Today we have to figure out what documents to take with us to the maternity hospital. In fact, this question is extremely important. Usually, expectant mothers think about packing things, but not enough attention is paid to documents. What can be useful to a woman in labor in this or that case? When and why to prepare a package of documents for the maternity hospital? The answers to these questions will be found below. In fact, understanding the topic being studied is much easier than it seems.
Documents and childbirth - is it necessary?
What documents will each girl need for the maternity hospital? And in general, are they needed at such a crucial moment? The answer is not so simple.
On the one hand, documents do not play any role directly for labor activity. They will not be needed either during labor or after the baby is born. On the other hand, it will not be possible to register a woman in labor at a medical institution without certain papers. In the best case, the girl will give birth in an observation room, along with unexamined people. At worst, the lack of certain documents will lead to the woman being denied services. Yes, according to the law they should not do this, but such cases do occur.
What does it mean? Documents for the maternity hospital must be collected in mandatory. It is recommended to prepare them in advance. This process will be described in more detail below.
When to start preparing
The first step is to choose the moment to start preparing all the documents. This question is individual. The answer to this directly depends on the course of a particular pregnancy. It is best to prepare documents for the maternity hospital along with the main bags.
More precisely, every woman at approximately 35-36 weeks of pregnancy should put all the documents necessary for childbirth in a separate file. It is advisable to keep it ready. Even better - always carry it with you. After all, in late pregnancy, contractions can begin at any time.
Passport
Now a little about what kind of papers a girl may need during childbirth. Where to start preparing for this process?
What documents are needed for the maternity hospital? The first piece of paper that a woman in labor should have in her bag is an identity card. More precisely, we are talking about a passport of a citizen of the Russian Federation. It is impossible to do without it. This applies to both paid and free births.
If at the time of the expected date of birth the identity card is at the production stage (for example, if it is replaced or lost), you will have to take with you a certificate replacing the passport. It is issued by the Federal Migration Service.
Policy
The next important document is the insurance medical insurance. Every person living in the Russian Federation should have it.
A policy is issued at the request of a citizen from insurance companies. For example, in Sogaz-Med. The procedure is absolutely free.
Documents for the maternity hospital do not end there. If the policy is exchanged at the time of contractions, you will have to use its temporary analogue. Without this document, a citizen may simply not be accepted into a medical institution or provided with services for a fee. Not the best best options developments of events.
Exchange card
What documents are needed for the maternity hospital? The next extremely important piece of paper is the exchange card. This " business card" for every woman giving birth. It must be registered with all expectant mothers.
The exchange card is a small A4 format magazine folder. It records information about the future mother, father, living conditions families. But main feature exchange cards is that they contain information about the woman’s health status. Tests, ultrasounds, examinations by specialists - everything is stored in the “exchange”.
Where can I get this document? It is issued when registering for pregnancy. An exchange card is issued either by an antenatal clinic or by any private medical center that has the right to manage pregnancy in women.
Birth certificate
What documents should every expectant mother prepare for the maternity hospital? Among the main mandatory documents is a birth certificate. This is a small paper, usually Pink colour. It is divided into several parts. One is left in the maternity hospital, one is given to antenatal clinic, in which the woman was observed, and the last part is transferred to the clinic for monitoring the newborn in the first year of life.
A birth certificate allows a medical institution to receive additional money for delivering births. The document is issued after the 30th week of pregnancy (usually later, around 36-37 weeks) at the antenatal clinic.
However, the absence of a birth certificate will not affect the progress of labor in any way. If the document has not yet been prepared at the antenatal clinic, the maternity hospital itself will issue it. Or one of your loved ones can bring a certificate after the birth of the child.
Contract
Documents for the maternity hospital must be collected carefully. Especially when it comes to paid childbirth. Why?
The point is that everyone in the Russian Federation offers both paid services, and free. In the first case, a woman and her baby receive increased comfort, a specific doctor during childbirth, a personal obstetrician, as well as an individual room (if paid for). Without a contract, even a girl who paid for the services will give birth as a “free woman.” Not the best prospect.
