality medical services. Medical institutions are interested in obtaining this document, as it pays for their services. For 2019, its amount is 11 thousand rubles.

A birth certificate can be issued by any pregnant woman, citizen of the Russian Federation or who has a temporary residence permit or residence permit. To do this, she will need a passport, an OMS policy and SNILS. It can be issued directly in the maternity hospital and in the children's clinic. You can learn more about the generic certificate from the article on our website.

The right to be admitted to a specialized maternity hospital

A pregnant woman has the right to be sent to a specialized maternity hospital if she has medical indications (from the cardiovascular, endocrine systems, kidney diseases, blood, etc.). The gynecologist supervising her makes the corresponding notes on the front side in the exchange card stating that upon the onset of labor, the woman should be taken to a specialized maternity hospital. Without appropriate marks and indications for hospitalization in a specialized maternity hospital, a pregnant woman is not admitted there, but will be sent to an ordinary "clean" maternity hospital if she has the results of examinations and tests. Without an exchange card, she will be sent to the infectious maternity ward. You can read more about specialized maternity hospitals on our website.

When prescribing medications, therapeutic or other procedures for a pregnant woman, the gynecologist-obstetrician must explain why he made such a decision, what goal he wants to achieve. Also, he must inform the patient about the benefits of the drug (procedure) and possible side effects that may arise during the treatment.

A pregnant woman has the right to accept the appointment of a local doctor or refuse it until she is consulted by another specialist. This right of a citizen of the Russian Federation is legally enshrined in the Federal Law “On the Fundamentals of Health Protection of Citizens in the Russian Federation”. Detailed information on the patient's consent or refusal to receive medical assistance can be found in article 20 of this law.

On the basis of Article 19, a person seeking medical assistance has the legislative right to:

1. Choose a medical institution and an attending physician. It is worth noting that the doctor chosen by the patient may refuse to manage the new patient if he is not in his territorial department. Therefore, it is necessary in advance to secure the consent of the gynecologist in writing.

2. Prophylaxis, diagnostics, treatment, medical rehabilitation should take place in medical institutions in which sanitary and hygienic standards are observed.

3. Receive advice from doctors of narrow specialization.

4. Receive urgent medical attention in cases of pain attacks through medical intervention.

5. Make sure that information about his illness will not become public. The concept of "medical secrecy".

6. Refuse medical attention.

7. Receive compensation for harm caused to his state of health at the time of medical intervention.

8. Get the opportunity to have a person next to him who is able to defend and defend his rights. Therefore, if a pregnant woman wants a loved one to be next to her in the maternity hospital, then she has the right to do so, prescribed in the Federal Law of the Russian Federation. To do this, you need to draw up a power of attorney, and in this case, legally, they cannot refuse you.

Important! If a pregnant woman refuses to follow the doctor's prescriptions, then he is obliged to inform her about all the possible risks that may arise. After a detailed conversation with the patient, in case of her categorical disagreement, he documents the official refusal. The document is certified by the signatures of the patient and the doctor. If she refuses to subscribe, the doctor writes it down.

Which authorities can you go to with a complaint about a doctor's actions?

If the patient believes that the doctor has violated his rights, he can file a complaint with the following authorities:

Administration of this medical institution (head physician);

The insurance company where he is insured;

To the branch of the MHIF;

Before contacting any authorities, you should correctly formulate your claims and write them down.

The right to the presence of strangers at childbirth

Increasingly, pregnant women choose to give birth in the presence of their husbands or other close people. The right to do this is spelled out in Article 51 of the Federal Law "On the Fundamentals of Health Protection of Citizens in the Russian Federation".

To implement it, the following conditions must be met:

The presence of isolated delivery rooms in the maternity hospital;

Absence of an infectious disease in a relative present at childbirth;

The delivery process excludes surgical intervention.

On the basis of statutory law, the “partner childbirth” medical service is provided free of charge. A husband or another close person can be with the woman in labor for the entire period of delivery, he can take photos and videos of the birth process. A partner to be present in the maternity ward must have a passport, fluorography results, removable shoes, a sterile gown and a cap.

