Maternity consultation for registration during pregnancy. What tests need to be taken when registering for pregnancy? Where to register

Due to constant migration, the population of our country experiences difficulties not only with housing and registration, but also with medical care, even if they have a compulsory health insurance policy. How acute is this issue in the obstetrics and gynecology system and, in particular, in such medical structures as antenatal clinics and maternity hospitals?

Rights of a pregnant woman

According to our legislation, a pregnant woman can be observed in any antenatal clinic located in any city or other locality our country, regardless of its permanent place of residence, registration and citizenship. Therefore, if pregnant women are refused to be registered (and such cases, unfortunately, do occur), this is illegal. Women should know that they can be registered in their home district in Moscow, and observed in another. They can be registered in the Moscow region, and register with the antenatal clinic at the place of actual residence - in Moscow. The same right applies to residents of other cities in Russia and even neighboring countries. Having a health insurance policy, regardless of the place of issue, allows the patient to present it at any antenatal clinic or maternity hospital, and it must be recognized as valid - this is ensured by a unified system of compulsory health insurance. Naturally, this provision applies to state medical structures. There are regulations, for example an order of the Ministry of Health, which confirms the right of patients to public health care regardless of their place of residence. If you do not have a policy, you will only be provided with emergency assistance. medical care. So, if it’s time for a woman to go to the maternity hospital, but she doesn’t have a policy or exchange card, she will still be hospitalized, but in a special (observational) maternity hospital - in Moscow this is the maternity hospital at City Clinical Hospital No. 6, since in this situation she is considered conditionally infected . To register at the antenatal clinic and to subsequently issue an exchange card, you must, in addition to your insurance policy, present a passport.

It is worth debunking the very widespread opinion of nonresident patients that Muscovites are provided with a wider range of medical services - for example, that nonresident patients are not hospitalized. This is not true - the volume of services provided is absolutely the same. And if during pregnancy a nonresident woman needs hospitalization (say, she has gestosis), she will definitely be admitted to the hospital. No one can refuse a pregnant woman, regardless of her place of permanent registration, just as no one can refuse emergency assistance. If the doctor refused her this, he will answer in court, especially if something happens to the woman. In any case, a woman who is denied medical care in a antenatal clinic or maternity hospital can contact a higher institution, and those who refuse will at least face an administrative review. True, if a patient is diagnosed with a serious pathology (for example, a blood disease), the treatment of which requires serious therapeutic measures and large material costs, the Moscow clinic may request financial support from her place of residence; this applies to refugees and displaced persons from the CIS countries. But even if the requested funds are not received, the woman will still receive medical care.

What are doctors afraid of?

So, what is the reason for the reluctance of doctors, despite the order of the Ministry of Health, to register nonresident patients in the antenatal clinic? First of all, this is explained by the fact that monitoring a pregnant woman - whether she is from Moscow or from out of town - is always associated with a certain responsibility. And therefore, administrators try to avoid this responsibility and not increase the number of their patients, primarily nonresident ones, firstly, because they may not have medical documentation about some serious diseases, and secondly, because nonresident patients who arrived to Moscow already at any stage of pregnancy, they may not have undergone the required examinations at their place of residence. Thus, information about any serious pathology detected through examinations or tests will not be received on time, which can lead to certain problems for which the Moscow doctor will be responsible by law.

The fact is that there is a clear plan for managing pregnancy: at each stage, a woman needs to undergo certain examinations and tests to make sure there are no pathologies. For example, in you need to do biochemical screening for fetal malformations, in - ultrasound. If a nonresident woman registers with the Moscow consultation before this date, she will undergo this examination. But if she, without being seen at the antenatal clinic at her place of residence, comes to Moscow at term and registers, then the period at which it was possible to determine a fetal malformation incompatible with life and take appropriate measures will be missed, because . Pregnancy can be terminated for medical reasons up to 22 weeks. After this period, the born baby is considered viable. A woman who registers after 22 weeks shifts the burden of responsibility onto the shoulders of doctors who did not have the opportunity to conduct a timely examination. Therefore, doctors do not refuse “their”, geographically assigned pregnant women who register too late, but often try to find any reason to refuse nonresidents.