That is why it is important not to forget the contract with the medical institution during childbirth. The document serves as confirmation that the expectant mother has paid for certain services and increased comfort.
For a partner
Now it’s clear what documents will be required for the maternity hospital. But that's not all. Today in Russia the practice of partner childbirth is actively developing. This is when someone close to you is with the woman in labor. This technique helps to provide the expectant mother with peace of mind. Often, such a service is provided only to women who have entered into a contract with one or another maternity hospital, although by law it is a free service.
Partner births also require certain documents from the accompanying person. What is it about? Most often, medical institutions require from a person who comes with a woman in labor:
- ID card (passport);
- blood tests for HIV, syphilis, hepatitis;
- fluorography.
Typically, no further documentation will be required. As practice shows, each maternity hospital puts forward its own requirements for accompanying persons. Some simply recommend taking your passport with you. And have fluorography and tests “just in case.”
Upon discharge (required)
Now a little about what documents you will have to pick up upon discharge from the maternity hospital. It's hard to believe, but childbirth is not only the birth of a baby. The event is burdened with a little paperwork.
So, upon discharge, a woman must have the following papers:
- passport;
- policy;
- birth certificate (2 parts).
These are mandatory documents. But in practice, most often the list is supplemented with several more papers. What is it about?
What documents do they give from the maternity hospital? The mother is required to receive a birth certificate for the baby. She will help register the newborn in the registry office. You cannot leave the maternity hospital without this paper.
Extract (additional documents)
The thing is that if she refuses the first vaccinations (BCG and hepatitis B), the mother will receive a document indicating this decision. In addition, the child will not be issued a vaccination card. This document will later be issued at the clinic where the baby is being monitored.
The exchange card is sometimes given to women as a souvenir. In addition, every new mother must be given a sheet from the “exchange” indicating the health status of the girl and the newborn.
But that's not all. In practice, among the mandatory documents upon discharge, there is a certificate about the outcome of the birth and its features. This paper is given to the antenatal clinic or remains with the new mother.
If you didn't give the documents
From now on it is clear what documents are given from the maternity hospital. In fact, everything is simpler than it seems. What to do if they refuse to issue some papers?
Without them, a woman may not be discharged from the maternity hospital. It is imperative to require:
- a certificate about the characteristics of childbirth;
- a page from the birth certificate about the mother’s health status;
- baby exchange card;
- vaccination card (if vaccinations were given in the maternity hospital);
- a certificate for the registry office about the birth of a child.
All of the listed documents, as already mentioned, are issued to all women giving birth. Without a certificate from the registry office, a child cannot be registered. And the lack of information about the health status of the newborn will interfere with normal monitoring of the baby in the clinic. Sometimes maternity hospitals immediately transmit information about the mother and newborn to the intended place of observation of the baby.
Conclusions and Conclusions
From now on, it is clear what documents may be required for the maternity hospital. A list of all papers was presented earlier. Documents must be provided in originals. Copies of these will not be accepted. This is normal.
Some mothers are interested in whether SNILS is needed when entering the maternity hospital. In fact, there is no need for this document. SNILS is not needed for childbirth. But it is advisable to have it with you.
Documents for childbirth in a maternity hospital must be collected and prepared in advance. Otherwise, a woman may face a number of unpleasant surprises. For example, instead of contract services, she will be provided General terms for childbirth. Or healthy woman They will take you to an observation room to give birth and put you not in a general ward, but in an observation room. This is far from the most pleasant thing. After all, in this case, you can end up in the same room with sick women in labor.
As a rule, collecting all the necessary papers does not cause any trouble for a woman. Every expectant mother should have all the documents, if correct. And if you put them in one place in advance, then in contractions or during planned hospitalization you don’t have to think about keeping all the papers with the woman in labor.
