Register with a antenatal clinic. Registration for pregnancy

Pregnancy is an important event in the life of every woman, and any expectant mother strives to ensure that this time passes for her and the child developing in her womb in the best possible way. The successful course of pregnancy largely depends on qualified medical supervision, therefore, the first thing a woman who finds out about her new situation should do is to register for pregnancy at an antenatal clinic. Let's talk about how, when and why you need to register and what you need for this.

When should a pregnant woman register with a gynecologist?

One of the first questions that bother women who have barely found out about their pregnancy is when exactly it is necessary to contact an antenatal clinic in order to register for pregnancy. Gynecologists recommend becoming under the supervision of a doctor already in the first trimester, or rather, before the beginning of 12 weeks. This will allow you to avoid complications when carrying a child, notice and prevent the threat of miscarriage in time and, if necessary, correct the course of pregnancy.

The desire of a pregnant woman to consult a gynecologist as early as possible is quite understandable, but it should be borne in mind that doctors rarely register future women in labor earlier than 7-8 weeks.

They explain this by the fact that the period from 1 to 6 weeks is a time when the risk of spontaneous abortion is still too high. To the objections of the expectant mother that she wants to preserve the pregnancy, the doctors answer: if the pregnancy was interrupted in the very first weeks, this indicates that the embryo is not viable or that it has serious deviations, so we can say that "natural selection" is acting here, as as sad as it sounds to a woman. Keeping such a pregnancy would not make sense.

However, you can still contact the antenatal clinic in the early stages to confirm or deny the onset of pregnancy. On examination, the gynecologist cannot always notice that the woman is in position, so it is likely that he will send her for an ultrasound scan or for an analysis that determines the level of hCG.

In order to correctly determine the period at which it is already possible to get registered for pregnancy, you need to start not from the expected date of conception, but from the first day of the last menstruation. In medicine, this is called the obstetric term, and this is the method of counting that gynecologists use to determine how many weeks a woman is pregnant. Having calculated the obstetric term, the gynecologist determines the expected date of delivery and the time of maternity leave.

Can I register after 12 weeks?

About why you need to get up for registration before 12 weeks, a little has already been said above. Many pregnant women are interested in whether it is possible to come to the gynecologist later. Theoretically, a woman can get under the supervision of a doctor even after 12 weeks, but then she must understand what consequences this can have for her and her child. The first important analyzes and studies are carried out already in the 1st trimester, therefore gynecologists strongly advise: it is better not to skip the recommended registration period.

Women who are under the supervision of a gynecologist in an antenatal clinic at an early date are encouraged by the state with a small payment that will be issued along with maternity payments.

Another important reason not to delay registration is the generic certificate. This is a document that provides a woman with free medical care throughout pregnancy, during childbirth and some time after. It is handed over to the antenatal clinic when the expectant mother goes on maternity leave, that is, at 28 or 30 weeks - depending on whether she is expecting one or more children. A prerequisite for obtaining a document is the fact of monitoring pregnancy for at least 12 weeks, and it is obligatory from one specialist. Therefore, even if a woman did not register early, she should appear at the gynecologist no later than 18 weeks (for multiple pregnancies - no later than 16), otherwise she may be legally denied a certificate, and then she will have to pay for childbirth ...

How do pregnant women get registered?

Back in the early 2000s, a pregnant woman was obliged to register for pregnancy exclusively at the place of registration. But in 2006, a decree was issued that regulated the issuance of a generic certificate. This document was created in order to improve the quality of medical care in antenatal clinics, maternity hospitals and children's clinics, based on the material interest of medical personnel.

At the same time, thanks to the birth certificate, any woman in our country received the right to independently choose in which women's clinic she would be monitored for pregnancy and in which maternity hospital she would like to give birth.

Thus, today, the expectant mother, having collected all the necessary documents, can choose herself in which medical institution it will be better and more convenient for her to be monitored during pregnancy, and has the right to register at almost any antenatal clinic - public or private, at the place of residence , registration or in any other area of \u200b\u200bthe settlement. If necessary, this can be done even in another city. It should be borne in mind that not all private clinics are accredited to issue a birth certificate, so it is imperative to clarify this point before signing up for pregnancy monitoring with one or another private gynecologist.

It is usually not difficult to register at the place of registration, especially if this is a women's consultation, in which a woman has already been observed earlier. To be placed under the supervision of a doctor, you will need the following documents:

• the passport;
• compulsory health insurance policy;
• pension insurance certificate.

Taking the expectant mother on the account, the doctor starts 2 cards - an individual card for a pregnant woman and an exchange card. The first is stored in the gynecologist's office until the very birth, the second is handed over to the patient. These are the most important documents for a pregnant woman and her gynecologist. The exchange card is especially valuable. It will contain all the information regarding the health of the mother, the course and outcome of pregnancy, and some information about the newborn. A woman must have an exchange card at any planned and unscheduled appointment, including with specialized specialists, and be sure to keep it with her during admission to the hospital.

