What good doctors are there in the antenatal clinic? Maternity clinic or private clinic? About the causes of women's health problems

If you are still in doubt, this short analysis of the pros and cons of both options will help you make a decision faster.

Having learned about her pregnancy, the expectant mother is faced with a choice: where exactly to be observed, at the district antenatal clinic or paid clinic? Of course, if she is able to pay for the contract for pregnancy management, otherwise such a question will not arise. So where is better?

Your choice is a paid doctor if...

1. First pregnancy. You shouldn’t expect anything from LC doctors individual approach, special courtesy or tenderness that inexperienced expectant mothers so need. Some of the gynecologists are capable of empty space bring the patient to tears or seriously frighten the patient.
2. Pregnancy occurs with complications. In a huge flow of pregnant women, the doctor may not be able to track the pathology or simply not prescribe consultations. additional tests and examinations.
3. You are anxious by nature. In this case, you probably won’t have enough of the required three ultrasounds over the entire 9 months and will want to communicate with your doctor more often. Fortunately, gynecologists from paid clinics usually give their Cell phones in case of any questions, and some even do an ultrasound themselves during each appointment - if necessary.
4. You have a weakened immune system or are afraid of getting sick. In private clinics, in principle, there are fewer patients than in free ones, so the risk of contact with patients is lower. In addition, you don’t have to sit in line for hours - everything here is clear by appointment and time.
5. You don't like changing doctors. Paid gynecologist He will definitely notify you about vacation or illness, reschedule your appointment, and in case of any problems, he will see you at almost any time. The same cannot be said about a doctor from a antenatal clinic: before your next visit, you may be surprised to find out that a completely different doctor will see you.
6. You are working. Moreover, in a responsible position, it is almost impossible to go to the doctor at any time except during lunch break. In this case, an antenatal clinic is not suitable for you, where you cannot make an appointment for a convenient time even a couple of weeks in advance, and you can only take tests on the appointed day at 8:30 in the morning. In paid clinics it is easier to get an appointment at a certain hour. In addition, many private medical centers and laboratories are open even on Saturdays.

Your choice is a doctor from the antenatal clinic if...

The best gynecologists in Moscow, their ratings, you will find on this page and you can make an appointment online! A gynecologist is considered a “women’s doctor.” No lady can do without this specialist. A gynecologist should become a true friend so that he can be entrusted with the most intimate secrets, which sometimes it is impossible to tell either relatives or friends. Experience, personal qualities, popularity among patients are the components the best gynecologists, their rating is high, and it is not always possible to “get through” to such a doctor.

The competence of gynecology includes:

• prevention of gynecological diseases;
• treatment of problems associated with the female genital area;
• assistance in conception or in preventing pregnancy;
• explanation of the functioning of the body, their connection with other areas of a woman’s health.

A gynecologist must be sensitive, attentive, and professional. His attitude, competence, knowledge not only in the field of reproductive and related fields form the basis of the recommendation.

Many people ask their friends: “Where can I find something like this? Do not consult a gynecologist with high rating? How to find". The answer is simple. On the portal where the best doctors in Moscow are presented.

Knowing firsthand that a “female doctor” is worth his weight in gold, we have compiled a portfolio of the most competent medical workers. Anyone interested can find information about the place of work and office hours.

If you are interested in a good gynecologist, the price of services varies depending on:

1. Qualifications.
2. Experience.
3. Experience in handling the most complex cases.

Consultation costs start from 1000 rubles!

The best obstetrician-gynecologist is always nearby

As for the management of pregnancy and childbirth, you need to be especially careful when choosing a doctor. The management of pregnancy, successful childbirth, the health of the mother and the unborn baby depend on his professionalism.

It is advisable to find it before giving birth the best gynecologist, who can be contacted at any time. He will become a personal doctor, one who will observe, advise, and carry out research procedures in a timely manner.

From visits to such a doctor, only good memories will remain, and not fears and fear of failure. Pregnancy is one of the best moments in a woman's life. More than half of her future depends on how confident she is in herself and in the doctor.

Among other things, below you can sort the best gynecologists in Moscow by:

• rating;
• length of service;
• cost;
• Possibility of home visits.