In fact, everything is much simpler than it seems. Every woman is required to provide documents to the maternity hospital. Upon discharge, almost all the documents provided are returned to new parents, and they are also issued certificates to register the baby at the registry office and to inform doctors about the progress of labor/health of the newborn. Minimum paperwork! It is not difficult to collect documents upon admission to the maternity hospital.
Although childbirth is a physiological process, it can also be extremely stressful for a woman. Entering a maternity hospital can also be an exciting event, since the unknown, fear of childbirth is frightening, and contractions are not the most pleasant sensation.
During such a period, you want at least a little support and attention. However, you don’t always come across friendly midwives and compassionate doctors. There is almost always someone who can ruin the mood. Sometimes we ourselves can provoke medical worker to discourteous treatment because we don’t know what to do in a given situation.
In the maternity hospital there is a certain number of rules of behavior that must be observed. How to behave correctly in this healthcare institution? Let's look at some established rules of behavior.
Once you have made your choice maternity hospital, do not be lazy to call the reception department or help desk and find out the basic rules and requirements of this medical institution. The best option would be to attend courses at the maternity hospital, where they will tell you everything in detail and give you a list of what you need to take with you.
You should not take a large number of things. Take the essentials for yourself and your child. Large packages are not particularly welcomed by the clinic staff, and it will not be very pleasant for you to drag them into the prenatal ward, then into the postpartum ward (although the health workers help, they are not obliged to do this).
In the reception department it is necessary to change clothes and shoes. When going to the maternity hospital, do not forget to take your passport and exchange card.
It is best to trim your nails or remove polish in advance. What is it for? The doctor can determine the first signs of hypoxia by the color of the nail plate. Long nails can damage the baby's delicate skin.
If you are not giving birth alone, your partner will also need a change of clothes and shoes, unless their provision is agreed upon with the maternity hospital.
After contractions become regular, you should not eat or drink. This is due to the fact that vomiting may develop against the background of contractions. If complications arise that require endotracheal anesthesia, a full stomach can harm the health of the woman in labor. You can fight unbearable thirst by wetting your lips with water or rinsing your mouth with it.
The expectant mother should remember that an examination by a gynecologist and recording of the fetal heartbeat are necessary to monitor the progress of labor.
In the absence of complications, the woman in labor is allowed to behave freely. This means that the expectant mother can take positions that relieve pain, walk, massage and breathing exercises within the ward. It is better to ask the medical staff about whether it is possible to walk along the corridor or visit the shower stall during contractions. Although in some maternity hospitals, midwives themselves offer to visit the shower.
Exercises on a fitball can help relieve pain during contractions, but it is better to talk to the staff in advance about the possibility of taking it with you.
During labor, do what your obstetrician says. Under the precise and qualified guidance of a specialist, you will succeed.
For two hours after giving birth, the woman remains under the supervision of medical staff. If all is well, then the mother and baby are transferred to the postpartum ward.
When leaving, do not forget to pick up the completed exchange card and the child’s birth certificate, which is provided to the registry office.
With wishes for an easy birth Yulia Ivanova
Pregnancy and preparation for the appearance of a “little miracle”, by definition, is one of the most pleasant periods in a woman’s life. However, the closer the day of birth, the more worries and worries expectant mothers have. The question of where the baby will be born becomes relevant. To this will be added preparations for the maternity hospital and worries about “how will I be there alone.” Together with MedAboutMe, we figure out how to safely survive your stay in the maternity hospital and remain satisfied at the same time.
Right to rights
In what status do people usually find themselves in medical institution? More like a supplicant than a client. It is a fact. Especially if it's an emergency. They look at the doctor with pleading in their eyes when someone close to them feels bad. They are embarrassed to disturb a nurse or orderly, so as not to hear in response another portion of “friendly instructions” about the rules of behavior for the patient, although we are talking about the direct responsibilities of the medical staff. Pregnant and giving birth women are especially vulnerable - they also worry about the child, especially if this happens for the first time.
Why does this happen? As a rule, because not everyone and does not always know about their rights when they get to the maternity hospital.