To Moscow? To Moscow! Pregnancy management in Moscow

Why do so many pregnant women strive to have their pregnancies and be examined in Moscow? The reason is rather socio-psychological. Some women living in other cities feel that their city or district health care is not qualified enough, and they strive to the capital. It is impossible to refuse such patients, but you can try to explain that it is better to be observed at the place of residence.

Why is it better not to change your place of residence in search of the best Moscow consultation or maternity hospital?

Firstly, the examination plan for a pregnant woman in any antenatal clinic in our country is the same. Material opportunities and provision (if we talk about public health care, and that’s what we’re talking about) are approximately the same. Therefore, there is no point in going to Moscow to register there, and the continuity of medical observation is disrupted: if a woman has been examined in one place for several years, all the data about her, diagnosis and other medical details are there. In the new place all this is missing. This can lead to some diseases going undetected. Registration for pregnancy, associated with a trip to Moscow, and the birth of a nonresident woman in a Moscow maternity hospital can be recognized as an exception, not a rule.

Secondly, if suddenly, for example, the entire Moscow region with its eight million population, among whom there are many pregnant women, moves to Moscow medical institutions, they will simply be blocked. So doctors also find themselves in a very difficult situation.

Thirdly, I would like to draw attention to the following circumstance. Often a woman focuses only on where and how best to give birth. But childbirth is only the final part of the entire pregnancy. Ensuring the normal course of pregnancy determines a normal birth. In many ways, their course depends not only on the maternity hospital staff, but also on the antenatal clinic doctor. If a doctor can provide qualified pregnancy management, then there is a high probability that the birth will take place without problems. And qualified doctors are available not only in Moscow consultations. But what if local health care cannot handle the diagnosis, or if testing and treatment is required that local health care cannot provide? If the doctor of the antenatal clinic, wherever she is located, discovers significant deviations during pregnancy, he has the opportunity to refer the patient for consultation to a larger medical center; for example, if an antenatal clinic is located in the Moscow region, then the patient may be referred for examination to the Moscow Regional Research Institute, and if this is a Moscow regional consultation, then to the Center for Obstetrics and Gynecology.

So, a pregnant woman, no matter where she lives, should have no reason to worry about receiving medical care, and she can focus entirely on her condition and on the unborn child.

Vladimir Serov,
Deputy Director of the Obstetrics Center,
gynecology and perinatology of the Russian Academy of Medical Sciences,
Academician of the Russian Academy of Medical Sciences, Professor, Doctor of Medical Sciences

A one-time benefit for early registration is a one-time payment awarded to women who contacted a medical organization about pregnancy before a certain period. The benefit amount is a fixed amount, which is indexed annually. We tell you more about the timing and payment itself in the article and video!

Attention

This type of financial support is aimed at motivating pregnant women to register as early as possible in order to:

• timely medical examination reduce health risks mothers;
• check the fetus for abnormalities as early as possible in order to minimize possible threats.

The payment of benefits is carried out by the government, which also accrues other types of material support due to pregnant women. you must contact one of them (depending on the woman’s employment status) and provide Required documents. depend on the period of application for benefits, as well as through which organization it will be accrued.

Photo: unsplash.com

Who is paid?

To receive a one-time payment upon registration in the early stages of pregnancy, in accordance with Art. 9 Federal Law (FZ) No. 81-FZ “On state benefits for citizens with children”, women registered in medical organization up to 12 weeks of obstetric period.

Attention

Depending on the fact of employment of the woman applying for payment, receipt may be carried out in one of two forms:

• compulsory social insurance;
• state social security.

To women subject to social insurance, the following categories of pregnant women include:

• officially employed employees for whom employers pay insurance premiums;
• those dismissed due to the liquidation of the employing organization or individual entrepreneur or the termination of activities subject to state registration (subject to their official recognition as unemployed within 12 months after dismissal);
• women among civilian personnel in military units located outside the Russian Federation.

To receive a one-time benefit upon early registration in the form state social support The following categories of pregnant women are eligible:

• full-time students;
• female contract soldiers, as well as employees in the Department of Internal Affairs, the Federal Penitentiary Service, and firefighting government agencies, National Guard troops, customs and drug control authorities.