But not all maternity hospitals have separate delivery rooms, therefore, the presence of a loved one during childbirth may be denied. Although, in the Methodological letter of the Ministry of Health and Social Development of Russia No. 15-4 / 10 / 2-6796 dated 07/13/2011. states that the administration of maternity hospitals is obliged to ensure that family members have free access to a woman in the prenatal and postnatal periods. In this case, a power of attorney will be required for the presence of a loved one.

Power of attorney to attend childbirth

The Federal Law, in particular, in Article 19, Part 10, stipulates that the authorized person has the right to be in the immediate vicinity of the woman in labor in order to see and hear her. Otherwise, the rights of the pregnant woman will be violated. The maternity hospital does not have the legal right to establish its own laws. The law is the same for all. The local routine of a medical institution cannot contradict federal law. Therefore, knowing it will help a pregnant woman defend her right to the presence of a confidant.

The validity period of a power of attorney is determined by a specific period, which is prescribed in it. The document indicates the initial date of its validity and the final period (maximum 3 years). To protect the rights of a newborn, it is necessary to indicate information about him in the power of attorney (you can enter it immediately after birth).

The document does not need to be certified by a notary office, after drawing up and signing it is already a legal document, but to "give it an official status" and for personal peace of mind, you can do this.

Practice shows that the presence of a power of attorney does not always guarantee a positive result; there are often cases of refusal by the administration of maternity hospitals in the presence of a trusted person near a pregnant woman. To protect your rights, you will need to make a lot of effort and knowledge of the law and prepare in advance to reflect the objections of honey. staff.

Sample power of attorney

POWER OF ATTORNEY

I, Ilyina Irina Sergeevna, residing at the address Moscow, st. Kotelnicheskaya, 17, building 3, apt. 7, passport series 13 07 number 956761, issued on 03/25/2014, subdivision code 301310, I trust gr. Ilyin Vadim Stanislavovich, born in 1985, place of birth in Moscow (passport series 13 08 No. z21435, issued on September 30, 2010), registered at the address: Moscow, st. Kotelnicheskaya, 17, building 3, apt. 7, to exercise on my behalf the patient's rights provided for by articles 19-22 of the federal law of November 21, 2011 N 323-FZ "On the basics of protecting the health of citizens in the Russian Federation", in particular , the right to choose a medical institution and a doctor, the right to give informed voluntary consent and refuse medical intervention, the right to receive any information about my state of health, the right to get acquainted with all medical documents concerning my health, to receive their copies, the right to choose persons who are in my interests any information about my state of health can be transferred, the right to address complaints and statements to any officials on my behalf, as well as to represent my interests in providing me with medical assistance in any medical and administrative institutions of the Russian Federation, to conduct civil cases in all judicial institutions with all the rights that are granted by law to the plaintiff, the defendant, i.e. the third person and the victim, including with the right to end the case peacefully, recognize or refuse in whole or in part from the claims, change the subject of the claim, appeal against the court decision, receive a writ of execution.
In accordance with Part 2 of Art. 185 of the Civil Code of the Russian Federation, notarization requires only a power of attorney to carry out transactions that require a notarial form and a power of attorney issued by way of transfer (part 3 of article 187 of the Civil Code of the Russian Federation). This power of attorney does not apply to such.

This power of attorney was issued for a period of ______, without the right to delegate authority.

Signature: ...

The right to receive health information

Article 22 of the Federal Law spelled out the rights of a person, including a pregnant woman, to receive complete information about her own state of health.

A pregnant woman has the right to:

To study your medical record;

To get acquainted with the history of childbirth;

To receive data on all performed manipulations and examinations;

On informing her by the attending physician on the issues of: appointments; drugs; diagnostics performed, etc.

To get acquainted with the diagnosis and prognosis.

All the information the patient needs should be received by her in full. If the attending physician is not able to convey to the woman the information she needs, then, to obtain it, she can contact:

1. To the head of the department of this medical institution.

2. To the specialist doctors participating in her examination.

Do not hesitate to ask the doctors questions. Your right to receive complete information about your own health status in a form accessible to you, that is, without terms with a detailed explanation of any paragraph.