Obstetrician-gynecologist, ultrasound diagnostics doctor at the Mother and Child clinic South-West. Published in the magazine Rody.ru No. 2-2017.

Where is the average expectant mother seen? At the antenatal clinic at your place of residence. And here she often immediately becomes somewhat dependent on this medical institution: she is assigned to a doctor according to her place of residence, she has to go to appointments frequently, and all the time she has to take a bunch of tests and undergo various examinations. Moreover, all this must be done within a certain time frame specified by the doctor, and God forbid you miss any of the appointments or consultations! Yes, examinations during pregnancy are necessary, but you also need to remember about your comfort and your rights. Let's talk about what the expectant mother has the right to in the antenatal clinic.

WATCH ANYWHERE

According to the law Russian Federation A pregnant woman can choose any antenatal clinic (GC), and not just the one to which she is assigned at the place of registration. This means that you can live in one area of ​​the city, and be observed in a completely different one: for example, near your place of work or simply in a antenatal clinic that you like better. Moreover, you can register for pregnancy even at a antenatal clinic in another city. The main thing is that you need a compulsory medical insurance policy, valid throughout Russia. To register at a antenatal clinic other than the place of registration, you need to write an application addressed to the head doctor of the consultation, bring the original and a copy of your passport, compulsory medical insurance policy, SNILS insurance certificate.

And even if for some reason you stop attending the antenatal clinic and go, for example, to a private clinic or simply don’t go and that’s it, no one has the right to deregister you from the housing complex. And at any time you can return to your consultation and continue to be observed there.

CHOOSE A DOCTOR

Also, according to the legislation of the Russian Federation, you can choose a doctor who will monitor your pregnancy, or change a doctor who, for some reason, was not suitable for you. To do this, you also need to write an application addressed to the head doctor of the residential complex.

And of course, every expectant mother in the antenatal clinic or maternity hospital has the right to read his medical card or birth history, look at records of examinations performed. And you don’t need to explain why you need it, it’s enough that this is your map and your research. If you do not understand why you need some kind of prescription or analysis, then the doctor should explain everything in an accessible form.

REGISTER FOR ANY TERM

You can register with the antenatal clinic at any stage of pregnancy. True, in a very short period of time, neither a doctor nor an ultrasound will be able to accurately confirm pregnancy, so it is still better to register after the 6-8th week. It is at this time that the doctor will be able to reliably establish the fact of pregnancy during examination.

There is another recommendation - to come to the antenatal clinic before 12 weeks of pregnancy. This is due to the fact that the first is done at 10–12 weeks and at this time the gestational age can be most accurately determined. By the way, those women who register with the antenatal clinic before 12 weeks receive cash payment, which is called a “one-time benefit for women registered with medical institution V early dates pregnancy (up to 12 weeks).” It’s true that they don’t give you much money at all, but it will be useful to someone.

But all this does not mean that you have to register strictly before 12 weeks. No, you can come at any time (even in the last trimester), the main thing is to have time to pass necessary tests before giving birth.

VISIT AT THE TIME YOU NEED

If you feel well, your tests are normal and you don’t want to go to the antenatal clinic often, you have the right to refuse regular visits gynecologist. Just tell your doctor about this, he should respect your decision. Yes, the doctor will warn you that you are responsible for your choice, but he should not intimidate you or threaten to refuse to issue an exchange card. If something like this happens, immediately go to the head physician antenatal clinic or contact the health department.

But you need to know that there are studies (ultrasound,) that must be done within a strictly defined time frame, otherwise their result may be unreliable. Therefore, ask your doctor in advance about the timing of some examinations.

SELECT SURVEYS

If you want to do all the examinations you need, you have the right to receive them in full. Every antenatal clinic has a list of tests and consultations required during pregnancy. You can ask your doctor to tell you about them in detail and do everything you need to do.

If, on the contrary, you think that a particular appointment is not necessary or is unacceptable for you, you can refuse it. No one has the right to force you to do an ultrasound, screening, or take any medications. And nothing will happen to you for this. Even if you refuse something, you cannot be removed from the pregnancy register or given a birth certificate or exchange card. The doctor will simply record your refusal on the card and write that it was explained to you why this or that study was recommended.

