Women's consultation registration during pregnancy. What tests should 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 with a compulsory health insurance policy. How acute is this issue in the system of obstetrics and gynecology and, in particular, in such medical structures as antenatal clinic and maternity hospital?

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 in our country, regardless of her permanent place of residence, registration and citizenship. Therefore, if pregnant women are refused to be registered (and such cases, unfortunately, happen), it is illegal. Women should be aware that they can be registered in their native area in Moscow, and observed in another. They can be registered in the Moscow region, and register at 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. The presence of a medical insurance policy, regardless of the place of its 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 medical insurance. Naturally, this provision applies to state medical structures. There are regulations, such as 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 receive emergency medical care. So, if it’s time for a woman to go to a maternity hospital, but she doesn’t have a policy and an exchange card, she will still be hospitalized, but to a special (observation) maternity hospital - in Moscow this is a maternity hospital at City Clinical Hospital No. 6, since in this situation she is considered conditionally infected . For registration in the antenatal clinic and for the subsequent issuance of an exchange card, it is necessary, in addition to the insurance policy, to present a passport.

It is worth debunking the very widespread opinion of patients from other cities that Muscovites are provided with a wider range of medical services - for example, that non-residents are not hospitalized. This is not so - the volume of services provided is absolutely the same. And if during pregnancy a non-resident woman needs hospitalization (say, she has preeclampsia), she will definitely be admitted to the hospital. A pregnant woman, regardless of the place of her permanent registration, no one can refuse this, 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 was denied medical care in a antenatal clinic or a maternity hospital can apply to a higher institution, and those who refuse will at least face an administrative review. True, if a patient has a serious pathology (for example, a blood disease), the treatment of which requires serious therapeutic measures and high material costs, the Moscow clinic may request financial support from her place of residence; this applies to refugees, displaced persons from the CIS countries. But even if the requested funds are not received, the woman will still be provided with medical assistance.

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 patients from other cities in the antenatal clinic? First of all, this is due to the fact that monitoring a pregnant woman - whether she is a Muscovite or a non-resident - is always associated with a certain responsibility. And so the administrators try to evade this responsibility and not increase the number of their patients, primarily from other cities, 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 could not pass the required examinations at the place of residence. Thus, information about any serious pathology detected through examinations or analyzes will not be received in time, which can lead to certain problems, for which, according to the law, a Moscow doctor will be responsible.

The fact is that there is a clear plan for managing pregnancy: at each stage, a woman needs to undergo certain examinations and take tests to make sure there are no pathologies. For example, in you need to do a biochemical screening for fetal malformations, in - ultrasound. If a non-resident woman registers with the Moscow consultation before this date, she will have this examination. But if she, without being observed at the antenatal clinic at the place of residence, arrives in Moscow on time and gets registered, then the period at which it was possible to determine the fetal malformation that is incompatible with life and take appropriate measures will be missed, because . You can terminate a pregnancy 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 an examination in a timely manner. Therefore, doctors do not refuse "their own", territorially attached pregnant women who are registered too late, but often try to find any reason to refuse non-residents.

To Moscow? To Moscow! Pregnancy management in Moscow

Why do so many pregnant women seek to conduct pregnancy and be examined in Moscow? The reason, rather, is 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 it is possible to 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 plan for examining 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 we are talking about it) are approximately the same. Therefore, it makes no sense to go to Moscow to get registered there, and the continuity of medical supervision is violated: if a woman has been examined in one place for several years, there is all the data about her, the diagnosis and other medical details. All this is missing in the new location. This can lead to the fact that some diseases go unnoticed. 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 the rule.

Secondly, if all of a sudden, for example, the entire Moscow region with its eight million population, among which 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 whole pregnancy. Ensuring the normal course of pregnancy determines a normal birth. In many ways, their course depends not only on the staff of the maternity hospital, but also on the doctor of the antenatal clinic. If the doctor can provide qualified management of pregnancy, then it is likely that childbirth will take place without problems. And there are qualified doctors not only in Moscow consultations. But what if the local medicine cannot cope with the diagnosis or if examination and treatment is required that the local health care cannot provide? If the doctor of the antenatal clinic, wherever she is located, detects significant deviations during pregnancy, he has the opportunity to refer the patient for a consultation to a larger medical center; for example, if the antenatal clinic is located in the Moscow region, then the patient can be sent for examination to the Moscow Regional Research Institute, and if it is a Moscow district consultation, then to the Center for Obstetrics and Gynecology.