Article 22 of the Federal Law informs about the following rights of the patient:

Refusal from the information provided about the threats that have arisen. For example: there is a threat of miscarriage, urgent hospitalization is required to maintain pregnancy, but the woman refuses to do so;

Refusal of preventive vaccinations;

Refusal to take the course of vitamins prescribed by the doctor;

Refusal of information on determining the sex of the fetus, etc.;

The right to receive, upon request, certified copies of personal health documents.

The right to absolute confidentiality of the information provided is reflected in Article 22 of the Federal Law. It says that a medical worker must observe "medical secrecy" about the state of health of a citizen who applied for medical care. Consequently, the data of the examinations of the pregnant woman and the diseases identified in this case are not subject to disclosure.

Methodological letter of the Ministry of Health and Social Development of Russia No. 15-4 / 10 / 2-6796 informs about the right of a woman expecting a child to receive information on the following issues:

Lack of artificial feeding, in what way it manifests itself;

Breastfeeding rules and techniques;

Increase in lactation, by what method to achieve this;

Internal routine of the maternity hospital (compliance with the rules of conduct and the implementation of the necessary procedures).

To convey to a pregnant woman the importance of breastfeeding a newborn in antenatal clinics, "Schools for young mothers" are organized. They conduct a cycle of classes devoted to this topic. Not only expectant mothers are invited to them, but also the rest of the family. All lessons are free of charge.

In addition to classes on the effectiveness of breastfeeding in an antenatal clinic, they are held in all inpatient gynecological (obstetric) departments of medical institutions:

At the perinatal center;

In the maternity hospital;

In the obstetric department of pathology of pregnant women.

Full information about the importance of breastfeeding for the growth and development of the baby helps women understand the importance of this process.

It is important to know! In all medical institutions, advertising of products that replace breast milk, that is, any mixtures, is strictly prohibited.

Discharge rules from the maternity hospital

The day of discharge from the maternity hospital is a joyful and troublesome event.
The main thing, after all the troubles, is not to forget to pick up the necessary documents, namely:

1. Pages from the exchange card. The first page, which records the woman's test results and a description of her pregnancy, remains in the maternity hospital. The newly-made mother is given two pages in her hands:

1.1. "Information from the maternity hospital about the mother."

It contains complete information:

About the general state of health of a woman;

The date of her admission to the maternity hospital;

Date and duration of labor;

Time of birth of the baby;

Data on the parameters of the child and his state of health at the time of delivery and on the day of discharge.

This page is submitted to the antenatal clinic, in which the woman was under the supervision of doctors during pregnancy.

1.2. "Information of the maternity hospital about the newborn."

This page will need to be handed over to the local pediatrician on the day he visits the newborn at home.

2. Tear-off coupon (third) of the generic certificate. It is a kind of check that confirms that the woman gave birth in the indicated maternity hospital.

3. Certificate (or medical certificate) of the birth of the child. Without this document, it is impossible to register a baby in the registry office, since it contains full information about him. This certificate is considered valid one month after the date of its issue.

The right to choose the provision of medical services

Based on Article 7 of the Constitution of the Russian Federation, the state is defined as social, where every citizen is subject to tax deductions. One of these deductions goes to the maintenance of the health care system, which gives a citizen of the country the right to guaranteed medical services, on the basis of a compulsory health insurance contract.

Based on the foregoing, a citizen of the Russian Federation has the right:

Choose a medical service on your own;

Refuse the provided medical service.

The state protects the rights of mothers and children, this is reflected in Article 38 of the Constitution of the Russian Federation.

A woman expecting the birth of a child bears full responsibility for it. Knowing your rights will allow a pregnant woman to defend them in practice.

A pregnant woman has the right to make the following decisions (agree or refuse):

Choosing a maternity hospital;

Joint childbirth (presence of a confidant, etc.);

Placement in a hospital for the preservation of pregnancy;

Ultrasound examination (ultrasound);

Taking medications prescribed by your doctor;

Medical examination;

Performing prescribed medical procedures;

Regular delivery of tests in medical institutions;

Consultation of specialists, etc.