In general, to get an exchange card, you need to pass a series of tests at least once ( clinical analysis blood, urine test, smear, tests for HIV, RW, hepatitis B and C) and visit an obstetrician-gynecologist at least twice. The first time you come to initial examination and in order to receive a referral for tests, a second time - to enter the examination results into the exchange card. The main thing here is to observe the “expiration date” of the tests.

DO IT AS YOU ARE COMFORTABLE

All examinations in the antenatal clinic are carried out completely free of charge. And even if there is no specialist or there is temporarily no research, you should be given a referral to another medical institution where all this is available. The doctor does not have the right to refer you for any additional paid tests or consultations if they can be done free of charge under compulsory medical insurance.

If you want to do some research yourself for a fee and in another clinic (for example, do an expert ultrasound), then its results must be accepted at the antenatal clinic (and not say that we only trust our tests or specialists).

If you want to be observed in the antenatal clinic the way you need, do not be afraid to talk about your preferences. Calmly and confidently remind you of your rights,your job is to choose what you need from medicine and what you don’t.

Other articles by the author

New Year- it's always festive table with various salads, snacks, hot and traditional champagne. What should expectant mothers eat on this holiday? Should you create a special menu for yourself or eat everything? Both are extremes, but we need a golden mean, and we’ll tell you about it.



Everyone has heard that sooner or later the expectant mother goes on maternity leave or maternity leave. But even pregnant women themselves do not have a very clear idea of ​​what it is - it seems that before and after childbirth you don’t have to work for some time, plus they have to pay you something else. In fact, there is no such term – “maternity leave” – in our legislation at all. This is what people call two types of leave: maternity leave and child care leave. And they receive and pay for them in completely different ways.

The diagnosis of “non-developing pregnancy” indicates that the pregnancy developed normally for some period of time, and then for some reason the fetus died. and the pregnancy stopped developing. And although this can happen at any time. In the vast majority of cases, pregnancy regression occurs in the first trimester.



Answers questions obstetrician-gynecologist, doctor ultrasound diagnostics. The article was published in the magazine “Rody.ru” No. 1-2017

TRAIN YOUR VESSELS AND HEART

The cardiovascular system expectant mother works with double load: the volume of circulating blood increases, due to the growing uterus and placenta, the blood supply to the pelvis increases. The walls of blood vessels dilate, the heart rate increases, arterial pressure decreases, and all together this leads to less oxygen entering the brain. These are, so to speak, physiological (natural) causes of dizziness and fainting, and they are not dangerous for either the mother or the baby.

What to do: start training your heart and blood vessels: take part in fitness for pregnant women, go to the pool, just take walks more often fresh air. With regular physical activity medium intensity workout of cardio-vascular system, and blood vessels respond more adequately to changing conditions environment, maintaining normal blood flow in any situation.



"Hypertonicity... Increased tone uterus...” - these words are heard by many expectant mothers. What is hypertonicity? What does it look like and what to do if it appears?

Many people cannot decide where to be observed during pregnancy. Faced with rudeness and queues in residential complexes, they think that it’s better to pay. Fortunately, many have the opportunity to be observed in civilized conditions. In addition, stress at such a time is completely inappropriate. But here they are afraid of something else - that they will “pump out” money. Or that there will be problems with documents when entering the maternity hospital. What to do? When I was deciding, it helped me that I was a former medical worker (laboratory doctor), and I worked both in the compulsory medical insurance system and in the paid one. I made a choice for myself, but first things first. I apologize in advance for the long and detailed story with digressions, but perhaps this will give readers food for thought.

Let me start by saying that my pregnancy got off to a rocky start. There was no delay yet, but severe abdominal pain began. The test showed one line. On the fourth day, I couldn’t stand the pain anymore (before that I thought that maybe I had a cold, and that’s how menstruation begins), I went to the clinic to see a therapist. After examining me, she prescribed urgent analysis blood (in a regular clinic, during lunch, free!), and half an hour later I was already examined by a surgeon (again, the therapist urgently took me out of line, the test was bad). The surgeon gave a referral to the Central District Hospital with suspected appendicitis. I sat there with this direction for about an hour. reception department(there was a queue of two people, so I don’t know how this can be explained).