So there should be no reason to worry about getting medical care for a pregnant woman, no matter where she lives, and she can completely focus on her condition and on her unborn child.

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

A one-time allowance for early registration is a one-time payment due to women who applied to a medical organization about pregnancy before a certain period. The allowance is a fixed amount that is indexed annually. We tell you more about the terms and the payment itself in the article and video!

Attention

This type of material 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.

They are engaged in the payment of benefits, which accrue other types of material support due to pregnant women. you need to contact one of them (depending on the woman’s employment status) and provide the necessary documents. depend on the period of application for benefits, as well as through which organization it will be accrued.

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To whom is it paid?

To receive a lump sum 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", can be counted by women registered in a medical organization up to 12 weeks obstetric period.

Attention

Depending on the fact of employment of the woman claiming the payment, the receipt may be in one of two forms:

• compulsory social insurance;
• state social security.

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

• officially working employees for whom employers pay insurance premiums;
• dismissed in connection with the liquidation of the employer or individual entrepreneur or the termination of activities subject to state registration (subject to official recognition of their unemployment within 12 months after dismissal);
• women in civilian personnel in military units located outside the Russian Federation.

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

• full-time students;
• female contract servicemen, as well as employees in the police department, the Federal Penitentiary Service, fire-fighting state bodies, the National Guard troops, customs and drug control authorities.

The amount of benefits in early pregnancy in 2020 from February 1 (indexation by 3%)

The size of the lump-sum payment for staging in the early stages 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. Upon 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 lump sum 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 the social security authorities.

Employed women receive funds at the 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 benefits are accrued directly from the FSS to officially working citizens. Submission of documents in this case, as before, takes place through the employer.

If there is a court decision on the fact that the employer did not pay benefits or about its bankruptcy, the dismissed woman can apply for payments to FSS directly.

How do I get early pregnancy registration allowance?

To receive a lump-sum payment, you must provide the organization appointing it with the following documents:

• a certificate from the antenatal clinic (or any other medical organization), which confirms registration in the early stages of pregnancy (according to paragraph 22 of the Order of the Ministry of Health and Social Development of the Russian Federation No. 1012n dated 12/23/2009);
• 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 must also contain institution seal who issued it. A single form of a medical certificate is not approved; it is drawn up in an arbitrary form.

The application must contain the following information:

• Name and position of the head of the organization;
• Name and position of the employee;
• content in free form;
• the gestational age at which the woman was registered with a medical organization;
• date of;
• signature.

When is the early registration fee paid?

In practice, the payment for early registration is most often transferred along with maternity allowance. To do this, in accordance with paragraph 24 of the Order of the Ministry of Health and Social Development No. 1012n dated December 23, 2009, when submitting documents for the 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 the social security authorities, then his appointment takes place within 10 days, and the payment is accrued no later than the 26th next (after the submission of documents) month.

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

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

Attention

A one-time allowance for early registration is assigned on the condition that the woman applied for it not later than six months from the end of maternity leave.

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Most women who are preparing to become mothers for the first time try to visit an antenatal clinic almost immediately after they find out 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 the moment of visiting the local gynecologist.

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

Why do you need to register?

As a rule, the purpose of pregnancy registration is to receive medical advice and free medical care during the gestational period. For this purpose, it is better to contact the medical institution in which the pregnant woman was observed regularly. Why exactly there? To make it easier for gynecologists to collect an 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 at all that it is not needed. In a systematic visit to the gynecologist's office, there are many advantages for both the child and his mother:

• Possibility to make the necessary tests free of charge.
• Counseling a pregnant woman on exacerbation of chronic diseases and pathologies.
• Issuing referrals and determining the timing of genetic screenings, including ultrasound and blood tests.
• Measurements of the parameters of a pregnant woman: weight, height, height of the uterus. Examination of a woman for the presence of edema at each of the scheduled visits.
• Early treatment helps to track the development of the baby with the timely correction of deviations and complications.
• Emergency care in critical situations and referral for hospitalization in a maternity hospital.
• Guaranteed financial incentive from the state. In Russia, the allowance for registration in the early stages of pregnancy as of February 1, 2018 is 628 rubles 50 kopecks. You can apply for a lump sum payment at the employer, at the place of study or at the social service for the protection of the population. To calculate benefits, you must provide a certificate from a medical institution confirming that the required time frame has been met. Payment of benefits is made within 10 calendar days from the date of issuance of the certificate.
• In the antenatal clinic, the necessary documents are issued: an exchange card, in which data on the state of health of the mother and child are entered, and a birth certificate (issued at 30 weeks for a singleton pregnancy, at 28 for a multiple pregnancy).

What are the deadlines for registration?

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

Ultrasound examination, if the patient has no complaints, occurs at 10-14 weeks. Just at this time, screening is also carried out, which will help make sure that the fetus has no 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;
• heavy bleeding;
• suspected ectopic pregnancy;
• history of spontaneous abortions;
• abdominal pain on one or both sides;
• increased tone of the uterus.

It is important to remember that a woman can visit a private ultrasound room without a referral from a local obstetrician-gynecologist, where she will be confirmed the fact of pregnancy. The study is carried out on the 10-12th day of delayed menstruation. A written conclusion obtained as a result of the study, the woman will need to show the district obstetrician. If you register permanently with the LCD later than for a period of 12 weeks, you can skip a lot of diagnostic measures.

Required documents

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

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

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

• Individual account sheet. The entire period of pregnancy is stored at the gynecologist conducting examinations.
• Exchange card. A document that is handed out at the time of registration. Women who are 8–9 months pregnant are not recommended to leave home for long distances without an exchange card. If the birth begins before the due date, the information entered in the exchange card will help the emergency doctors who came to the emergency call to decide on further actions in relation to the woman in labor.

Can women who due to circumstances do not have a place of permanent registration be registered? They can. To do this, an appointment with a gynecologist must take identification documents and a compulsory medical insurance policy. According to the laws of the 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 her own request, change the LCD. To do this, an application is made in the name of the head physician indicating the registration in the passport and the address of the permanent place of 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 the paperwork of the pregnant woman. During the visit:

• An initial inspection is carried out on the chair. For the entire pregnancy, it is carried out twice: at the first appointment and for a period of 30 weeks. The purpose of the examination is to confirm the fact of uterine pregnancy, assess the condition of the cervix and take smears.
• The doctor measures height, weight and blood pressure.
• History 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 in the family. The features of the life of a pregnant woman are clarified, whether she works, whether there are bad habits.
• The woman is given directions for tests. The baby's father is undergoing a fluorography.
• Necessary documents and maps are drawn up.

What happens if a woman is not registered?

A woman in position should clearly understand that only she is responsible for her unborn child. Her health will depend on what lifestyle she leads during 9 months of pregnancy. Every woman has the right to free medical care and supervision, regardless of her social status and marital status. Use it or not, it's up to her.

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

Refusing to visit the local doctor, both the first and the second make a mistake, and it's not just about paying the due allowance. Even a woman who carried and gave birth to three children will not be able to predict exactly how the pregnancy will proceed. In the event of complications or situations that require a lightning-fast reaction on the part of medical personnel, it will be difficult for doctors to decide on their further actions without an exchange card, where the results of analyzes and necessary studies are entered.

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

Already in the first weeks of pregnancy, the girl needs to submit various certificates to the hospital and to work. This is necessary in order to receive all due benefits.. When and where do I need to apply for registration and for receiving maternity benefits?

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Documents for registering a pregnant woman

To register for pregnancy, contact your gynecologist at the clinic, you need to bring take the following documents:

• The passport
• Compulsory health insurance policy
• SNILS

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

In addition, you will be issued a certificate of early registration (up to 12 weeks). When you provide her with a job, you will be paid a one-time allowance in the amount of 581 rubles. 73 kopecks. This certificate can be provided to the employer, both immediately and before you go on maternity leave. This allowance is not allowed.