Where to go in case of violation of the rights of a pregnant woman

If a pregnant woman believes that her rights have been violated, then they will help her restore them:

Administration of a medical and preventive institution (a complaint is made to the name of the chief physician);

An insurance medical organization in which a pregnant woman received a medical insurance policy (MHI);

Local Health Authority;

Administration of the Mandatory Health Insurance Fund (MHIF);

Statement of claim to the court.

It should be remembered that the compulsory health insurance agreement contains complete information about the services provided by medical and preventive institutions. A pregnant woman should carefully study this list in order to know what specific requirements she can make to medical personnel.

Important! The patient has the right to independently make decisions regarding her own health and the health of the unborn child. If she refuses the provided medical services, then she bears full responsibility for the safety of her life and the safety of the fetus.

All pregnant women should be regularly examined by an obstetrician-gynecologist. This will allow early detection of emerging complications and prevent their consequences for the mother and baby.

To get an appointment with a doctor, it is best to register with an antenatal clinic or conclude a pregnancy management contract. We do not recommend that you go to a private center from time to time, because the doctors there usually do not bear any responsibility for you.

Frequency of visits

From the moment of registration or conclusion of a contract and until 12 weeks of pregnancy, a doctor's examination is required once a month.
From 13 to 28 weeks - once every three weeks.
From 29 to 36 weeks - once every two weeks.
From week 36 to delivery - weekly check-up.

Before each visit to the doctor, you must pass a urine test.

What the doctor does at the examination

  • Measurement of growth - carried out on the first visit. Needed for calculating body mass index.
  • Weighing - carried out at each examination. By weight gain, the doctor determines whether the pregnancy is proceeding normally and whether there are hidden edema.
  • Blood pressure measurement (BP) and heart rate - at each reception. Allows you to detect dehydration with a strong (drop in blood pressure) or the onset of late toxicosis (increase in blood pressure more than 140/90 mm Hg)
  • Measuring the pelvis - carried out at the first examination. Indirectly shows the width of the pelvis, since the thickness of the bones also affects the width of the birth canal. When in doubt, the Soloviev index is used: the circumference of the wrist in centimeters. If it is more than 14, then the thickness of the bones is considered large, and the birth canal with the same external dimensions of the pelvis will be narrower.
  • Palpation (probing) belly - is carried out at every appointment. With the help of it, the doctor can find out if the tone of the uterus is increased (threat of miscarriage), how the fetus is located, what is its presentation.
  • Internal inspection - is carried out at the first reception, later according to indications (for example, for pain and bloody discharge). The doctor inserts his hand into the vagina and determines the condition of the uterus and cervix. In some cases, a small disclosure is already determined by 28 weeks and can be the cause.
  • Vaginal swab - taken at the first visit and at 36–37 weeks. It can be used to identify infectious diseases and determine the “smear cytotype” - a sign of the stage of readiness for childbirth.
  • Measuring the circumference of the abdomen - starting from 14-15 weeks and then at each examination.
  • Measuring the height of the fundus of the uterus - from the bosom to the upper edge of the uterus, measured at each examination after 14-15 weeks.
  • Listening to the fetal heartbeat - is usually performed starting from 14-15 weeks, when it is heard in a regular obstetric stethoscope. With a Doppler stethoscope (electronic), you can hear your heartbeat earlier. This provides very important information about the child's condition.
  • - do starting from 30-32 weeks and further according to indications. In other words, the doctor can refer you to CTG at any time, as soon as he suspects something is wrong with the child.

If you are late

What if you are late or cannot come to your appointment? It is imperative to call the antenatal clinic and inform the doctor about it. The doctor places the patient cards on the shelves at the appropriate attendance dates, if you are late or cancel the attendance, you will be transferred to another date.
If you cannot come because you are not feeling well, then call an ambulance, a doctor will examine you and, if necessary, take you to the hospital.

A pelvic exam is a medical procedure that examines a woman's pelvic organs. Gynecologists strongly recommend that every woman who has reached puberty undergo it once a year. And, although everyone knows about these recommendations, not everyone is in a hurry to follow them.

Pregnancy is the time during which this unspoken norm of "dating" - once a year - is more than fulfilled!