Fortunately, the surgeon who examined me did not confirm the diagnosis and referred me to gynecological department. They received me quickly there. As it turned out later, the head of the department herself accepted. After the examination, she said that I had no problems with them, and sent me back to the clinic to see a therapist so they could figure out where the pain was coming from. At the same time, in the hospital, apart from a simple examination, they did not conduct any examinations, not even an ultrasound. Knowing that without acute indications, which had already been ruled out, the therapist would simply drag me through tests and specialists, for whom there was a huge queue, I went to a paid clinic for an ultrasound. Gynecological ultrasound showed 6 cm in the ovary (for reference, the ovary itself is smaller), and the location of this ovary was also incorrect, which could have caused painful sensations. But it was not possible to confirm or verify the pregnancy - the period was still very short. They scheduled another appointment in a few days.

Just after these few days, the family one showed two stripes. I went for an ultrasound to rule it out (it is precisely accompanied by severe pain). There I was delighted - the pregnancy was intrauterine. But they said that it would be better to go to a hospital if I want to save her. The city here is small, and there are no paid hospitals, so I had to go to a regular one, and directions to it could only be given in a state housing complex. Therefore, I went from a paid clinic to a free residential complex. 40 minutes in line at the registration desk, 20 minutes. explaining why I have a policy from another city, and scolding me for not having a residence permit here. This is none of their business at all, it’s good that I clearly know my rights, so I can defend them, I think that anyone else would be confused by their confident tone that I was wrong, by the way, this didn’t happen at the clinic. About 2 more hours in line to see the doctor (with acute pain and the threat of termination of pregnancy). At the appointment, the doctor looked at my ultrasound last and pulled me into a chair first. At this stage, they still don’t feel the pregnancy, but with the threat and tone, they need to climb “there” as little as possible. As a result, she copied the diagnoses from the ultrasound and gave me a referral.

I went to the hospital the very next day. Again the chair is the first thing, again the diagnoses copied from the ultrasound, and the doctor who does not answer any questions, saying that the nurse will explain everything to me when she administers medications and takes tests. The hair on my head started to stand up! How do you mean “the nurse will explain”? And he doesn’t even say in advance what medications he prescribes! The rudeness is excellent, but something happened to me. Usually I always defend my rights, without even swearing, but simply insistently demanding that they give me what they are obliged to give. And the doctor is simply obliged to familiarize the patient with his state of health, the prescribed treatment and the possible pros and cons of this treatment, so that the patient has the opportunity to exercise his right to refuse this treatment.

In general, this doctor’s behavior paralyzed my brain. I went to the nurse (okay, at least she turned out to be a human), they took tests on me (half of which they did to me a month ago. But no one looked at this certificate, although they had no right not to trust it, I am a regular donor and my blood type is Rh -factor, HIV, hepatitis - this is a mandatory check for all donated blood). They gave me an injection and gave me a prescription to the pharmacy so that I could buy the medicine there myself. It turned out that I couldn’t take some of the medications. Well at least I understand this. In the evening, after a complete daytime stupor, I became furious with all this. I decided that I would not give in to this particular doctor again, I would check all appointments immediately, despite any objections. I waited for the morning rounds with firm confidence in my decision.

A miracle happened: the doctor who saw me went on vacation, and I already had another doctor. After looking at the map, she again invited me to the chair! Explaining this by saying that he cannot treat me based on examination by other doctors. Here a question has arisen for the manager: why does a doctor going on vacation accept incoming patients? But after eating this too, I went to the examination room. Dina Evgenievna turned out to be a doctor from God, and without any demands she explained what was happening to me, what she was prescribing (she changed the treatment radically, even without my instructions that the wrong medications were prescribed). The only thing she didn’t approve of (she even scolded me at first) was that I had already done 2 ultrasounds at that time, but after my explanation of the whole situation she softened. This doctor could not only make prescriptions, but also hear the patient, and not treat him as a patient devoid of his own will and reason.