By law, when the period reaches 30 weeks, and if a severe or multiple pregnancy is 28 weeks, a woman is granted sick leave for pregnancy and childbirth. Its duration is 140 days.

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

It is worthwhile to calculate 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 very noticeable. A woman has the right to go on sick leave later. But in this case, it is not extended, but simply reduced for these days.

If the pregnant woman is a student, then the amount equal to the scholarship will be paid for sick leave.

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

• - a document that gives the right to receive money to the clinic for the management of 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 when, as confirmation of the assistance provided during childbirth.
• Exchange card- a document of a pregnant woman, in which, throughout the entire period, the results of the analysis and the peculiarities of the woman's well-being are entered.
• Refusal of hospitalization. It is obtained if you do not plan to go to the hospital before giving birth. It can only be issued if there is no threat and the pregnancy is proceeding normally. After receiving this certificate, you can come to the hospital when you feel that the contractions have begun.

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

By the way, it is for the same reason that it is better to collect a package with essentials, which relatives will immediately bring. So you can be sure that in a hurry you will not forget anything.

Documents upon discharge from the hospital

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

What documents, where we provide:

• 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, in a couple of weeks you will be able to get SNILS for the baby.
• Exchange card and part of the birth certificate, which is transferred to the local pediatrician.
• Help for women's consultation.

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

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

To do this, you must submit the following documents:

• Child's birth certificate.
• Certificate of registration of marriage.
• A certificate from the other spouse's place of work on non-receipt of payment.

In 2016, this payment is 15512.65 rubles. This amount is paid to everyone, regardless of seniority.

One week before your maternity leave ends (some employers may accept the application right away) it is necessary to write an application at work for receiving benefits for caring for a child up to 1.5 years old.

To do this, we provide the same documents as for a one-time payment, only the certificate from the second spouse 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. In the event that one of the periods you were on maternity leave or earlier the salary was higher, you can replace one year with the previous one. For example, do not take into account 2015 and 2014, but 2014 and 2013. It is worth calculating everything in advance, you can even take a certificate of income from work to check everything.

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

The allowance for caring for a child up to three years is now 50 rubles a month.

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

Oddly enough, but the dairy kitchen is still functioning. Pregnant women and children under one year of age are eligible 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 area, then you can get compensation 349 rubles. To do this, you need to apply to the social. protection. You need to have a certificate from the local pediatrician with you.

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

Legal view on the 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 development of the baby 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 trouble.

Why you need to register
If a woman does not lead a healthy lifestyle, she may have clear threats to the fetus. In this case, it is advisable for her to register with a gynecologist. Also, accounting is required in order to reveal hidden genetic diseases that will be passed on to your baby one hundred percent. Do not forget that the first trimester is the period when every day the unborn child "receives" new organs, they form and develop in it. And you need to know what is happening to them, and what pathologies may threaten your fetus.

What documents are required in order to register for pregnancy
"Pregnancy Questionnaire" - it is filled by the most pregnant woman. In it, she must absolutely truthfully fill in each column, and not hide any questions from the doctor. Indicate genetic diseases of your own and relatives, venereal diseases, bad habits, dependence on drug addiction, alcoholism or smoking.
If a woman hides any diseases or addictions, the gynecologist does not bear any responsibility for the abnormal development of the fetus.
"Individual card of a pregnant woman and a woman 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 data of the woman.
"Exchange card" - this document is issued immediately upon visiting a gynecologist and when a woman becomes registered. At each visit to the doctor, this card must be with a pregnant woman.

What tests do you need to pass in order to register for pregnancy?
Analysis is required for registration. After all, it is they who will be able to tell the doctor about what abnormalities are in the woman’s body, and therefore they will help in the future to conduct correct monitoring for 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 swabs;
• RMP analysis (syphilis);
• HIV analysis;
• Ultrasound for alpha-fetoprotein, human chorionic gonadotropin, estirol (16-18 weeks of pregnancy);
• a certificate from a mammologist;
• Ultrasound 9-11 weeks;
• biopsy analysis;
• colposcopy.

A genetics consultation is essential for many pregnancies and registrations. Reasons for this consultation:

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