In order to register not at the place of residence or registration, you need to collect all the same documents, make a copy of them and attach to the application. The application addressed to the head of the consultation will contain a request to be attached to this clinic to monitor the course of pregnancy. In addition, you need to have a copy of the temporary residence permit or a copy of the lease with you. As practice shows, the latest documents in clinics are not always required, but in order to avoid unnecessary fuss, it is best to take care of this in advance.

Examination of a pregnant woman when registering

To register for pregnancy, a woman will not only have to collect the necessary documents, but also undergo a series of examinations. First of all, this will be an examination by a gynecologist, with whom she plans to be observed.

When the expectant mother is registered and her individual and exchange card is filled out, the following information is required:

• the date of the last menstrual period (to calculate the obstetric period);
• data on the mother's health: what diseases and operations she underwent, whether there were still pregnancies and childbirth, whether she has bad habits;
• data on the weight and size of the pelvis of the pregnant woman;
• blood pressure rate.

The doctor can conduct an examination on a gynecological chair and take a smear for analysis of microflora. At the same appointment, the gynecologist will explain what tests the expectant mother will have to undergo in the near future. A pregnant woman also needs to visit narrow specialists - a therapist, dentist, ophthalmologist, ENT doctor.

For a period of up to 30 weeks, a pregnant woman will need to see a gynecologist at least once a month, after that - once every 2 weeks. A period of 36 weeks or more implies a visit to the doctor every week until delivery.

It is not worth neglecting visits to a gynecologist leading a pregnancy either at the very beginning or at a later date: the future mother herself and her doctor largely depend on how responsible the future mother and her doctor are to their health and development, the successful delivery and the birth of a healthy and strong baby. Therefore, it is very important to choose high-quality medical care and register on time.

In the previous article Pregnancy - " Step-by-step instruction"- What, Where, When? A visit to the obstetrician-gynecologist, we talked about the first steps to take when learning about pregnancy. In this article we will talk about what awaits you at the first appointment and what tests need to be passed to a pregnant woman.

2 STEP. REGISTRATION FOR PREGNANCY.

Registration for pregnancy should be done early (up to 12 weeks). In this case, you will calmly pass all examinations, specialists, and besides, you have the right to receive a one-time benefit in the amount of 438.87 rubles. (amount as of 01.01.2011). The antenatal clinic doctor will tell you where to go for registration: perhaps he will lead your pregnancy himself or guide you - which specialist you should make an appointment with.

WHAT ARE WAITING FOR YOU AT THE FIRST RECEPTION DURING PREGNANCY.

Despite the fact that in fact this appointment is not the first (you have already gone to the initial consultation with the gynecologist, confirmed the pregnancy and received the first recommendations), it is from this visit that you will come to the obstetrician-gynecologist as a pregnant woman “officially”. So…

1. You will be charged with two exchange cards - one will remain with the doctor, the second will always be in your hands. These cards will contain all information about you, photocopies of your documents, data on how your pregnancy is proceeding, the results of tests and ultrasound examinations. Find out in advance what you and your husband were ill with in childhood, what diseases your close and distant relatives have / had. Keep your exchange card as carefully as your passport and always carry it with you.
2. You will be weighed and measured blood pressure on both hands (this will be repeated at each appointment); on the couch - measuring the circumference of the abdomen and the height of the uterine fundus (will also occur at each reception), measuring the pelvic bones and the circumference of the wrist (Solovyov index). You are expected to be examined on a gynecological chair (in this case, you will immediately take a smear on the flora and oncocytology of the cervix).
3. You will find out the expected due date.
4. You will receive directions for tests. The nurse will tell you where and when you need to take them.
5. Additionally, you will need to visit a therapist (the first time - after being examined by an obstetrician-gynecologist, as soon as all tests are ready, the second time - at 30 weeks of pregnancy), an ophthalmologist, an ENT doctor (the sooner the better), a dentist (if you have not done before). Other specialists - according to indications.
6. If your spouse did fluorography during the year, bring a conclusion with the seal of the institution, if you didn’t do it, let him do it, and bring it anyway (make 2 copies, keep the original, the doctor of the children's clinic may need it after the baby is born). The same goes for relatives living with you in the same room.
7. You will receive information about courses for pregnant women, which are held on the basis of the antenatal clinic. Be sure to check out the suggested topics - for sure there might be something interesting for you.

WHAT YOU MAY NEED WHEN VISITING A DOCTOR.