After my condition improved, she did not keep me in the hospital for safety reasons. I apologize for the very intimate detail, but you can’t erase the words from the song, and many pregnant women will understand me. I had problems with my intestines—I didn’t want to empty myself of the contents for several days. As you understand, hospital bathrooms did not help solve this problem at all, and even vice versa. This was one of the factors for sending me home, with a promise to immediately go to the residential complex and, if something went wrong, call an ambulance. As a person who understands something about how our body works, I can say that this is not at all a minor problem, as many people believe, and not only for me, but also for the child. So, dear women, do not start this problem, if you have it, be sure to bring it to the attention of your doctor - this problem is most often solved even without medications and enemas.

Keeping my promise, the next day I went to an already familiar residential complex. Again there were problems at the reception, then it turned out that the card was lost (then found), and there was a huge line to see the doctor, who was also 2 hours late for the appointment! At the reception, because my condition was still weak, she suggested going back to the hospital, after my refusal she suggested day hospital, but I didn’t want to go there either, because... I felt sick in the morning and didn’t have the strength to go anywhere (I’m unemployed, so I didn’t need to be excused from work). To this I heard that I was an enemy to my health, that if I was just going to sit at home, then I would give birth at home without a doctor, and in general, what would I do with them then... Well, a lot more...

And then I had an epiphany. I calmly explained that I had come to them to register, that I would take all the tests on time and that I was not going to give birth at home, but without urgent need I won’t go to the hospital, because it’s worse for my health than being at home. And for their (doctors’) peace of mind, I will not do anything. It was clear that she did not expect such a clear and firm position. But afraid to take responsibility, she sent me to the head of the housing complex. Again an examination, again persuasion to go to the hospital, but still I achieved my goal. Of course, I signed a refusal to be hospitalized. I was prescribed treatment and sent home in peace, having been registered.

Now I go to the gynecologist at the LCD every 2-3 weeks (it takes no more than an hour - they set a time for pregnant women and take them between patients), and the day before the appointment I take tests in the morning. They understood that I was taking my pregnancy responsibly, but not as an illness. I, in turn, don’t expect much from them - I know what tests need to be taken, at what time, if they forget to schedule them, then I remind them (for this, by the way, it is not necessary to have a specialized education) and I take them for myself, not for them . Sometimes they still try to scare them with something, but I have a filter on them, I understand that it is easier for them to intimidate and put them in hospital in order to be on the safe side and relieve themselves of responsibility, and sometimes in order to “sell” dietary supplements . At the same time, they really work at a frantic pace and cannot pay enough attention to each patient, so sometimes they forget something, sometimes they don’t explain everything, sometimes they leave something unfinished...

Here I would like to draw your attention to the fact that you definitely need to pay attention to what is written on your card. Test results and all appointments must be recorded. My doctor really likes to prescribe dietary supplements, and says that without them I can’t bear pregnancy, but he doesn’t write this in the chart. Draw your own conclusions about the appropriateness of these appointments. All your complaints should also be on the card. Special attention Make sure that the card contains medications that you should not take (God forbid, but you may end up in the hospital unconscious, and then the doctor will only rely on the card). For example, I am not allergic, but I can’t take one medicine (not because), and the card only contains the column “allergies to medications.” I insisted that they write down for me at least what I was not allowed to do. And, by the way, they reacted absolutely normally to this.

When visiting a residential complex, I don’t always find an explanation for the doctors’ actions. When I complained about headache, which is not related to blood pressure, I was sent to the sellers of dietary supplements, and not to a neurologist. Therefore, I also use paid medical services as needed. For example, there is only a fee for routine ultrasounds. Firstly, there is a long queue at the residential complex and it’s stuffy, and secondly, the machine is prehistoric - even at the second ultrasound they don’t tell anyone their gender, because they can’t see anyone’s! What do they even see there, I wonder? In addition to routine ultrasounds, I sometimes go to the doctor.