What to do? Just read the article. 30, which is in the “Fundamentals of legislation protecting health” Russian citizens. If possible, consult with a lawyer in advance about what you can and cannot demand in the maternity hospital. Believe me, you will learn a lot of interesting things.
Firstly, to the woman admitted to the maternity hospital, the medical staff and service staff must be respectful. Any woman who has given birth (well, perhaps, except for those who were identified as special conditions paid clinics) faced inhumane treatment of herself. The most “harmless” of the set is “What are you yelling about? I knew what I was getting into!” Psychological trauma after such “friendly” words there are a lot. It is difficult to prove rudeness.
What to do? Don't get upset. You can go to court. In addition, the mother (or relatives) has the right to write a complaint about boorish behavior or the words of the doctor to her immediate superiors, citing the law on the protection of rights. It will definitely work. Medical staff must know that they are responsible not only for their actions, but also for their words.
Secondly, women are not always informed that partner childbirth is a free service, according to the law. Paid partner births are organized in private medical institutions.
What to do? Inform in advance that you want to exercise this right and prepare for it. Remember that you must pay for medications for the mother and partner yourself.
Thirdly, a woman has the right to refuse any medical intervention. This can be demanded both in relation to the woman herself and in relation to the child. Reason: the same Law (Article 33).
What to do?
notify the doctor; listen carefully to his explanations about possible consequences; sign a record of this in the appropriate medical document. Specialist commentary Sergei Golovin, lawyer
The first thing you need to understand is that only you can determine where to give birth and how, whether the father will be present or not. If they demand money for the presence of the father, you must complain - this is illegal, unless there is no technical possibility.
Only you can accept final decision:
whether to save or not; refuse a doctor if he is rude or behaves unprofessionally; whether to take prescribed medications; whether to take the prescribed tests.
Upon admission to a medical institution, you may be asked to sign an application where you immediately agree to any interventions and medical procedures.
Remember - this is illegal. You may not always be able to understand what is happening, so my advice is to give a notarized power of attorney to a person who can protect you and, if you need to refuse or allow doctors to perform certain procedures.
You or your authorized representative have the right to receive complete information about the progress of treatment and the course of pregnancy in an understandable form.
The doctor should answer all the questions that concern you. This also applies to prescriptions, medications - what are they for, side effects how they can affect the child, the doctor must know and explain all this.
Using a birth certificate, a woman can register with any municipal or state antenatal clinic if she wishes, if she does not want to go to the one at whose address she is registered. In case of refusal, according to the law, criminal liability arises. If this happens, contact the head physician; if this does not help, write to the police or prosecutor’s office. If you do not have a birth certificate, you must be admitted to the maternity hospital.
After the birth of the baby, the mother has the right to attach him to the breast. In the future, she may refuse supplemental feeding and breastfeed on demand.
You are responsible for the child, so it is your right to refuse medications that may be administered to the child. Mom has the right to know what these drugs are, their effects and other information.
You have the right to refuse vaccinations if you think that this is not necessary or if you do not like the instructions for the drug. If you do not want to be seen by a doctor or health visitor, you can refuse this. If you think that the baby is sick, but the doctor says that everything is fine, ask for tests and ask the opinion of another doctor.
Also, according to labor law, you have the right to:
for leave and maternity benefits; you cannot be fired; You cannot be refused employment because of your position; cannot be required to work overtime or night work; send on a business trip; are obliged to reduce production standards while maintaining earnings. I’ll come quickly, I’ll give birth quickly
Depending on the type of birth a woman has, her behavior in the maternity hospital is determined.
Experienced mothers know everything and even more, so they can give professional advice to “firstborns.” Don't be alarmed - this word is sometimes also used to describe women giving birth for the first time. And your status will soon change - you will become a mother.
Those who have a difference of 5-6 years between the first and second visit to the maternity hospital will notice changes. If you're lucky, they'll be for the better.
And yet, every woman on the eve of childbirth will face the following question: how to survive there?
It's not that scary. We need to prepare for what awaits there. Mentally and physically. However, for those mothers who already have a child, the option “I already know everything, so I’ll quickly come, give birth and go home” will not work.