You will meet quite often with the obstetrician-gynecologist who is managing your pregnancy. It is very important to try to establish a trusting relationship with this person, to be able to ask any question (even the seemingly most ridiculous one). Be considerate (not only to yourself, but to others as well), be polite and open to communication. The main thing you need when you go to the doctor is patience. Along with this, take with you:

1. Documents: passport, compulsory medical insurance policy, pension certificate (make copies of each document in 3 copies), if any - the results of the latest analyzes, expert opinions, certificates, etc .;
2. A voucher for an appointment with a doctor - it will be printed at the reception before the appointment (an original compulsory medical insurance policy will be required);
3. A diaper for examination on the couch for each appointment (if you want to use "your own"), there is always a disposable diaper in the doctor's office;
4. Shoe covers - you can buy them in advance (they are cheaper in the pharmacy than in the vending machine). Shoe covers do not allow air to pass through, so the legs “do not breathe” in them and sweat quickly. If you have to wait for a visit for some time, it is better to bring a second shoe with you;
5. A small book or magazine to read while you wait for your turn.
6. A notebook in which you describe the new sensations you have and the questions prepared in advance for the doctor.

STEP 3. DYNAMIC PREGNANCY MONITORING.

HOW OFTEN WILL YOU VISIT YOUR DOCTOR.

• Until 15 weeks of pregnancy (I trimester), you will meet with an obstetrician once every 3 weeks.
• From 15-16 to 28-29 weeks of pregnancy (II trimester) - once every 2 weeks.
• After 29-30 weeks of pregnancy (III trimester) - 1 time in 7-10 days.

In addition, you will visit other specialists (therapist, ophthalmologist, etc.), and in some cases (for example, too much weight gain, etc.) attendance by an obstetrician-gynecologist will be prescribed more often. By the way, if you plan to leave for a long time, for example, to the village to see your grandmother or on a long vacation to the sea - be sure to notify your doctor, get the necessary recommendations and find out where you can go for medical help in an emergency.

HOW OFTEN DO YOU SHOULD DO AN ULTRASONIC FRUIT SURVEY.

According to Order No. 808 of 02.10.2009 "On Approval of the Procedure for the Provision of Obstetric and Gynecological Care", screening ultrasound examination of the fetus (a study to identify risk groups for the development of a particular pathology) is carried out three times: at a gestational age of 11-14 weeks, 20-22 weeks and 32-34 weeks. The doctor can refer for ultrasound examination (ultrasound) more often only when there are certain indications for this.

STUDIES THAT YOU WILL BE PASSED DURING PREGNANCY.

The list of tests will be individual for each woman. On the one hand, there are regulatory documents that strictly regulate the frequency and scope of examination, on the other hand, any pregnant woman is unique, including the nature of the course of pregnancy and the presence of concomitant diseases. In one case, the volume of analyzes will be minimal, in another case, the list of examinations may be somewhat wider (solely for your own benefit). In order to make it easier for you to navigate in the huge flow of paper directions, we will try to divide them into the following positions:

THREE TIME STUDIES DURING PREGNANCY

(at the first visit, at 18-20 and at 30 weeks):

1. general blood analysis;
2. blood chemistry;
3. a blood test for syphilis;
4. blood clotting test (coagulogram).

STUDIES CONDUCTED TWICE PER PREGNANCY

(at first visit and at 30 weeks):

1. examination on a gynecological chair;
2. microscopic examination of the vaginal discharge and oncocytology of the cervix;
3. blood test for HIV;
4. blood test for HbS antigen (hepatitis B);
5. blood test for HCV (hepatitis C);
6. doppler ultrasound - a study of blood flow in the vessels of the fetus, umbilical cord and uterus (done after 20 weeks of pregnancy, as a rule, together with ultrasound of the fetus in the II and III trimesters).

STUDIES PERFORMED BEFORE EACH DOCTOR APPEAL

1. general urine analysis - throughout pregnancy;
2. after 30 weeks of pregnancy - fetal cardiotocography (CTG) - assessment of fetal cardiac activity.

STUDIES CONDUCTED ONCE PER PREGNANCY

(on first call)

1. a study for the presence of pathogens of the TORCH complex (toxoplasma, rubella, cytomegalovirus, herpes simplex virus);
2. electrocardiography of the heart;
3. blood group and Rh factor. BUT! If you have a negative Rh factor, your spouse also takes this test. In the event that he has a positive Rh factor (in combination with your negative one), you will donate blood for antibodies to Rh factor once a month.

RESEARCHES CONDUCTED WITH THE PURPOSE OF IDENTIFICATION OF DEVELOPMENTAL FAULTS AND GENETIC PATHOLOGY IN FUTURE BABY

1. biochemical screening. It is carried out at the gestational age of 10-13 weeks (double biochemical test), when the concentration of the free b-hCG subunit (human chorionic gonadotropin) and pregnancy-associated plasma protein-A (PAPP-A) is determined. A triple biochemical test is performed at 16-20 weeks of pregnancy - this is the determination of b-hCG, alpha-fetoprotein (AFP) and free estriol (E3).
2. ultrasound screening. During an ultrasound examination in the period of 10-13 weeks of pregnancy, the coccygeal-parietal size (CTE), the thickness of the collar space (TVP), the presence or absence of a nasal bone in the fetus are determined.
3. combined screening - a combination of ultrasound and biochemical screening.