Amount of benefit in early pregnancy in 2020 from February 1 (indexation by 3%)

The amount of a one-time payment for early stage production is determined by Art. 10 of the law on state child benefits and indexed every year according to Art. 4.2 of the same Federal Law. Based on the indexation carried out on February 1, 2020 (the coefficient was 1.03), the amount of this payment is equal to RUB 675.15.

To receive a one-time payment, a woman must contact one of the authorized organizations. Depending on her social status benefits can be assigned:

• at the place of work (service);
• at the place of study;
• in the FSS;
• in social security authorities.

Employed women receive funds at their place of work (service), fired due to the liquidation of the official place of work, it is necessary to contact the social security authorities. Full-time students receive payment at the place of study - in their educational institution.

Attention

In many regions of the Russian Federation, there is a pilot project “Direct Payments”, according to which officially working citizens receive benefits directly from the Social Insurance Fund. Submission of documents in this case, as before, occurs through the employer.

If there is a court decision on the employer’s failure to pay benefits or on its bankruptcy, the dismissed woman can apply for payments to the FSS directly.

How to receive benefits for early pregnancy registration?

To receive a one-time payment, you must provide the following documents to the organization assigning it:

• a certificate from the antenatal clinic (or any other medical organization), which confirms registration in the early stages of pregnancy (according to clause 22 of Order of the Ministry of Health and Social Development of the Russian Federation No. 1012n dated December 23, 2009);
• application for payment.

Attention

A certificate from a medical organization must be issued by a doctor(he must certify it with his personal signature). It should also contain institution seal who gave her away. A unified form of medical certificate has not been approved; it is drawn up in any form.

The application must include the following information:

• Full name and position of the head of the organization;
• Full name and position of the employee;
• content in free form;
• the period of pregnancy at which the woman registered with a medical organization;
• date of;
• signature.

When is money paid for early registration?

In practice, payment upon early registration is most often transferred along with maternity benefits. To do this, according to clause 24 of Order of the Ministry of Health and Social Development No. 1012n dated December 23, 2009, when submitting documents for assignment of payments under BiR, it is also necessary attach a certificate from a medical institution confirming the fact of registration in the early stages of pregnancy.

If a woman applies for benefits to social protection authorities, then his appointment occurs within 10 days, and payment is accrued no later than the 26th next month (after documents are provided).

Payment is made in one of two ways, which the applicant chooses at her discretion:

• by money transfer via Russian Post;
• transfer to a current account (card) through a bank.

Attention

A one-time benefit for early registration is assigned provided that the woman applies for it no later than six months from the end of maternity leave.

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Most women preparing to become mothers for the first time try to attend an antenatal clinic almost immediately after they learn about their situation. Those who are going to experience the happiness of motherhood for the second, third or fourth time, on the contrary, may delay visiting the local gynecologist.

Did you know that women who register before 12 weeks are paid a lump sum benefit? Let's find out the details of its design.

Why do you need to register?

As a rule, the purpose of registering for pregnancy is to receive medical advice and free medical care during the gestational period. For this purpose, it is better to contact the medical institution where the pregnant woman was regularly observed. Why go there? To make it easier for gynecologists to collect anamnesis and assess the patient’s health status.

There is no law that would oblige a woman to register for pregnancy, but this does not mean that it is not needed. There are many advantages to systematically visiting a gynecologist’s office for both the child and his mother:

• Possibility to do the necessary tests for free.
• Consulting a pregnant woman on exacerbations chronic diseases and pathologies.
• Issuing referrals and determining the timing of genetic screenings, including ultrasound and blood tests.
• Measurements of the pregnant woman’s parameters: weight, height, height of the uterus. Examination of the woman for the presence of edema at each of the scheduled visits.
• Early treatment helps monitor the baby’s development process with timely correction of deviations and complications.
• Emergency care in critical situations and referral to hospitalization in a maternity hospital.
• Guaranteed financial incentives from the state. In Russia, the benefit for registration in the early stages of pregnancy as of 02/01/2018 is 628 rubles 50 kopecks. You can apply for a one-time payment from your employer, your place of study, or the social welfare service. To calculate benefits, you must provide a certificate from a medical institution confirming that the required time frames have been met. Payment of benefits is made within 10 calendar days from the date of provision of the certificate.
• The antenatal clinic issues the necessary documents: an exchange card in which data on the health status of the mother and child is entered, and a birth certificate (issued at 30 weeks for a singleton pregnancy, at 28 for a multiple pregnancy).