After the first trimester, my condition improved dramatically, so there is no reason to go to the doctors. But all the same, questions accumulate that LC doctors do not answer (they have no time, they don’t know, or they are playing it safe). Sometimes it is important to get a second opinion about the course of your pregnancy. That's why I write down all my questions, even small and stupid ones. And when enough of them accumulate or there is even the slightest reason, I go to a paid clinic. For example, after visiting the dentist, it turned out that several of my teeth had fallen out. When I told the doctor at the residential complex about this, she prescribed me a calcium supplement in addition to multivitamins. Because excess calcium is just as harmful as its deficiency, and excess vitamin D, which is part of the additional drug, can generally cause fetal development abnormalities, I decided to double-check this prescription.

I went to paid doctor, who wrote out a referral for tests. According to the results, it turned out that my calcium was normal. Of course, moving to a different climate zone and pregnancy is hard on the body, which could have an impact, including on the teeth. But calcium correction is not required. Another example. Dear pregnant women, please note that your blood pressure is recorded on the card at each appointment. It is correct to measure it on two hands (first on one, then on the second). Personally, I always measured it on one, and on the card they wrote the value and “both” in brackets. It’s clear that they don’t have time, but it turned out that I have 120/70 on one hand and 90/60 on the other. With such different pressures, you shouldn’t just take Magne-B6 for prevention. This drug is really very good, which is why it is prescribed to all pregnant women. But there are exceptions, like me, for whom it can cause unwanted side effects. After stopping it, I stopped having terrible headaches (it can reduce intracranial pressure those who have problems with blood pressure). So the paid doctor helped me out in many ways. Not to mention that he listened to my stupid and not so stupid questions with great patience and understanding and answered them in detail, which is also important. Of course, he has time to carefully examine the patient, listen and answer questions.

Surely you are now wondering why I still go to a consultation and only sometimes to a paid doctor, if everything is so great with him? I answer. Because

1. The housing complex will give it to me. I am planning a paid birth, but man assumes, but God has it, especially since there is a crisis now and it is unknown how it will affect my family’s finances, so I need to be on the safe side, and a certificate is given at the consultation if you are observed there for at least 12 weeks.
2. Despite the fact that I have the opportunity to go to a paid doctor, it is still not a cheap pleasure to manage a pregnancy with him. Moreover, many necessary tests They are quite expensive, but in the residential complex they are done for free, and it does not require much more time - tests are taken in the morning, there is no queue at all for urine, and the queue for blood is also much shorter than in the clinic.
3. At a doctor’s appointment, I don’t lose my composure—I behave soberly, so the doctors’ intimidation doesn’t affect me, and I, without losing nerve cells, I go to the residential complex (especially impressionable, suspicious and suggestible, it’s scary there, of course).
4. When everything is going well, there is no need for extra attention either, you immediately relax and begin to listen to yourself, at such a moment you will definitely hear something wrong and run to the doctor (who is so attentive and kind) to calm you down.
5. After all, all doctors are reinsurers, but in paid medicine it doesn’t cost a pretty penny, and thoughts of a “money scam” arise. A month after the planned ultrasound, I had an appointment where they confirmed that everything was fine with me. In general, I went to consult whether it was possible to go to the pool; the residential complex does not approve of this. So, at this appointment, I was offered to undergo an ultrasound again, and when I asked directly what the indications were for this, they answered that, in principle, none, but it wouldn’t hurt to be on the safe side. I didn’t give it up out of economy - since everything is fine, then why interfere in the affairs of nature? And there is still debate about the harm or harmlessness of this examination.
6. In paid medicine, too, not all people are friendly and competent enough. When I donated blood at a paid clinic, they picked out my vein, saying that my veins were bad (the donor’s!). Then the blood flowed badly. The nurse said that my blood pressure was probably very low. But without measuring my blood pressure or even offering me sweet tea, she calmly let me go, hungry (they take tests on an empty stomach), pregnant, with supposedly very low blood pressure. She didn’t know that the car was waiting for me, but she didn’t take any human or professional participation, and I really almost lost consciousness... In a paid clinic, where there is no flow and they charge a lot of money, such an attitude is akin to rudeness.
7. Courses for future parents in our city are only available at residential complexes.

In any case, wherever you are observed, the main thing is your personal positive attitude. We ourselves are more responsible for our health than all doctors combined.