These tests assess your risk of developing Down syndrome, Edwards syndrome, and neural tube defects. In women with a favorable history (when nothing portends the development of genetic pathology), only ultrasound is performed at 10-13 weeks of pregnancy and the determination of AFP and hCG at 16-20 weeks of pregnancy.

A woman who is preparing to become a mother should be aware of her responsibility for the health of her baby. Some come to this moment seriously and even before pregnancy visit the doctor, planning conception and passing the necessary tests that confirm the health of the parents. Others become registered as pregnant. When is it better to do it?

Why do I need to register?

Usually, a woman finds out about pregnancy at a period of 6-11 weeks. During the first visit to the gynecologist, she will be asked to formalize, getting registered for pregnancy. This can be done in any antenatal clinic to which the patient is assigned - at the place of registration or work, where it will be more convenient. It is not necessary to choose the clinic where the woman was observed regularly, although in this case it will be easier for doctors to familiarize themselves with the patient's card, to find out about the availability chronic diseases and the treatment performed.

According to the law of the Russian Federation, a woman has the right to receive free medical care for all 9 months of carrying a baby, regardless of whether she is registered with the LCD for pregnancy or not. But a planned visit to a gynecologist, passing the appropriate tests, regular and systematic monitoring of the development of the fetus helps to avoid many problems and identify any deviations.

A woman needs medical advice from a specialist throughout her pregnancy, starting from the early stages.

Due to their own laziness or illiteracy, some women refuse to register at the LCD, so as not to waste time undergoing doctors and taking tests. There is no law that obliges you to do this. Meanwhile, early registration at the clinic has its advantages for both the mother and the baby (to a greater extent):

1. At the initial stages, important systems and organs of the child are laid. At this time, it is important to see a doctor and follow his recommendations on nutrition, taking vitamins, etc.
2. With the onset of pregnancy, the immune system decreases, chronic diseases become aggravated, which can affect the health of the fetus. The gynecologist will be able to correct any ailment.
3. Staging in the early stages increases the chances of a successful pregnancy. But in the following months it is important to observe the development of the fetus, possible deviations in its development.
4. With the help of analyzes, it is determined whether the expectant mother belongs to any risk group that complicates childbirth.
5. There is also a financial benefit from early registration. If a woman registered with a doctor before 12 weeks of pregnancy, she is entitled to a one-time payment (after childbirth). The amount is symbolic - just over 600 rubles, but the payment is guaranteed by the state.

Which week is the best time to register?

Each woman decides for herself when she first consults a doctor about pregnancy management. Everything is individual. First, not all expectant mothers learn about their situation at the same time. Unplanned babies can go unnoticed, and only after a long delay and a change in general condition, a woman begins to think about a possible pregnancy.

Strict maximum and minimum terms are not spelled out anywhere, but they exist:

1. Ideally, register before 12 weeks. At this point, the first important research begins: the delivery of tests and procedures that monitor the baby's health.
2. The deadline is 30 weeks. It is then that maternity leave begins, and the woman still manages to issue all the certificates and go through some research.

It's not worth pulling with a trip to the gynecologist, but is there any need to hurry up to get registered? You can draw up all the necessary documents and get medical advice much earlier than the "optimal" 7-12 weeks, although at this time it is enough to consult a therapist and gynecologist. This is especially important when the doctor guides the patient through the planning stage and carefully monitors her health. There are recommendations for each staging period.

Registration up to 6-7 weeks

It is difficult to register as an expectant mother in a residential complex for a period of 1 to 4 obstetric weeks for several reasons. Before the first delay, it is difficult to diagnose the onset of pregnancy, both for the woman herself and for the gynecologist. Visually, the uterus does not change. The presence of an embryo can be determined only with the help of ultrasound. If a woman comes to the doctor at this time, he may attribute the signs of an interesting situation to hormonal imbalance.

Early registration is quite acceptable, but there is no point in running to formalize, having just seen two stripes on the test. Gynecologists do not recommend registering for up to 6 weeks, because during this period, the likelihood of a spontaneous miscarriage is high. In the case of the development of some pathologies, natural selection occurs. Sometimes, on the recommendation of doctors, preservation assistance is not provided during this period: it is believed that it is better to give birth later, but a healthy child. Sometimes they completely refuse to register for a short period of time, arguing that a miscarriage may occur. But they confirm pregnancy with ultrasound.

There are situations when the expectant mother is being followed from the 5th week. Difficult cases include:

• a history of miscarriages;
• serious chronic diseases;
• age from 35 years old and above;
• unfavorable working conditions for women.

Registration from 6-7 to 9 weeks

If the pregnancy is proceeding normally, the woman reached 7 weeks or more, was convinced of her position with the help of a pharmacy test and came for a consultation with a specialist, he should not have a reason to refuse her registration. Diagnosis is easier. If desired, a woman can go to private clinics and make sure about pregnancy using blood tests (to the level of hCG) and ultrasound. With these documents, then they come to the antenatal clinic.