How long does it take to register?

A woman is recommended to register for pregnancy at 8 weeks. How to calculate the deadline? The countdown begins from the first day of the last menstruation. These numbers are approximate, and it is difficult to independently determine when exactly conception occurred. The exact gestational age is determined using ultrasound.

An ultrasound examination, if the patient has no complaints, occurs at 10-14 weeks. It is at this time that screening is carried out, which will help ensure that the fetus does not have genetic malformations.

In some cases, ultrasound is prescribed earlier than 10 weeks. The study can be carried out earlier if the pregnant woman has:

• bloody spotting;
• severe bleeding;
• suspected ectopic pregnancy;
• history of spontaneous abortions;
• abdominal pain on one or both sides;
• increased uterine tone.

It is important to remember that a woman can visit a private ultrasound room without a referral from a local obstetrician-gynecologist, where the fact of pregnancy will be confirmed for her. The study is carried out on days 10–12 of missed menstruation. The woman will need to show the written conclusion obtained based on the results of the study to the local obstetrician. If you register permanently with the LCD later than 12 weeks, you can skip many diagnostic measures.

Required documents

In addition to the results of instrumental and laboratory studies, the LCD must provide:

• passport;
• compulsory medical insurance policy;
• individual insurance account number, which can be obtained from the pension fund.

Based on these documents, two personal medical records are registered:

• Individual accounting sheet. It is stored for the entire period of pregnancy by the gynecologist who conducts the examinations.
• Exchange card. A document that is issued upon registration. Women who are 8–9 months pregnant are not recommended to leave home long distances without an exchange card. If labor begins ahead of schedule, the information entered into the exchange card will help emergency doctors who arrive for an urgent call to decide on further actions regarding the woman in labor.

Can women who, due to circumstances, do not have a place of permanent registration, register? They can. To do this, you must take identification documents and a compulsory medical insurance policy to your appointment with a gynecologist. According to the laws Russian Federation All citizens of the country are provided with free medical care in the event of an insured event (this includes observation and treatment during pregnancy, childbirth and postpartum rehabilitation).

The expectant mother can at will change LCD. To do this, an application is drawn up addressed to the chief physician, indicating the registration in the passport and the address of permanent residence. In case of refusal to change the institution, a complaint should be sent to higher authorities.

Registration process

The doctor or nurse is directly involved in preparing the documents for the pregnant woman. During the visit:

• An initial examination is carried out on the chair. During the entire pregnancy it is carried out twice: at the first appointment and at 30 weeks. The purpose of the examination is to confirm the fact of intrauterine pregnancy, assess the condition of the cervix and take smears.
• The doctor measures height, weight and blood pressure.
• An anamnesis is being collected. The gynecologist finds out how long the menstrual cycle lasts, whether the pregnancy is the first, whether there have been miscarriages and abortions, whether there are genetic diseases. The peculiarities of a pregnant woman’s life are clarified, whether she works, and whether she has any bad habits.
• The woman is given directions for tests. The baby's father undergoes fluorography.
• The necessary documents and cards are prepared.

What happens if a woman does not register?

A pregnant woman must clearly understand that only she is responsible for her unborn child. Her health will depend on the lifestyle she leads during the 9 months of pregnancy. Every woman has the right to free medical care and observation, regardless of her social status and marital status. Whether to use it or not is up to her to decide.

Very often, young girls for whom pregnancy came as a surprise try to hide the fait accompli for as long as possible and do not go to the antenatal clinic until the last moment. Experienced mothers with many children do the same, for whom registration is associated only with constant testing and sitting in endless queues.

