The pregnancy test was positive. When the first emotions subsided, the question arises of what to do next - how and when to go to the doctor and get registered at the dispensary, should it be done in the early stages? Among women, there is an opinion that it is not worth getting up early for registration - they will torture you with analyzes. But this position is irresponsible, because unnecessary tests will not be prescribed if the woman is healthy and everything is proceeding normally.
Terms of production
Helping expectant mothers during the period of bearing crumbs is regulated by a special order of the Ministry of Health of November 1, 2012, number 572n (with amendments). This document lists all situations that may arise in the course of interaction between doctors and expectant mothers, but the exact dates of registration are not indicated.
It is believed that early registration should be considered a consultation and admission of a woman for dispensary observation up to 12 weeks. In fact, a woman can come to a consultation later, she will not be denied registration, but the consequences of a late appearance can be catastrophic. Let's see why.
The first trimester of pregnancy, which lasts from the very beginning and up to 13 weeks inclusive, is the most responsible in a child's life - there is a process of laying and forming its internal organs and systems. After that, during the two remaining trimesters, the baby only grows and gains weight, everything that was formed in the early stages is only being improved.
Anything can affect the formation of a baby - from genetic factors to chronic diseases of the mother. Therefore, the task of doctors is to identify possible risks for a woman and her fetus as early as possible. This does not mean that you will start to be intimidated and nervous. Just assessment of the viability of the fetus, the correctness of its development and the prospects for pregnancy as a whole is most accurate when it is drawn up precisely in the first trimester.
The tests that the expectant mother will hand over at an early stage are of great diagnostic value. And at 11-13 weeks, the first prenatal screening is carried out, which is the most informative in determining the risks of genetic abnormalities in a child - Down syndrome, Patau, Turner syndrome, etc. The pregnant woman must be properly prepared for screening and preliminarily examined (general tests).
If the results are disappointing, the timing will allow the woman to have an abortion for medical reasons... Otherwise, she may not find out that she is carrying a sick child until a long time, when a minimally traumatic abortion will be impossible, or even learn about the child's illness after his birth, that is, face a terrible fact.
That is why you should not postpone the visit to the doctor until later. Do this earlier, but keep in mind that you will not be registered if the doctor does not receive confirmation of your "interesting position." therefore it is best to go to the antenatal clinic at 6-7 weeks of pregnancy (that is, 4-5 weeks after the onset of the missed period). At this time, the doctor will be able to determine pregnancy with a vaginal gynecological examination without any problems, confirm it according to the results of an ultrasound scan, and there will still be a lot of time before the screening in order to have time to do all the necessary tests.
There are situations when it is better to register earlier. If you have had miscarriages before, if pregnancy occurred as a result of IVF, if an ultrasound scan showed that you have twins, and if your mother has any chronic diseases, it is better to go to the doctor 10-14 days after the start of the delay.
It is already possible to determine pregnancy at this time by ultrasound and in most cases with a vaginal examination, and therefore it is better to be safe.
The first 9-10 weeks of pregnancy are considered the most critical for the baby. They completely determine whether he will be healthy, whether he will be alive, whether it will be possible to save the child at all... Don't worry that your doctor won't register you so early. If the pregnancy can be confirmed, registration is your right and it is the doctor's responsibility to ensure that your right is exercised. All other options for medical actions (“go and think about whether you need a child and come in a week”, “let's arrange you later, in a month,” etc.) are illegal, and you have the right to demand compliance with the order of the Ministry of Health or contact the prosecutor's office with a statement of violation of your legal rights.
Most expectant mothers in Russia are registered, according to statistics, at 6-8 weeks of pregnancy, about a third come to the doctor with a request to register them at 9-10 weeks, after 15-16 weeks only 1.5% of women apply.
How does this happen?
A woman should make an appointment with an obstetrician-gynecologist for a consultation, visit a doctor at the appointed time with a passport, compulsory health insurance policy and SNILS. After the examination, the doctor will confirm the fact of an "interesting situation" and will start a special card of the pregnant woman and the woman in labor in the name of the woman, which will remain with the doctors in consultation. You will be given a small medical card - an exchange one. In it from the big one will write out the main test results, ultrasound data, screening results, as well as weight, weight gain and some other important parameters. When the time comes, you will go to the maternity hospital with this small exchange card.