The period of 7-9 obstetric weeks is suitable for the first visit to the gynecologist. The woman will be assigned the necessary examinations, which include:

• general analyzes of urine, feces and blood;
• determination of the Rh factor;
• hepatitis test;
• testing for syphilis;
• smear;
• bacterial culture of urine for hidden bacteria;
• ECG, etc.

From this moment (6-9 weeks), a woman can begin to undergo a mandatory examination by doctors, in addition to a gynecologist. Time allows, there is no point in rushing, and until about 12-20 weeks it is necessary to go through the following specialists:

• Your family doctor;
• ophthalmologist;
• Laura;
• Dentist (therapist);
• endocrinologist (not always).

Registration from 9 to 12 weeks

In the early stages, modern medicine is able to identify genetic pathologies of the fetus. Thanks to this, treatment is started on time. The first examination - the so-called screening - is also aimed at offering an abortion in case of negative results. The timing of testing is prescribed by a gynecologist, but if pregnant women are at risk, the examination is carried out at 10-12 weeks. If you register before this date, the chance to diagnose pathology in time and take action is higher. Women who are not registered in the ZhK can also do screening, but for a fee, in private clinics.

The deadline for 12 weeks is the approximate end of the first trimester. It is believed that an abortion performed for medical reasons during this period does not pose a threat to the health of the mother.

When the first visit to the gynecologist takes place for a period of 9 weeks or more, the specialist can make a diagnosis based on the examination of the uterus and mammary glands. Also, the expectant mother is sent for an ultrasound examination to exclude ectopic pregnancy and make the necessary measurements of the fetus. At 10-12 obstetric weeks, it is not too late to register. Antenatal diagnostics will be carried out in full.

Registration process in the residential complex

A pregnant woman has the right to apply not only to the city polyclinic at the place of registration, but also to attach to any other one - at will. Convenient location is an important criterion, since you will have to visit doctors regularly. In addition, you can choose "your doctor", an acquaintance or on a recommendation, and register with his clinic. Before making an appointment with a gynecologist, you will need to attach to the LCD - bring an OMS policy and passport, write an application.

State polyclinics work according to the district principle, when a certain area is assigned to each doctor. The pregnant woman is referred to “her” doctor. But she can choose a gynecologist on her own and be monitored by him (with the consent of the doctor). The patient has the right to change the doctor during pregnancy in the absence of mutual understanding and other reasons.

When the gynecologist conducts the initial examination, the woman once again writes a statement (addressed to the head of the LCD), and the gynecologist starts an outpatient card, which is kept in his office. It is important to collect anamnesis, find out what diseases (hereditary and chronic) the expectant mother has, whether there were any problems with pregnancy in the past (abortions, miscarriages), and so on. The woman attaches the necessary documents and their copies to the card:

• the passport;
• compulsory medical insurance policy, giving the right to receive free medical care;
• sNILS pension insurance card.

How often should you see a doctor?

In the office of the gynecologist, to which the woman goes, there is a card index where all outpatient cards of pregnant women are kept. Besides, the doctor keeps track of the computer base when and which patient comes to the appointment. If there are no deviations, you will have to visit the gynecologist every 2-3 weeks. Plus to this, regularly take tests (blood, urine), consult with specialists.

The situation is complicated by the possible incompatibility of the Rh factors of the mother and the child, then it is necessary to donate blood for the determination of antibodies at least once a month (once every 4-2 weeks, depending on the period). The expectant mother will have to run, but everything is done for the health of the baby and the woman herself. The sooner you can diagnose possible problem, the sooner it will be eliminated.

If the pregnant woman does not register

Sometimes it happens that a woman deliberately does not register at the clinic and visits a doctor immediately before or during childbirth. The pregnancy can go well and the baby is born healthy. But if problems arise that lead to a miscarriage or fetal pathologies, no one will be able to tell the expectant mother how to act. Such connivance in relation to one's own health and the health of a child is fraught with consequences.

For not registering, the state has no right to punish either a fine or suggestion. A woman punishes herself, depriving herself of timely medical care, diagnostics, support. Even if the expectant mother feels great and has already had childbirth experience, it is still recommended to undergo planned examinations. No one can predict how the pregnancy will proceed. If a " interesting position"Confirmed (at least by a test), but registration is complicated by departure or other reasons, you can be examined a little later.

There is no optimal “single” time for registration. Each woman decides for herself at what time it is convenient for her to do this. For short periods of time, the gynecologist may refuse to register and prescribe a second appointment in a couple of weeks, in the case when there is definitely a pregnancy. It is recommended to get registered for the 1st trimester, since all the necessary primary research is carried out during this period.

Already in the first weeks of pregnancy, the girl needs to submit various certificates to the hospital and to work. This is required to receive all eligible benefits.... When and where do you need to apply for registration and pregnancy benefits?