By refusing to visit a local doctor, both the former and the latter make a mistake, and it is not just a matter of paying the required benefits. Even a woman who has carried and given birth to three children will not be able to predict exactly how the pregnancy will proceed. If complications arise or situations requiring a lightning-fast response from medical personnel, it will be difficult for doctors to decide on their further actions without an exchange card where the results of tests and necessary studies are entered.

No one can force a woman to register with a residential complex. However, if any health problems arise in the mother or child during pregnancy, the development of adverse consequences becomes more likely.

Already in the first weeks of pregnancy, the girl must submit various certificates to the hospital and to work. This is necessary to receive all benefits due.. When and where do you need to submit documents to register and receive maternity benefits?

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Documents for registering a pregnant woman

To register for pregnancy, go to the clinic and see your gynecologist, you need to bring take the following documents:

• Passport
• Compulsory health insurance policy
• SNILS

What documents are needed to work during pregnancy in order to switch to light work? When visiting the clinic, get a certificate from your doctor stating that you are pregnant. You need to take it to your employer. During pregnancy, a woman cannot work on weekends, at night or overtime. If you provide a document confirming the mother’s pregnancy to the registry office, you can speed up the registration of marriage.

In addition, you will be given a certificate of early registration (up to 12 weeks). When you provide it for work, you will be paid a one-time benefit in the amount of 581 rubles. 73 kopecks. This certificate can be provided to the employer either immediately or before going on maternity leave. This benefit is not eligible.

According to the law, when the period reaches 30 weeks, and if a difficult or multiple pregnancy reaches 28 weeks, the woman is granted maternity leave. Its duration is 140 days.

Important! The amount of payment for sick leave is considered 100% of average earnings for the last 2 years. Only closed years are counted. This means that if you go on sick leave on December 30, 2016, then the years 2015 and 2014 will be used to calculate your average earnings.

It is worth calculating in advance in which case it will be more profitable for you. The doctor is required to issue sick leave at 30 weeks, but many pregnant women try to resolve this issue with their gynecologist, since the difference in payment can be quite noticeable. A woman has the right to go on sick leave later. But in this case it is not extended, but simply shortened for these days.

If the pregnant woman is a student, they will pay an amount equal to the stipend for sick leave.

In addition to the sick leave, before going on maternity leave, the consultation will issue the following documents for receiving sick leave and maternity benefits:

• - a document that gives the right to receive money to the clinic for managing your pregnancy. It consists of several coupons. One remains in the antenatal clinic, the second part is transferred to the maternity hospital, you will receive the birth certificate itself as confirmation of the assistance provided during childbirth.
• Exchange card- a document from a pregnant woman, in which the results of the analysis and the characteristics of the woman’s well-being are entered throughout the entire period.
• Refusal of hospitalization. You get it if you do not plan to go to the hospital before giving birth. Can only be issued if there is no threat and the pregnancy is progressing normally. Having received this certificate, you can come to the maternity hospital when you feel that contractions have begun.

Important! Childbirth may not begin according to schedule, so after the 30th week, women are advised to carry with them all the above documents, as well as a passport, insurance policy and SNILS.

By the way, it is for this same reason that it is better to pack a package with essentials, which relatives will immediately bring. This way you can be sure that you won’t forget anything in a hurry.

Documents upon discharge from the maternity hospital

Upon discharge from the maternity hospital, you will also receive documents that will need to be submitted to various institutions for the child to become a full citizen. In all cases, be sure to check the correctness of your data and the child, then it will be extremely difficult to correct.

What documents do we provide where:

• Certificate of birth of a child. Provided to the registry office for the child to be registered. Also, data from the registry office is transferred to the pension fund, and in a couple of weeks you will be able to receive SNILS for your baby.
• Exchange card and part of the birth certificate, which is transferred to the local pediatrician.
• Help for antenatal clinic.

What documents do you need to provide for work or social security?

When you have received your child's birth certificate, it's time to go to work to write an application.

To do this, you must submit the following documents:

• Child's birth certificate.
• Marriage registration certificate.
• A certificate from the other spouse’s place of work confirming non-receipt of payment.

