When do they give a referral to the maternity hospital? Referral to the maternity hospital When should a referral to the maternity hospital be given.

Not all expectant mothers know when and how to choose the right maternity hospital.

IN Soviet times our parents went to the medical facility closest to home. Modern medicine gives pregnant women the right to choose any maternity hospital depending on their requirements and taste preferences. A woman is not limited in her choice; she just needs to fulfill several conditions.

Is it possible to choose a maternity hospital yourself?

On recent months Pregnant woman is puzzled by the question of whether the ambulance will take her to the chosen maternity hospital.

Many expectant parents make arrangements with the doctor in advance while the pregnant woman is registered. It is considered normal practice to first meet with your doctor and obstetrician 1-2 months before the expected date of birth.

During such a period of time, you can have time to meet with the doctor several times, he will be able to carefully look at the medical (exchange) card and find out about possible complications. In this case, you will be able to establish contact with a professional doctor.

On your first visit to the maternity hospital to the expectant mother Often it is proposed to conclude a contract on a paid basis, and they begin to introduce her to the list of additional services. They require comfortable living conditions, necessary medications and attentive attitude of workers. So, you will be able to choose a separate room and stay in it with your husband, mother and other close relatives.

In the process of getting to know a doctor, it is strongly recommended to take his phone number and also clarify the possibility of calling at any time of the day if necessary. Such an agreement implies a monetary reward.

It is important to understand that even paid childbirth does not guarantee its easy resolution. Often, on a paid basis, the conditions for the expectant mother in the maternity hospital are improved.

If you are unable to pay for childbirth, you can use a birth certificate, which allows a mentally vulnerable woman to be confident in the future and not worry about the upcoming event.

In 2006 it was adopted government program, which allows pregnant women to choose a consultation and maternity hospital. Its action has significantly improved the medical care of the population.

At the same time, young mothers and their children are provided with high-quality medicines completely free of charge. Having a birth certificate greatly simplifies financially the management of pregnancy, childbirth and further monitoring of children by pediatricians in the first year of their life. It allows a woman to choose in which maternity hospital she would like to give birth to her baby. The expectant mother has the right to come to any medical institution and declare her desire to become its patient.

When is it impossible to choose a maternity hospital on your own?

Today, there are a number of cases that do not allow a woman in labor to choose a maternity hospital according to her wishes.

The first reason is the lack of a birth certificate when contractions begin. In this case, the ambulance will take the woman to the nearest facility. The occurrence of such a situation sometimes leads to the most unfavorable consequences in the form of a lack of urgent qualified assistance from medical workers and the necessary equipment.
Secondly, all maternity hospitals are forced to close one or more times a year for sanitary treatment. Therefore, when the day of birth coincides with this procedure, the expectant mother will not be able to get to the selected clinic.
Many maternity hospitals specialize in providing certain types help. If complications arise during pregnancy, it would be advisable to contact an institution that meets the necessary requirements. Not all clinics are equipped with everything necessary to attend childbirth for women suffering from diabetes mellitus, problems with the cardiovascular system and so on.

The essence and purpose of the birth certificate

The state program “Health” organizes competition between medical institutions that strive to provide comprehensive care to a large number of pregnant women. At the same time, it is possible to improve the quality of medical services provided in all clinics.

Registration of a birth certificate helps stimulate the desire of all health care institutions to provide assistance in gynecology, obstetrics and pediatrics. Hospitals are becoming interested in equipping with certified medicines, as well as modern equipment.

To issue a certificate, you must complete the following steps:

register (in the 1st trimester) at the antenatal clinic;
Regular visits to the clinic (for at least 12 weeks);
monthly visit to the pediatrician with an infant.

Who can issue a birth certificate:

All citizens of the Russian Federation, regardless of age, official employment or registration.
Women with any fetal condition, with or without a legal spouse.
Citizens of other countries with a temporary residence permit or residence permit also have the right to obtain a certificate.

The need to obtain a birth certificate

A birth certificate is a kind of financial incentive for modern clinics, maternity hospitals and antenatal clinics, which provide the population with high-quality medical care on favorable terms. They receive cash payments of a set amount from a special fund (FSS), ensuring interest in each expectant mother, as well as her baby.

According to the birth certificate, a woman chooses a maternity hospital for herself, taking into account the characteristics of the course of pregnancy. The presumable nature of the birth (complicated or uncomplicated) is also taken into account. When choosing a maternity hospital, it is strongly recommended to take into account the territorial criterion (the nearest place where contractions began).