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Documents for registration of a pregnant woman

To register for pregnancy, contact your gynecologist at the clinic, you need 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, get a doctor's certificate stating that you are pregnant... It needs to be taken 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 at the registry office, you can speed up the marriage registration.

In addition, you will be given a certificate of early registration (up to 12 weeks). When applying for a job, you will be paid a lump sum in the amount of 581 rubles. 73 kopecks... This certificate can be provided to the employer, both immediately and before going on maternity leave. This allowance is not eligible.

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

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

It is worth calculating in advance in which case it will be more profitable for you. The doctor is obliged to issue a 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 shortened for these days.

If the pregnant woman is a student, she will be paid for the hospital amount equal to the scholarship.

In addition to the sick leave, before going on maternity leave, the consultations issue the following documents for obtaining sick leave and maternity benefits:

• - a document that gives the right to receive money from 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, the birth certificate itself you will receive with, as confirmation of the assistance provided during childbirth.
• Exchange card - a document of the 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. It is received 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 proceeding normally. Having received this certificate, you can come to the hospital when you feel that contractions have begun.

Important! Childbirth may not start on schedule, therefore, after the 30th week, women are advised to carry with them all of the above documents, 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 essential items that relatives will immediately bring. This way you can be sure that you will not forget anything in your rush.

Documents upon discharge from the hospital

When you are discharged from the hospital, you will also receive documents that will need to be provided for 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 do we provide:

• Birth certificate 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 can get SNILS for the baby.
• Exchange card and part of the generic certificate, which is transferred to the local pediatrician.
• Help for antenatal clinic.

What documents need to be provided for work or social protection

When you have received your 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:

• Birth certificate of the child.
• Marriage registration certificate.
• Certificate from the place of work of the other spouse on non-receipt of payment.

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

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 a childcare allowance for a child under 1.5 years old.

To do this, we provide the same documents as for a one-time payment, only in the certificate from the second spouse it should be indicated 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 the 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 is worth calculating everything in advance, you can even take a certificate of income at work to check everything.

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

The childcare allowance for a child under three is now 50 rubles a month.

If your second child has already been born, then you are also entitled to maternity capital, in 2016 this amount is 453,026 rubles.

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

These are the benefits you can get during pregnancy and after childbirth. The amount of payments may change every year, as in some regions there are payments for women who decide to have a child.

Legal perspective on the payment of benefits:

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It would not be an exaggeration to say that being pregnant is a whole science. The expectant mother is often required to have such practical knowledge and skills that she had no idea about before. Our article will help you find the answer to key questions: where to register for pregnancies and for what period. Timely registration for pregnancy will help avoid complications, carry and give birth to a healthy baby.

Where to register for pregnancy?

First of all, the expectant mother needs to register for pregnancy with an obstetrician-gynecologist. Where to register for pregnancy: in an antenatal clinic, a commercial medical center, in a medical center at a maternity hospital - it's up to you. It all depends on your preferences and material capabilities.

You can register for pregnancy free of charge at the antenatal clinic at the place of registration or at the place of actual residence, regardless of registration. To register for pregnancy in the antenatal clinic, you must present your passport and compulsory health insurance policy. The presence of the policy, regardless of the place of issue, allows the patient to present it at any antenatal clinic or maternity hospital, where it must be recognized as valid - this is ensured by a unified system of compulsory health insurance. There are regulations confirming the right to public health care regardless of where you live. In the absence of a policy, you will only receive emergency medical assistance.

It is better to get registered for pregnancy in the antenatal clinic in which you have been observed for several years, so as not to violate the continuity of medical supervision. After all, there is all the data about your health, diagnoses, the results of examinations, treatment, etc. are written down. In the new place, all this is absent, therefore some diseases remain unnoticed. It is also necessary to be guided by the place of observation: it is good if it is convenient to get to the consultation. If it is impossible to combine these two requirements, then in the antenatal clinic, where you were observed earlier, you can take an extract about previous diseases, operations.

It happens that a woman is registered (registered) in one area of \u200b\u200bthe city, but lives in another area. In this case, you can register for pregnancy at the place of residence. As a rule, patients in the antenatal clinic are monitored by an obstetrician-gynecologist assigned to a certain area. But it should be borne in mind that you have the right to choose any obstetrician-gynecologist working in this antenatal clinic. If for one reason or another you do not get along with your doctor, you can change your doctor.