Of course, if you reasonably approached the child planning process, the visits to the doctor were made in advance: you passed all sorts of tests, possibly confirmed the presence of ovulation by ultrasound, and of course you were already examined on the gynecological chair. However, this does not exempt you from another examination when registering for pregnancy.

Preparation for examination by a gynecologist

There are a number of rules for preparing for a visit to a gynecologist, the observance of which is desirable:

  1. Immediately before going to the antenatal clinic (LCD), it is better to take a shower and put on fresh linen. To douche or not - the doctor should see the most natural state of the genitals, and even the smell can tell a lot.
  2. The bladder, and ideally the intestines, should be empty so you will experience minimal discomfort during palpation.
  3. During the day before the examination, sexual intercourse is undesirable: the remnants of semen or lubricant from the means of barrier contraception can distort the results of the taken smears.
  4. You must take with you: medical insurance policy; a towel or diaper that will cover the chair; you can purchase a disposable gynecological kit with a plastic mirror at the pharmacy (in most LCDs, the instrument is metal, and the coldness of the mirror inserted into the vagina will increase the discomfort).
  5. The mental attitude is also extremely important. Believe me, the doctor asks all the questions, sometimes very delicate, not out of idle curiosity - this is necessary to create a complete picture of your women's health.

Inspection stages and what is checked at each of them

Gynecological examination during pregnancy carried out in a special chair, where the woman is sitting or reclining, putting her legs apart on supports.

First, the gynecologist examines the condition of the external genital organs: evaluates the appearance of the skin and mucous membrane of the perineum, the clitoris and the visible opening of the urethra, the labia, and the anal area. Such a study allows you to detect cracks, hemorrhoids and other diseases.

At the next stage, an intravaginal examination takes place with the help of a mirror, during which pathologies of the vagina and cervix are revealed, the presence of pregnancy is confirmed (a bluish cervix is \u200b\u200ba sure sign). The introduction of a speculum into the vagina is the most unpleasant and painful moment of the entire examination. Trust your doctor and try to relax as much as possible. With the help of mirrors and a beam of light directed at them, diseases such as erosion, polyps, and inflammation can be seen.

By examining the state of the opening of the cervical canal (external os), it is possible to determine the threat of termination of pregnancy from the earliest possible date, as well as diagnose in order to start treatment on time. The gynecologist must pay attention to the nature of the discharge: cloudy, with an atypical odor may indicate the presence of an infection, bloody streaks - about a possible threat of miscarriage.

At the stage of examination with mirrors, the following tests are taken from the vagina:


After the doctor removes the mirror, a manual examination begins - a two-handed vaginal examination. In its course, the size and condition of the uterus, ovaries and fallopian tubes is determined. Many pregnant women try their best to avoid manual examination, fearing provocation of miscarriage, and it is completely in vain: the load on the cervix during intercourse is much more intense. In addition, if a woman has a history of premature birth or the threat of termination of pregnancy, the gynecologist will not palpate the external pharynx to determine its patency. An experienced doctor just needs to touch the neck to understand what state it is in.

Rarely, very rarely in antenatal clinics, another stage is included in the gynecological examination: examination of the mammary glands. If the gynecologist is reluctant to check that part of the body, you can ask politely to do so. We are sure that you will not be denied.

How often does a gynecologist's examination take place during pregnancy?

Pregnancy pregnancy strife. If, with its ideal course, you sit on the "gynecological throne" only three or four times (when registering, before going on maternity leave and just before childbirth), then if there is evidence, you can do this at every visit to the LCD.

A gynecological examination cannot be attributed to a pleasant medical manipulation, but the information that a doctor receives in its course is invaluable. From the totality of examination results, analyzes and ultrasound data, a complete picture of the course of pregnancy is formed, which the doctor can correct if necessary, and the result will be the birth of a long-awaited healthy baby.

As soon as a girl begins to have sex, she should annually consult a gynecologist for preventive purposes. But few of us do it, and for sure none of us likes this procedure. Meanwhile, with the onset of pregnancy, it is mandatory, and neglect of such a visit to the clinic can end in tears. Therefore, the expectant mother herself should be interested in registering on time and diligently visiting the gynecologist, how many times it will be required.