You can receive a birth certificate absolutely free of charge at 28-30 weeks of pregnancy at a consultation or at an obstetric center where the expectant mother is registered. The document allows you to choose the best medical institution.

You will need to obtain a birth certificate to select:

consultations for pregnancy monitoring;
maternity hospital;
children's clinic for patronage monitoring of your child up to 1 year.

Having a certificate in hand, a woman has the right to contact any maternity hospital she likes (with an exchange card) and agree on the upcoming birth. The manager is required to sign the card, so on the expected day of birth, the expectant mother can come to the selected hospital. When contractions occur at home, emergency doctors will take the woman in labor there.

It is impossible to sell or cash out the certificate; it is not financial assistance. The main purpose of the document is to pay for medical services in government institutions. The certificate will not be accepted by commercial private clinics.

Is an ambulance required to take you to the maternity hospital and admission without a certificate?

A birth certificate protects a pregnant woman from the provision of poor-quality and hazardous medical services. She has the right to choose any antenatal clinic (maternity hospital), even if the medical institution is located in another city or region of our country. The issuance of the document helps women receive comprehensive support during pregnancy and early after childbirth.

Even in the absence of a certificate, a pregnant woman will not be denied medical care. She will be able to go to the maternity hospital only at her place of residence. The document gives the right to choose any maternity hospital, regardless of registration. Moreover, in the hospital itself, if a woman has all necessary documents They will help her obtain a certificate on the spot. If a document is lost, it can be easily restored. The antenatal clinic will be interested in the efficiency of this process, since based on it, the institution’s bank account receives cash for the services provided.

Modern maternity hospitals are divided into 3 types:

the predominance of uncomplicated births (up to 500 babies are born per year), they do not provide for a 24-hour presence of an obstetrician;
birth of up to 1,500 children per year (the department has intensive care and intensive care units);
regional and federal institutions providing assistance during pregnancy and postpartum period(often there is a pathology department).

Depending on the characteristics of bearing a child, the gynecologist issues a referral to a maternity hospital in one of the above categories. With such documents, you can go to the selected hospital during contractions. In case of post-term pregnancy (from 40 weeks), you can be admitted to a hospital in such an institution until you wait for the onset of labor.

How to choose a maternity hospital?

Which maternity hospital is better to choose? This question puzzles many women in labor starting from the first trimester of pregnancy. Expectant parents often visit several institutions, learn about the conditions offered, communicate with doctors and choose the best option. It is important that an agreement is concluded between the pregnant woman and the maternity hospital. The attending physician makes appropriate notes in the pregnancy chart. Only in this case, when the water breaks or contractions begin, can you require the ambulance to take the woman to the maternity hospital of her choice.

To understand how to choose the right maternity hospital, you need to study its following criteria:

proximity of the institution to home;
living conditions (availability of a separate shower, cleanliness, sterility, etc.);
availability of good medical equipment;
qualifications and experience of personnel;
the possibility of partner (joint) childbirth;
24-hour stay with the baby.

When choosing a maternity hospital, it is necessary to study the attitude of all staff towards natural childbirth.

Domestic medical institutions focus mainly on natural childbirth. In this case, planned caesarean section is used exclusively according to indications.

Sometimes emergency situations occur when weak labor occurs when the water breaks. In this case, additional stimulation cannot be avoided, and the life of the newly born person will depend on the highly qualified personnel and the availability of modern medical equipment. After a successful birth, it is advisable for the mother and newborn to be cared for by experienced gynecologists, neonatologists and polite medical personnel.

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Legislative side of the issue

They began to be issued to women who registered for pregnancy. This innovation was a qualitative improvement in the medical care provided to women during pregnancy and childbirth. This program increases the financial interest of healthcare institutions. This issue is regulated by the Order of the Ministry of Health and Social Development of the Russian Federation dated November 28, 2005.

Having learned about pregnancy, a woman must register with the antenatal clinic at her place of residence before 12 weeks. During the entire obstetric period, the expectant mother visits her doctor regularly twice a month, a total of 10 times. Such regular appointments and examinations, ordering tests and observations ensure timely diagnosis of complications and identification of dangerous pathologies.

According to this document, a pregnant woman is given the right to choose a supervising doctor, a antenatal clinic for registration, in addition there is a possibility choose a maternity hospital where the baby is to be born. The doctor cannot refuse the patient. However, this practice is rarely used by women in labor, since most of them have either entered into a contract with a specific institution in advance, or do not consider it necessary to fuss about this and go to the nearest free maternity hospital already with contractions.