You can also be monitored during pregnancy in commercial medical centers. There are many options here - both the centers themselves and the range of services provided. You choose a center (be sure to find out the reviews of those who have already been observed there), a specialist, a contract, conclude a contract that has legal force. The cost of contracts is different: from 10 to 60 thousand rubles - it all depends on the volume of examinations, doctors' consultations, the duration of pregnancy, etc. You should definitely find out if the medical center in which you are going to be monitored has permission to issue an exchange card, because even the presence licenses for certain types of obstetric health care are not a guarantor of such permission. Meanwhile, an exchange card is a document where the results of all examinations carried out during pregnancy are entered, and it is necessary for admission to a maternity hospital. A woman receives an exchange card after the 28th week of pregnancy. Check if a commercial medical center issues a certificate of incapacity for work for pregnancy and childbirth to its clients (in other words, is it possible to arrange sick leave and maternity leave there). The order of communication with an obstetrician-gynecologist will be based on a scheme similar to a antenatal clinic.

Another option for registration for pregnancy is observation at the medical center at the maternity hospital; its advantage is the ability to conduct pregnancy and childbirth by one obstetrician-gynecologist.

Required documents for registration for pregnancy

The compulsory medical insurance policy is a document that gives the right to receive free medical care in all state medical institutions of the Russian Federation, regardless of the place of issue of the policy and the place of residence of the patient. This right is enshrined in the Federal Law of November 29, 2010 No. 326-FZ "On Compulsory Medical Insurance in the Russian Federation". The scope of services under this policy is provided for by the basic compulsory health insurance program. In the absence of a compulsory medical insurance policy, the patient has the right to receive only emergency medical care.

To register for pregnancy, you must write an application addressed to the head of the antenatal clinic for registration and attach the necessary documents to it.

Women's consultations work on a local basis, that is, a specific area is assigned to each doctor. As a rule, the pregnant woman is attached to the obstetrician-gynecologist, leading the site to which the place of residence of the expectant mother belongs. But, as we have already said, a woman can choose a doctor on her own (with the consent of a doctor), as well as change an obstetrician-gynecologist if there is no mutual understanding with him. The change of the obstetrician-gynecologist leading the pregnancy is made with the consent of the head of the medical institution, in whose name a statement is also written.

Documents of the future mother

• One of the main documents issued to a pregnant woman in an antenatal clinic is an exchange card. It contains basic information about the course of pregnancy, necessary for the implementation of continuity between hospitals. An exchange card is issued at 22–23 weeks of pregnancy. An expectant mother should always have her with her in case of emergency medical attention. At each subsequent visit to the antenatal clinic, you must bring an exchange card with you to record the examination data and research results. If there is no exchange card, the pregnant woman is assisted in the observational department of the maternity hospital, where incompletely examined or infected women are hospitalized.
• A certificate of incapacity for work (prenatal and postnatal leave) is issued by an obstetrician-gynecologist conducting a pregnancy at 30 weeks of pregnancy at a time for 140 calendar days (70 calendar days before delivery and 70 calendar days after delivery). In case of multiple pregnancies, a certificate of incapacity for work is issued at 28 weeks of pregnancy for 194 calendar days (84 calendar days before delivery and 110 calendar days after delivery).
• In addition, in the event of incapacity for work before the start of maternity leave (for example, the threat of termination of pregnancy), the obstetrician-gynecologist of the antenatal clinic also issues sick leave to the expectant mother.

Registration period for pregnancy: the sooner the better?

It is advisable to register with the antenatal clinic from the early stages of pregnancy (up to 12 weeks), immediately after establishing the fact of pregnancy. If you suspect pregnancy, in any case, you should consult an obstetrician-gynecologist, who will establish its term. Also, the doctor will give recommendations on further behavior and explain when it is better to register. The optimal period for registration for pregnancy is 5-6 weeks of pregnancy. Monitoring from the early stages of pregnancy allows the obstetrician-gynecologist to get the most objective and complete picture of a woman's health. If there are any deviations from the normal course of pregnancy, early registration allows them to be diagnosed in a timely manner and provide the necessary medical care.

Tests are now available to diagnose fetal chromosomal abnormalities. And one of them (double test) is carried out exactly at 10-14 weeks of pregnancy. Thus, if you contact at a later date, you may be late with this test. This test is valid only if it is performed at certain periods of pregnancy: double test - at 10-14 weeks, triple test - at 16-20 weeks. They are not performed at a later date. There are several reasons for this.

Firstly, at these dates, if fetal malformations are detected, a relatively safe termination of pregnancy is still possible.

Secondly, it is in the period of 10-14 weeks of pregnancy that the increase in blood biochemical parameters can be correlated with the thickening of the collar space of the fetus, revealed during ultrasound. At a later date, the thickening of the collar space is no longer observed.

Thirdly, it is in the period of 16–20 weeks that the most reliable and pronounced increase in biochemical parameters is noted in case of fetal malformations.

An important role is played by an ultrasound scan of the fetus, performed in the early stages of pregnancy, the optimal period is 5–6 weeks of pregnancy. A woman is referred for an ultrasound scan at the first visit to a medical institution in case of suspicion of pregnancy. This makes it possible to establish the fact of a uterine pregnancy, excluding an ectopic pregnancy, to confirm the presence of a fetal heartbeat, to diagnose multiple pregnancies, increased uterine tone, etc. An important point is to measure body weight at the beginning of pregnancy to assess the overall weight gain over the entire period of waiting for the baby. This increase should not exceed 10-12 kg. An increase in body weight greater than this value is pathological, most often indicates the presence of edema and requires drug correction. If a woman registers for pregnancy at a later date, it is sometimes difficult to assess the weight gain, which means that it is sometimes difficult to determine the further tactics of pregnancy.