Expert commentaryMichelle Oden, obstetrician-gynecologist, researcher, author of the book “Revived Childbirth”
The circumstances of a person’s birth influence the following qualities: sociability, aggressiveness, friendliness, and the ability to love. Over 50 years of work, I had the opportunity to attend 15 thousand births.
The main advice for a woman who is about to give birth is that she needs a special atmosphere and environment. Everyone knows this, but few people care about it and not everyone understands it.
Thanks to research, we have begun to better understand the true reasons that make childbirth difficult. This is cause for concern.
A woman giving birth needs to produce a whole cocktail of hormones produced in the brain. Not the whole brain participates in this during childbirth, but only its oldest part. Using modern scientific language, it can be explained that if during childbirth some events begin to activate the cerebral cortex, which is more developed in humans than in animals, then this slows down the process of childbirth. Any stimulation thought processes may interfere with the progress of labor.
What are these factors that prevent the intellect from resting?
Firstly, the language. Especially rational. A woman giving birth enters a certain state that allows her to relax. All her sensations are directed inward. Any questions at this time disturb the woman.
Secondly, bright light. During childbirth, a woman does not need vivid visual impressions. On the contrary, dim lighting helps her.
Thirdly, the feeling that the whole world is watching you. It gets in the way. Studies have been conducted in the West that have confirmed that it is calmer for a woman when there are not a lot of people around during childbirth, except for the midwife.
Fourthly, the release of adrenaline (and during childbirth is fear) also negatively affects a woman. Any impressions that frighten the woman in labor slow down the process. A woman needs security. The midwife must play the role of an advocate.
In the traditional sense, feeling protected during childbirth means that there is someone nearby whom the woman trusts and feels protected. The midwife in this situation is the prototype of the mother who will protect.
And one more important question. For thousands of years people have tried to describe love, but no one was interested in how the ability to love develops.
I have an answer to this question - love begins at the moment of childbirth. If you interfere with the natural course of childbirth (pain relief, for example), this ability to love may not be formed.
Lifehacks for the maternity hospital
Any woman who appears in a building where they help the birth of new citizens of the country will benefit from the experience from previous “races,” which is now called a “life hack.”
1. Experienced mothers know: you need to get ready for the maternity hospital in advance (about a month in advance) and you need to do it yourself in order, as they say, to “remember everything.”
2. Upon admission (unless labor has already begun), certain procedures are required, some of which the woman can do at home in advance, in order to:
firstly, reduce the reception time; secondly, exclude manipulations with someone else's shaving machine and scissors.
3. Throw out of your head “horror movies” about incessant unbearable fights. Consult a doctor, midwife or more experienced mother in advance and get down to business. Instead of mental suffering on the topic “Oh, I can’t stand this unbearable pain!”, screams from the heart and endless calls to the medical staff, walk, breathe, count contractions. Before the time (before the pushing begins), do not pull the nurses and doctors.
Personal experience
Svetlana Zolotareva, perinatal and analytical psychologist
When should mommy “move forward” to the maternity hospital?
If your water breaks at home, start counting the water-free period. You can't wait more than 12 hours.
About contractions.
Subjectively, contractions occurring once every 5 minutes are really sensitive. If you are counting on anesthesia in advance, then it is at this moment that the doctor will ask: “Shall we take pain relief?” The decision whether to take pain relief or not depends on how this process goes for you. This largely depends on your motivation, since many women now want to minimize the intervention of doctors. Someone is waiting in advance for the anesthesiologist. You make the decision. Everyone's pain threshold is different and you will have your own experience.
What awaits you in the maternity hospital?
I want to warn you. In any maternity hospital, three procedures await you in the emergency department:
asking questions that seem unnecessary to women - you can write everything off from the exchange card - but this survey is necessary for verification; shaving the perineum (to avoid anything, take a razor with you or do it at home); magic enema (our domestic women are unusually shy and the feeling of shame covers all labor, so take a shower after the enema and before “sending” to the maternity ward).