The first examination by a gynecologist during pregnancy

In the first weeks of pregnancy, all women have different "relationships" with doctors. Most of us, on our own initiative, go for an ultrasound scan to confirm our assumptions after a home test. But some immediately go to the gynecologist, and this is a good decision (however, it is best to visit the doctor closer to the eighth week from the date of the last menstruation). An experienced doctor, even without equipment, will be able to diagnose the presence of an ovum in the uterus, as well as assess the state of the reproductive system and the health of the expectant mother in general. He will direct the patient to an ultrasound scan, indicating exactly when it is better to do it, and will tell you when to come to him again, what to register (this must be done no later than 12 weeks of the period). If the terms already allow, then the first visit to the gynecologist and registration can occur at the same time. Therefore, it will be useful to take your passport with you.

During such a meeting, the doctor will certainly be interested in many facts from your past and present life, in particular, regarding the state of your (and your close relatives) health, the presence of chronic diseases and bad habits, the number of sexual partners and pregnancies, and he will definitely specify which of these ended in interruption, and some in childbirth. It is extremely important to provide the doctor with the most reliable information, because all these facts can significantly affect the course and outcome of this pregnancy. The date of the patient's last monthly period will help determine the approximate gestational age and the expected date of delivery.

To get more information and see a broader diagnostic picture, the doctor will send the newly baked pregnant woman for additional examinations, the mandatory of which are blood and urine tests, consultation with a surgeon, ophthalmologist, dentist, therapist. In the future, according to the results of these examinations, there may be a need for additional ones: the more extensively a woman with the pathologies identified in her is examined, the greater the chances of bearing and giving birth to a healthy baby, therefore, such "adventures" among doctors should be taken with all seriousness and understanding.

During the first visit to the gynecologist, he examines the patient on a couch (assessing the location, size and condition of the uterus), measures her height and weight, blood pressure and pulse, pelvic size. A gynecological examination on a chair is also mandatory, during which smears will be taken for research: a smear on the flora (which allows you to identify some genital infections) and a cytological smear (which examines the state of cells for the presence of oncological and other pathological changes). To do this, when going to the doctor, you must bring with you a set for a gynecological examination, which is sold in any pharmacy.

Thus, already the first visit to the gynecologist is able to reveal a number of pathological conditions that threaten pregnancy: increased uterine tone and the threat of miscarriage, inflammation in the genitals, erosion, fibroids, polyps, infectious diseases (vaginosis, gonorrhea, trichomoniasis, thrush, etc.) ), isthmic-cervical insufficiency, etc.

How is an examination by a gynecologist on a chair in the early stages of pregnancy

Of course, there is nothing pleasant about such manipulation, but if you approach the issue calmly and rationally, then you can survive it absolutely normally.

First, a woman's genital tract is examined using a gynecological speculum inserted into the vagina. At this point, try to completely relax (folding your arms over your chest): this will allow the doctor to perform the manipulation as efficiently and painlessly as possible. Do not be too active during the examination, do not turn around and do not distract the doctor: it is better to ask all the questions you are interested in immediately after the end of the manipulation (or even before it starts).

After examining the mucous membranes and tissues of the cervix and vagina in the mirrors, the doctor will draw a conclusion about their condition and, if necessary, prescribe a colposcopy for the patient (if modified cells are found on the cervix) or carry it out immediately, if such an apparatus is at his fingertips. Then the gynecologist performs a finger examination of the vagina, examining it with the fingers of one hand, and probing with the other from the outside, through the abdominal wall.

Many women are worried if such an examination by a gynecologist is not dangerous and not harmful to the chair, because the ovum is still very tiny and vulnerable. But in reality it is nothing dangerous (obstetricians compare that the effect on the cervix during intercourse is much more intense). Moreover, sometimes, making an examination on a chair, the gynecologist can determine an ectopic pregnancy, which is extremely important.