But for such an important event as the birth of a new person, it is necessary to prepare well, choose personnel and a place for the birth, especially if the state bears the costs. The fact is that it itself consists of several parts, tear-off coupons, each of which has a specific purpose. One pays for the observation of a woman during pregnancy and the provision of medical services to her at this stage in the amount of 3,000 rubles. The state also transfers 6,000 rubles to the maternity hospital in the event of a successful birth for each patient. Additionally, funding for dispensary observation of a child during the first year of life was introduced in the amount of 1,000 rubles for each newborn.

Procedure

Usually, the treating gynecologist, along with the birth certificate, issues a referral to the maternity hospital chosen by the woman.

However, the fact is that this choice is limited territorial framework, more precisely, the administrative-territorial division of municipalities and affiliation with a specific department.

All maternity hospitals in the country divided into three categories:

The condition of the pregnant woman and the peculiarities of the course of the entire period decide which category of institutions the attending physician from the Women's Consultation Center will refer her to. Based on the results of the decision direction will be issued, you can go with him to childbirth already with contractions. Or you can go to the chosen maternity hospital to maintain the pregnancy when the appointed period has already approached, that is, exceeded 40 weeks. A woman in labor has the right to choose, taking into account the testimony of the gynecologist and existing pregnancy pathologies, a specialized or regular maternity hospital.

Many people are used to and love everything in life to go according to plan, and expectant mothers are no exception. However, is it possible to know the exact date of birth? No one knows this; a gynecologist can only guess from the parameters of the fetus and the last menstruation when exactly the baby will be born. Of course, it is better if the expectant mother is already in the maternity hospital when contractions begin, because childbirth can be rapid and complicated. How do you know exactly when to go to the hospital if there are no contractions? For this purpose, the expectant mother is given a special referral to the maternity hospital.

What is a referral to a maternity hospital?

A referral to a maternity hospital is a document that is handed to the expectant mother by the local doctor at the antenatal clinic at 38-39 weeks of pregnancy. The validity period of this document is 10 days and if for some reason the expectant mother does not appear at the emergency department of the maternity hospital during this period, then the referral will have to be taken again from the local doctor.

You should not neglect the referral to the maternity hospital and procrastinate until the last minute. Most women, having received a referral from a gynecologist, are in no hurry to go to the maternity hospital and stay at home until contractions begin, after which they call ambulance and are worried about getting to the nearest maternity hospital in time. The situation in this case is also complicated by traffic jams and the fact that the pre-selected maternity hospital may suddenly close for cleaning. That is why it is very important to receive a referral to the maternity hospital on time and know that they will be waiting for you there within the specified period of time.

How to get it?

In order to receive a referral to the maternity hospital, the expectant mother must regularly attend the antenatal clinic and register with the doctor on time. The doctor observing the pregnancy, closer to the expected due date, issues the expectant mother a birth certificate, and with it a referral to the maternity hospital. It is better to choose the institution where you would like to give birth in advance and tell your local doctor about this, however, in most cases, a referral is issued to the maternity hospital that is closest to your place of residence.

Is it necessary?

Perhaps every expectant mother wonders, is it really necessary to get a referral to the maternity hospital? After all, you can just come with contractions and the doctors will deliver the baby anyway. It is best to have such a document in hand, because, as mentioned above, maternity hospitals in big cities are often closed for cleaning and then the woman in labor will simply not be accepted, but will be sent to another hospital. So it’s worth thinking about whether the expectant mother needs such an “adventure”, because in such cases, babies are often born right in an ambulance.

Hello, can I have an operation to remove the fallopian tubes under your compulsory medical insurance policy for free, without having a Moscow registration!

Answer from GKB 29:

Hello, Natalya! Thank you for your request. Yes, it's possible. You need to get a referral from the clinic you are assigned to.

Hello, today we attended a training course on pregnancy planning for diabetes. I liked everything very much, the only time that is not convenient for everyone is 13-00 during the week, as everyone is working. Perhaps the next lesson should be scheduled earlier or in the evening. We will be very grateful, many in the group agree.

Answer from GKB 29:

Hello! Thank you for your feedback. We will take into account your wishes.

Hello, please tell me, I live in the Southern Administrative District, can I ask you to give me a certificate for your maternity hospital and give birth at your place? Thank you!

