Being pregnant is a whole “science”. There are so many different nuances in which it is so easy to get confused or miss something important. For example, registration. Everyone knows that pregnant women need to go to the doctor and register. But when is the best time to do this, opinions differ. After all, some are not going to go to the doctors at all until the end of pregnancy, while others, with the help of a gynecologist, make sure that a little person has settled in their tummy, and there are those who practically “move” to the antenatal clinic for the entire period of pregnancy.
Let's not go from one extreme to another and soberly discuss the issue of registering for pregnancy.
When should you go there for the first time?
Doctors say: the sooner the better. And that's why.
- Since at the very beginning of pregnancy all the important systems and organs of the toddler are formed, the “expectant” needs to be very careful with medications. In addition, it will be very nice if the doctor prescribes her vitamins. He will choose them after studying the tests and the needs of the mother’s body.
- Pregnancy is a burden on the body, and a woman’s immune system “loses its vigilance” at this time, giving chronic diseases a chance to make themselves known loudly. And this is a danger for the child. In this situation, it is better to be under the caring “wing” of medicine.
- According to Russian laws, a working (officially!) woman who registers before 12 weeks receives a special payment.
Most often, a woman sees a delay, buys a pregnancy test, a second one, and when it confidently shows two lines, she goes to confirm her pregnancy with a gynecologist. Depending on her employment, she ends up in the residential complex at 7 or 11 weeks. It is then that she is registered.
There is no need to visit the clinic at an earlier date. Firstly, the doctor will not diagnose you before seven weeks, since not every pregnancy survives at such an early stage (nature works here - if the fetus has a pathology, the body launches a miscarriage program). Secondly, many women themselves do not yet realize that they are pregnant.
Most women start exchanges at 12 weeks.
Which medical institution can I go to?
The easiest and most accessible way is to register at the nearest clinic or antenatal clinic of the residential complex (on a territorial basis).
In this case, you can choose specialists, subject to their consent, independently and be serviced by them (with Part 1 of Article 21 No. 323-FZ of the Russian Federation).
In this case, you can change a doctor only once a year (with the exception of the situation when a change of medical organization and service specialists is made in connection with a move).
At the same time, when deciding where to receive medical care, a woman expecting a child has the right to receive complete and reliable information:
• about the institution itself
• about the services that this organization provides to the population
• about the qualifications of doctors, their work experience, education
• this right is enshrined in law (Part 7, Article 21 No. 323 of the Federal Law of the Russian Federation).
There are advantages to choosing a clinic at your place of residence, close to your home:
• many tests, ultrasounds, consultations and examinations are free. In addition, you will be able to receive some medications for free if prescribed by a doctor.
• It is not necessary to register at your place of registration; you can also register at your actual place of residence. You can choose a consultation closer to home, this will make life easier in the last months of pregnancy
• medical supervision at the place of residence will provide the attending physician with complete information about the state of health, previous problems, diseases, test results, etc.
• in a municipal medical institution you will not have to worry about issuing an exchange card, sick leave, or birth certificate.
It can be noted that many people do not like the fact that in the state free clinic they do not devote too much time to women, sometimes there are queues, but in the state clinics there are very good specialists with many years of experience.
This may not necessarily be a clinic; you can entrust your health and the health of your unborn baby to a private clinic, as well as to a specialist who carries out medical activities individually (Article 15 No. 326-FZ of the Russian Federation).
Where do I need to register?
Our mothers and older sisters went to their district clinic, where a local gynecologist is assigned to your street. Opening your exchange card, sending you for tests, examining, measuring your belly, and in general, guiding you all the way to the maternity hospital is his concern. If you are satisfied with the local doctor, you can go to him (many women do this, especially if the clinic is near their home - it’s inconvenient to travel far with a belly).
However, modern Russian legislation allows you to choose any other clinic or any other doctor. Do you live in the city, but are registered in the village with your mother? City doctors have no right to refuse you. The main thing is to write an application addressed to the manager or chief physician, indicating in it the address of your residence, as well as the insurance policy number. Paid (private) clinics, medical centers and maternity hospitals are also at your service, where they are also registered.
If you have moved or you simply did not like the clinic where you immediately registered, you can change it. But don't forget to ask your former gynecologist for a transcript.
An important point: having chosen a paid clinic, immediately ask whether they will give you an exchange, as well as maternity leave.
Where to be monitored during pregnancy?
Can you go to any antenatal clinic, or do you need the one you are assigned to at your place of registration? According to Russian legislation and the order of the Ministry of Health, a pregnant woman has the right to be observed free of charge in any antenatal clinic located in any locality in our country, regardless of her residence permit (registration), citizenship and compulsory medical insurance policy.
You have four options at your disposal. Two main ones: antenatal clinic at the place of residence or at registration. And two more: a paid clinic or a more conveniently located antenatal clinic (you will need to unlink from the consultation at your place of registration).
Think about which option would be best for you: read reviews, ask friends who are pregnant or have recently given birth. And don’t forget to consider the territorial factor: the path to the doctor should not be long and inconvenient, because in the later stages long walks can become difficult.
You may want to be observed in a paid clinic. It's no secret that more comfortable conditions have been created here for a pregnant woman. As a rule, there are no queues; all examinations are carried out in one place. The only, but significant, disadvantage of paid clinics is the high cost of service. If you choose paid pregnancy care, do not forget to make sure that the clinic has the appropriate license.