In addition, women who are registered in the early stages of pregnancy are issued a certificate at the antenatal clinic, according to which the state pays a lump sum for pregnancy and childbirth.

We register for pregnancy: the first appointment at the antenatal clinic

During the first visit, the obstetrician-gynecologist asks about the state of health of the pregnant woman, asks about previous illnesses and operations, the presence of chronic diseases, the course of previous pregnancies and childbirth, the presence of occupational hazards. In addition, asks questions about the health of the child's father and immediate family.

The next step is an examination on a gynecological chair, which makes it possible to assess the correspondence of the size of the uterus to the expected period of pregnancy, its excitability, as well as the condition of the cervix and its appendages. In addition, during the examination on the chair, the internal dimensions of the pelvis are also assessed. A smear from the vagina on the flora is taken.

At the end of the examination, the obstetrician-gynecologist makes a conclusion about the presence of risk factors and draws up a pregnancy management plan, gives the expectant mother recommendations on the daily regimen and rational nutrition... Vitamins are prescribed, and if necessary, medications. A pregnant woman is given referrals for examinations, which include a general clinical blood test, determination of blood group and Rh factor, blood test for HIV, syphilis, viral hepatitis B and C, biochemical blood test, general clinical urine test. In addition, an ultrasound scan of the fetus is required. The expectant mother also receives referrals to specialists: therapist, otorhinolaryngologist, dentist and ophthalmologist.

A repeat visit is scheduled after 7-10 days with the test results, the conclusion of the therapist and other specialists. Later, in the first half of pregnancy (up to 20 weeks), the expectant mother visits the doctor once a month, after 20 weeks of pregnancy - 2 times a month, after 32 weeks of pregnancy - 3-4 times a month.

There is a standard for medical examinations during pregnancy, which are free of charge. These are general blood tests (blood is taken from a finger), biochemical blood tests (blood is taken from a vein), blood tests for HIV, hepatitis B, syphilis, general urine tests, vaginal smears, ultrasound examinations, consultations with a dentist, ophthalmologist, therapist. In the presence of chronic diseases, the mother may need additional examinations and consultations. If you need to do analyzes that are not included in the standard, then they will have to be paid for. In most medical institutions, it is customary to skip pregnant women out of turn, so correctly indicate to the rest of the patients your position.

Before meeting with an obstetrician-gynecologist, you can make yourself an approximate list of questions that you need to ask so as not to forget anything and discuss all the details that interest you. If the antenatal clinic doctor discovers significant abnormalities during pregnancy, it is always possible to refer the patient for consultation to a larger medical center. For example, if such a consultation is located in the Moscow region, then the patient can be sent for examination to the Moscow Regional Research Institute of Obstetrics and Gynecology.

If a pregnant woman has concomitant chronic diseases or complications of pregnancy, additional specialist consultations and examinations are prescribed. Referral to higher-level obstetric and gynecological centers is possible.

Observation in the antenatal clinic continues until the end of pregnancy, that is, before childbirth.

Registration for pregnancy: commercial medical centers

An alternative to antenatal clinics are commercial medical centers, where pregnancy can also be managed. These facilities usually offer pregnancy management contracts that include all the necessary medical services. The cost of these contracts depends on the volume of services provided. Observation of a pregnant woman by an obstetrician-gynecologist begins from the moment of the conclusion of the contract and takes place, as a rule, up to 36 weeks of pregnancy, after which the pregnant woman continues to be monitored by the doctor leading the birth. When choosing a commercial medical center for the purpose of pregnancy, you should definitely inquire whether this medical institution has permission to issue exchange cards and sick leaves. In other words, will maternity leave be issued in the prescribed manner and an exchange card will be issued. The frequency of visits to the obstetrician-gynecologist and the scope of examination in a commercial medical center will be based on the same principle as in the antenatal clinic.

In paid medical centers, admission and all examinations (including ultrasound) are carried out by appointment. The patient arrives at the appointed time, and this allows you not to waste time waiting in line. Also, an important aspect is round-the-clock communication with the doctor leading the pregnancy. This service is provided in many commercial medical centers. Typically, such institutions have a convenient working schedule, patient reception and testing can be carried out on weekends and holidays, which is convenient for working patients. The terms of the research execution are minimal.

Most commercial medical centers have their own 24-hour or day hospital with a comfortable, cozy atmosphere, single or double wards. Psychologists work in many centers. There are no fundamental differences in the tactics of medical supervision and treatment methods between commercial medical centers and state antenatal clinics, since the standards of care are the same.