In 2016, this payment is 15,512.65 rubles. This amount is paid to everyone regardless of length of service.

A week before your maternity leave ends (some employers may accept your application immediately) You must write an application at work to receive child care benefits for children up to 1.5 years old.

To do this, we provide the same documents as for a one-time payment, only the second spouse’s certificate must indicate that he does not receive benefits.

Important! To find out what the benefit will be, we take 40% of the average earnings for the last 2 closed years. For example, in 2016, 2015 and 2014 will be taken into account. If you were on maternity leave for one of the periods or your salary was higher before, you can replace one year with the previous one. For example, take into account not 2015 and 2014, but 2014 and 2013. It’s worth calculating everything in advance, you can even take a certificate from work about your income to check everything.

If a woman does not work, then monthly payments will be fixed- 2908 rubles, and at - 5817 rubles.

The child care allowance for children under three years of age is now 50 rubles per month.

If you have already had a second child, then you are entitled to the same maternal capital , in 2016 this amount is 453,026 rubles.

Oddly enough, the dairy kitchen is still functioning. Pregnant women and children under one year of age have the right to receive dairy products. If the child is exclusively breastfed, then receiving dairy products is possible after the child is six months old. If there is no dairy cuisine in your region, then you can receive compensation of 349 rubles. To do this, you need to submit an application to the social network. protection. You need to have a certificate from your local pediatrician with you.

These are the payments you can receive during pregnancy and after childbirth. Each year, the amount of payments may change, and some regions also have their own payments for women who decide to have a child.

Legal view on payment of benefits:

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Every pregnant woman must register. She does this primarily for herself, and not for the doctor. Do not forget that the baby’s development occurs gradually, and he, like a sponge, absorbs everything that his mother gives him, and it is advisable to know exactly how this happens in order to avoid troubles.

Why do you need to register?
If a woman doesn't lead healthy image life, it may have obvious threats to the fetus. In this case, it is advisable for her to register with a gynecologist. Recording is also mandatory in order to identify hidden genetic diseases that will one hundred percent be passed on to your baby. Don't forget that the first trimester is a period when every day unborn child“receives” new organs, they form and develop in him. And you need to know what is happening to them, and what pathologies may threaten your fetus.

What documents are needed to register for pregnancy?
"Pregnant woman's questionnaire" - it is filled out by the pregnant woman herself. She must fill out every column absolutely truthfully and not hide any questions from the doctor. Indicate genetic diseases of yourself and your relatives, venereal diseases, bad habits, addiction to drugs, alcoholism or smoking.
If a woman hides any illnesses or addictions, the gynecologist does not bear any responsibility for the abnormal development of the fetus.
"Individual card for pregnant women and women in labor" - it is issued so that the doctor can enter into it all the changes that occurred during pregnancy, as well as all the woman’s data.
"Exchange card" - this document is issued immediately upon visiting a gynecologist and when a woman registers. At every visit to the doctor, this card should be with the pregnant woman.

What tests need to be taken in order to register for pregnancy?
Analyzes are required for registration. After all, they will be the ones who will be able to tell the doctor about what abnormalities exist in the woman’s body, and therefore will help in the future to conduct proper monitoring throughout the entire pregnancy. So, what tests are needed for registration:

• weight height;
• pressure, pulsation;
• blood type, Rh factor;
• general blood analysis;
• General urine analysis;
• vaginal smears;
• analysis of bladder cancer (syphilis);
• HIV analysis;
• Ultrasound for alpha-fetoprotein, human chorionic gonadotropin, estyrol (16-18 weeks of pregnancy);
• certificate from a mammologist;
• Ultrasound 9-11 weeks;
• biopsy analysis;
• colposcopy.

Consultation with a geneticist is mandatory for many pregnancies and registration. Reasons for this consultation:

• age limit for women is 35 years, for men - 40;
• chromosomal abnormalities of one or both parents;
• presence of stillborn pregnancies;
• incestuous relationships;
• cases of miscarriages;
• previous infections during previous pregnancies;
• oligohydramnios or polyhydramnios;
• fetal development disorders during a routine ultrasound examination;
• harmful work;
• menstruation disorders;