When they are registered, certain tests and studies are prescribed. The woman receives referrals for them along with an exchange card right on the day of contacting an obstetrician-gynecologist. Over the next couple of weeks, she can slowly go and pass everything she needs:
- general and biochemical blood tests;
- coagulogram - analysis for blood clotting factors and determination of hemostasis;
- analysis for blood group and Rh (if a woman has a negative Rh, her husband or the biological father of the child needs to pass the same test in order to assess the likelihood of a Rh conflict);
- blood for HIV status, syphilis, hepatitis B and C;
- blood for infectious diseases (TORCH);
- general urine analysis;
- a smear from the vagina.
Additionally, the doctor may ask to bring certificates from a therapist, cardiologist, dentist, ophthalmologist and ENT specialist, as well as fluorography data taken no later than a year ago.
Common questions about the rights of pregnant women
Despite the seeming simplicity of the registration process, women have a lot of questions, because not every obstetrician-gynecologist in Russia exactly observes the order of the Ministry of Health (and if in secret - not everyone read it!). Therefore, let's look at the main points so as not to be offended.
Choosing a antenatal clinic
The presence of a compulsory medical insurance policy gives a woman the right to independently choose a consultation that completely suits her. If a lady is registered in Orenburg, but lives in Moscow or vice versa, you do not need to go to the city of registration to register. It is enough to provide the address of your actual residence in the consultation. Nobody has the right to deny you registration not by registration: they are registered at the place of actual residence.
If the consultation at the place of residence is not well known and you do not want to go there, choose any other one, to which it will be convenient for you to get to the doctor for examinations, print out Article 5 of Federal Law No. 323-FZ and go to the chosen place... The printout can be useful if you are denied an installation, citing that you have nothing to do with the consultation at your place of residence. This article says that help should be provided to you regardless of where you live.
If there is no policy, you need to get it. Working ladies go to their place of work or to an insurance company, non-working ladies go directly to an insurance company. Now it is possible to get a policy when contacting the MFC.
If the doctor does not register
By law, a woman has the right to be registered from the first appearance. If the doctor, under any pretext, refuses this, go to the head of the consultation, if there is no understanding there, then you can fill out an electronic appeal to the prosecutor's office.
Do you pay benefits for registering early?
The allowance is a one-time benefit, it will be received by those who register before 12 weeks of pregnancy. In 2018, its size was 648, 47 kopecks. It is paid at work or in social agencies, if a woman does not work, within 10 days from the date of provision of a certificate from the consultation on early registration.
Why do I need an exchange card?
The presence of "exchange" is necessary for the birth to take place in the maternity hospital or perinatal center that you choose yourself. This is a medical document in which all the examinations carried out by the pregnant woman will be entered. Without an exchange card, there is a chance by ambulance to get only to the maternity hospital on duty, and only to the infectious (observational) department, where women with infections go, as well as unexamined (just your case).
All analyzes that will be prescribed upon registration should be exclusively free of charge. The doctor's attempts to redirect you to a paid center for additional examinations are illegal.
Dispensary registration - cooperation or bondage?
A woman should understand that the recommendations of a doctor during dispensary observation are given for her own good, but no one has the right to force her to fulfill them by force. A woman has the legal right to refuse the prescribed medication, examination, and analysis at any time. The doctor has the right only to explain to the pregnant woman the possible consequences of her refusal.
As for other subtleties of the relationship during dispensary observation in a consultation, a woman should know that she has the right to herself and completely free of charge:
- choose a doctor who will observe her;
- choose a maternity hospital in which childbirth will take place;
- receive advice from any specialist doctors, if necessary;
- count on keeping her personal data confidential;
- refuse any medical intervention;
- require measures to reduce pain;
- admission to the maternity hospital of a lawyer, a trustee, as well as a spouse.
Also, partner childbirth is now relieved of the synonym "paid service", they should be carried out free of charge under the compulsory medical insurance policy, if a woman insists on the presence of a partner.
The doctor says nothing
This is a direct violation of information rights. A pregnant woman has every right to know what the tests showed and how to understand it, what the ultrasound shows and what causes it, ask any questions to the doctors and receive comprehensive, detailed, understandable answers to them.
Also, a woman has the right not to receive information from a doctor if, for some reason, she does not want to know it (for example, about the sex of the unborn child). It is enough to refuse to provide such information when registering.
Now you are “savvy” and ready to go to the doctor. We hope that this information will help you register, carry out and give birth to a healthy baby without any problems.