Answer from GKB 29:

Hello! You can choose the medical institution that you want.

Hello, what is the schedule for visiting patients at the ENT department?

Answer from GKB 29:

Hello! Visiting patients: Working days: from 17:00 to 19:00 Weekends and holidays: from 11:00 to 13:00 and from 16:00 to 19:00 Conversation with doctors: from 13:00 to 14:00

Hello! Tell me if it's possible natural childbirth in this situation and who you can consult: after laparoscopy in 2007. (removal of fibroids measuring 3.0 cm) there is a scar along the front wall. Now the IVF pregnancy is 30 weeks (progressing well). Age 42 years. Thanks in advance for your answer. Best regards, Natalya.

Sometimes you get the impression that, in the modern local understanding, giving birth is like serving in the army. Those who have not been there will not understand)) But regarding childbirth, we are talking more about childbirth in a maternity hospital. And the referral that the gynecologist, often in a categorical form, issues to the maternity hospital is tantamount to a summons to the military registration and enlistment office. Tremble, women, and show up with your belongings at the recruiting station in the reception room exactly with the directions issued. And if you don’t show up, that’s it...

You will be deprived (of the very same basic value that is given for “timely” registration and, attention, compliance with the recommendations of the local doctor). Not a bad way to manipulate a pregnant woman, it’s sad to realize it.

These are all jokes, but, seriously, there are quite a lot of threats to deprive of benefits (without specifying that the gynecologist can “punish” a woman by depriving her of just this one small benefit) and I regularly hear about them from pregnant women. A reason to hint that you may not receive this benefit may even be irregular tests. And this happens, unfortunately.

Another funny or unfunny thing: one pregnant woman (out of 3 residential complexes), who refused planned hospitalization (the woman’s health was ok, but “according to plan”), was told by the gynecologist to come to the next appointment with... her mother. To what? So that her mother is at home, she has long since reached adulthood and married woman, scolded? Don't know.

Pregnant women often ask, what will happen if I refuse a planned referral to the maternity hospital at 40 weeks?

Nothing will happen, that's your right.

In the same way, you can refuse hospitalization if you mixed up training contractions with real ones and arrived in. A day or two passed, there was no birth, no reason to worry about your health, you got bored and wanted to go home, but the doctor who is in charge of your ward said that no, they won’t let you out? Intimidating - you can easily write a refusal to further hospitalization and go home.

Forced hospitalization in our country only for mentally ill people who pose a threat to themselves or others. If you are not chasing your loved ones with an ax and are not trying to go out the window, no one will forcibly admit you to the hospital.

Legal side of the issue

Now in some consultations, doctors allow pregnant women to sign a document of consent/refusal from hospitalization in a maternity hospital, which cites the laws of the Republic of Belarus on the right of citizens to free medical care, on the rights of a child to medical care and Presidential Decree No. 18, which they like to use to scare parents :) At the same time, the gynecological service forgets, as it were, to mention the Law of the Republic of Belarus “On Health Care” dated June 18, 1993, Articles 44 (Conditions for the provision of medical care to the patient) and 45 (Refusal of the patient to provide medical care, including medical intervention).

Those. on the one hand, I really like the tendency of antenatal clinics to increase the legal literacy of expectant mothers. A reminder that responsibility for a healthy pregnancy and childbirth lies with the woman herself, and medicine is only help where this help is needed, where there is a health problem. But I don’t like that this awareness is one-sided and looks like intimidation of women. How long can you manipulate and intimidate pregnant women? I would like human ways to communicate :)

It is clear that closer to childbirth, the cerebral cortex of any, even the most educated and self-confident woman, physiologically begins to slow down - this is the body’s preparation for childbirth. And so we become very sentimental, moody and gullible. And doctors are people who are unconsciously associated with the parental position, people whom you want to trust, and in general, hope for their professionalism.

But what kind of trust and professionalism are we talking about if every “extra” day after a baby’s birth becomes a “post-maturity” and a threat to the child? Childbirth between 38 weeks and 42 weeks (!). No one calls birth at 38 weeks premature. And 40 weeks is the EXPECTED date of birth, the arithmetic average, so to speak.

How many of us have heard from doctors in a residential complex or maternity hospital the phrase “think about the child” as the last argument about deciding on planned hospitalization, induction of labor (artificial induction of labor), an oxytocin drip, etc.?

When do they give a referral to the maternity hospital? Referral to the maternity hospital When should a referral to the maternity hospital be given.