For your first visit to the doctor, take with you your Russian passport and compulsory health insurance policy.
How to prepare for registration?
- Find documents: passport, as well as medical insurance policy (without it, medical support is impossible, only calling an ambulance). Don’t worry if your passport doesn’t have a residence permit – since 2010 they haven’t looked at it.
- You will be examined in a chair, so it will be better to buy a disposable examination kit (check if it comes with gloves - if not, buy more).
- A pen and notepad will also come in handy - here you will write down the names of the doctor and nurse, their phone number.
- When you first fill out your medical card, you will be asked about past illnesses, abortions, and illnesses of your relatives. Well, you can know everything about your grandparents, but about your husband’s relatives, ask your loved one or his mother in advance. In addition, your weight, height, blood pressure will be included in the card.
Other data that will be entered on your card:
- How your past pregnancies proceeded (if any), with all the details.
- Do you have children, how did you give birth, what was their height and weight, are they sick?
- Your entire medical history: chronic diseases, bad habits, have you had toxoplasmosis, rubella, herpes, sexually transmitted diseases, have you visited a psychiatrist.
- Features of your monthly cycle, what contraception you use.
- All information about your husband: how old is he, do you know his blood type and Rh, are there any bad habits, hereditary diseases.
- In the case of relatives (yours and your husband’s), the doctor will be interested in whether any of them had tuberculosis, diabetes, hypertension, cancer, or genetic diseases.
During the examination, the doctor will tell you about the condition of the cervix and vagina, measure the width of the pelvis, and take a smear of microflora. He can tell whether you are definitely pregnant, and if so, how far along you are now. He may also examine your breasts (evaluating the mammary glands), measure your pulse and blood pressure, and assess the condition of your eyes and skin, as well as your lungs and heart.
At the end, he will tell you when you should visit the residential complex for your next appointment.
What happens if a pregnant woman does not register?
In some situations, it happens that a pregnant woman herself refuses to register with a medical institution and goes to the doctor before giving birth. The entire period of gestation can be stable and without complications, and the child will be born completely healthy. However, if problems arise that can lead to fetal development disorders or miscarriage, no one will help the expectant mother. Such a neglectful attitude towards the unborn child and one’s own health can lead to extremely undesirable consequences.
The state does not impose any penalties for refusal to register. In this case, the woman punishes herself by losing professional support, diagnosis and treatment. Even if a pregnant woman is in excellent health and has already undergone more than one birth, it is still advisable for her to undergo all the necessary examinations and tests. It is difficult to predict how the entire pregnancy will unfold. If conception has been confirmed, but placement in the LCD is complicated by a long trip or some other reason, you can make an appointment with the doctor a little later.
There is no exact deadline for registering at the antenatal clinic. All pregnant women independently decide in what week they should seek support from a medical institution. For short periods of time, the obstetrician-gynecologist may even refuse the application and schedule a second consultation after 2-3 weeks. To avoid problems and misunderstandings, it is recommended to register during the 1st trimester of pregnancy, because routine examinations, examinations and tests are prescribed during this period.
And what will happen next?
All pregnant women are referred to other specialists, as well as to the laboratory. They need to go through and pass:
- stool and urine analysis (general),
- urine for bacterial culture,
- blood from a finger (general analysis),
- blood from a vein (for biochemistry, blood type and Rh factor),
- blood for syphilis, HIV, hepatitis,
- blood sugar, clotting,
- vaginal smear for TORCH infections, as well as microflora,
- the office of a therapist, ENT specialist, endocrinologist, ophthalmologist and dentist (be sure to visit them - with a baby in your arms it will be very problematic for you to treat your teeth),
- ECG and ultrasound.
In government hospitals, all these tests and examinations should be provided to you free of charge.
Sometimes doctors may refer you for additional tests or to more specialized doctors.
As a rule, you will be sent to the laboratory after your first visit to the gynecologist, and on your second visit (in a week or two) you will come to him with ready-made tests. After looking at them, the gynecologist can prescribe vitamins and/or medications that are safe for your situation. However, there is a list of drugs that are prescribed to almost all pregnant women. These are: folic acid, multivitamins, iodine, calcium preparations (especially if the dentist notices you have problems with your teeth).
If your pregnancy is going as expected, the gynecologist will wait for you once a month, and the dentist and therapist – once every three months. Closer to childbirth (from 36 weeks), you should visit the gynecologist more often - every seven days, until the birth.
In general, registration is becoming more and more convenient for “waiting” people from year to year. Of course, some expectant mothers find it inconvenient to take time off from work several times a month to visit a gynecologist-dentist-therapist... But let your bosses understand your position - you are now pregnant, which means they have no right to refuse you... And in the end, very soon you're on maternity leave, so don't think about your career, but about your baby, for whose health timely tests are very important. So take care of yourself and everything will be fine!
How to get maternity leave?
The specialist issues the patient a certificate confirming her incapacity for work. It is completed by the doctor who conducted the examination or by an obstetrician-gynecologist. The following deadlines exist for this:
- stable course of gestation - from 30 weeks. The duration of maternity leave is 140 days - 70 days before childbirth and 70 after;
- multiple pregnancy - from 28 weeks, leave is granted for 180 days.
In case of complications, the validity period of the certificate of incapacity for work is increased by 16 days. In this case, its duration will be 156 days.