During a gynecological examination, the condition of the genitals of the expectant mother and the external surfaces adjacent to the vagina is assessed:

  • anatomy (structure) of the genital organs;
  • size, consistency and location of the cervix;
  • the state of the external os (canal opening) of the cervix;
  • condition of the mucous membranes of the vagina;
  • the nature of the mucous discharge;
  • location and condition of the fallopian tubes, ovaries, uterus;
  • type and condition of the external opening of the urethra, clitoris, labia;
  • the condition of the skin of the perineum and the inner side of the thighs (to assess the likelihood of varicose veins, to detect a rash or irritation);
  • the condition of the anus (for the presence or predisposition to the appearance of hemorrhoids or cracks);
  • the size and condition of the bones of the pelvis, pubis, sacrum.

All these data are of great importance for the management of the current pregnancy. After all, any deviations in the state of the mother's health (varicose veins, hemorrhoids, genital infections and other inflammatory processes, anatomical features of the structure of the genitals) can interfere with the normal development and birth of the unborn child.

Therefore, such an inspection should in no case be neglected. Moreover, during the entire period of gestation, it will have to be repeated several times, since the state of a woman's body can change under the influence of hormonal fluctuations and suppression of the immune system.

In addition, you should properly prepare for a gynecological examination so that its results are as informative and reliable as possible:

· Take a hygienic shower (but without the use of cosmetic hygiene products).

· Exclude sexual intercourse the day before the visit to the clinic.

· Empty the bowels and bladder before the examination (that is, it will not be superfluous to go to the toilet before entering the doctor's office, especially if you had to wait in line).

Examination by a gynecologist in late pregnancy

Closer to week 16 and further, the gynecologist during each of your visits will additionally measure the height of the fundus of the uterus, abdominal circumference and listen to the fetal heartbeat with a stethoscope. Such studies will help him draw conclusions about the well-being of the development of the baby and the state of health of the mother herself. It is imperative that blood pressure is measured and weighed so as not to miss the onset of gestosis (a serious and dangerous condition that develops in the second half of pregnancy).

Closer to the 28-29th week, you will need to see a doctor every 2 weeks, and after the 36th - every week. Moreover, shortly before the expected date of birth, a woman must again undergo an examination on a chair so that the doctor can assess the readiness of the birth canal for the child to pass through them. Typically, this examination is carried out at 36 weeks. The doctor assesses the estimated size of the baby (in particular, its head), their correspondence to the pelvic ring, determines the location of the fetus in the uterus and the method of future birth, the readiness of the cervix for them (as the date of birth approaches, it begins to shorten and soften), and also takes a smear again on the flora.

If necessary, sanitation is performed - that is, preparation of the birth canal (it includes anti-inflammatory, antifungal or antibacterial therapy if an infection is detected).

How often a gynecologist's examination is required during pregnancy: visit schedule

From the moment of registration, you will have to visit a gynecologist approximately once a month, and each time you will need to go to him with the result of a fresh urine test. But the examination of the gynecologist on the chair during pregnancy is not carried out every time: if there are no violations, no pathologies have been identified, then for the entire period of gestation, it will be necessary to lie down in the gynecological chair 3-4 times, and each time the doctor will re-take a smear on the flora, since it is capable change (now many factors are joining that can cause pathological processes in the genital tract of the expectant mother).

Obstetricians do not recommend performing gynecological examinations on days when you had your period before pregnancy, because these periods are considered dangerous. It happens that after examining on a chair, a woman has a stomach ache or pulls the lower abdomen, sometimes even smears. There is nothing dangerous in such consequences if they are quickly passing (this happens from micro-damage to blood vessels and cells that occurs when the speculum is inserted into the vagina). But if, after the examination by the gynecologist, blood has gone, the spotting does not disappear after a day or (even more dangerous) intensifies, then it is necessary to urgently call the doctor or go to the hospital.

In general, how many times a gynecologist's examination on a chair during pregnancy will be needed depends largely on its course. This schedule is individual. It is not worth diminishing the importance of such examinations: this simple and affordable method allows you to timely identify and prevent a number of pathologies that negatively affect the course of pregnancy. This is a preventative measure, but it can also be curative. When undergoing treatment for some painful condition, an additional examination on the chair may be required at the end of it - for control.

However, we wish you only good medical reports!

Especially for - Ekaterina Vlasenko