If you have contact lenses.
It is better to take glasses for childbirth. If you don’t want to, be sure to take a spare container with a spare pair of lenses. Glasses, in my opinion, are more convenient. This is temporary while you are in the maternity hospital.
4. You’ll be lucky if they take you to the ward “after that” on a gurney. Usually, with the air of a philosopher, you have to accept the fact that you will have to get to it yourself, trying not to drop the diaper lining and things. You'll be lucky again when the pediatric nurse follows the child and grabs your things.
5. Many people know that a woman who has given birth is “attacked by zhor.” However, you may be late for the next lunch or dinner due to your busy childbirth, so stock up on something conveniently edible in advance: everything that you can eat quickly and without unnecessary preparations. The hospital catering unit should not be completely written off. Sometimes there is quite edible food there.
6. A warning that it is strictly forbidden to take linen into the maternity hospital - both bed linen and underwear. Everything is explained by the requirement to maintain sterility. Do not take into account the lack of three times (according to the rules) wet cleaning in the room, but rather do not be too lazy to stock up on sterile pads and sterile disposable panties.
7. The maternity hospital provides diapers. True, they have holes and are rough for a delicate body, but mommy needs to provide an option that the laundry is not open on weekends and holidays. Stock up strategically in advance. Disposable diapers are also useful, but you need to wrap the baby in something. Many maternity hospitals allow you to take baby clothes - bodysuits and rompers.
8. Bring earplugs. Mom must sleep sometime. If your own baby is calm, your neighbor’s may start screaming. If this “trouble” has passed, then any woman will wake up from the sound of buckets rattling late in the evening or early in the morning, doors swinging open at dawn with the simultaneous switching on of lights and screams notifying that the temperature is being taken.
9. Rumors about sterility in the maternity ward should not confuse either expectant or established mothers when they head to the shower or toilet. Suggested disposable toilet seat covers are not commonly observed. Not everyone will be able to handle the weight, especially the Caesar babies. A roll of regular transparent bags will help a lot. Some mothers use cling film.
10. A woman who has just given birth can, of course, ask a “stupid” question to the doctor, but experienced mothers They know: doctors don’t like this disgrace. Especially during the rounds. It is worth asking your roommates or nurse any questions you may have in advance. If the question still remains relevant or the baby’s condition raises real concerns, you need to ask the doctor again - preferably after a round.
11. Don't forget to take water with you. Much water. Childbirth is difficult physical exercise. Remember how much water you drank after fitness classes “before.” It is not recommended to drink water from the hospital tap, and tea provided during breakfast or dinner runs out quickly.
12. When collecting a cosmetic bag for the maternity hospital, put chapstick in it. Your lips dry out, during childbirth you often lick them, and even try to bite them. After childbirth, your lips will “thank you” for your forethought.
13. Bring warm clothes: a jacket, a shawl, socks. Drafty corridors are common, and after childbirth, women often feel cold.
14. Phone charger is your everything. The flow of congratulations, chats and messages after a joyful event cannot be handled by any phone. He will have to be “fed.”
15. Be sure to take your husband with you to the maternity hospital - it is irreplaceable and very useful.
Childbirth is a unique process. Any woman needs timely support. She hopes that everything will go well for both her and the baby.
The main thing is confidence, a calm attitude towards what is happening and positivity. Add knowledge to the kit - success is guaranteed.
When going to the maternity hospital, a woman should take into account that right in emergency room she will have to sign an impressive stack of documents. Why is this necessary and what kind of papers are we going to figure it out together with a specialist.
February 12, 2018 · Text: Svetlana Lyuboshits· Photo: GettyImages
obstetrician-gynecologist
In accordance with Article 20 of the Federal Law “On the Fundamentals of Protecting the Health of Citizens in the Russian Federation” of 2011, a necessary precondition for any medical intervention is the voluntary consent of the patient or his legal representative. In other words, before touching you, the doctor must make sure that you do not object to this. Because to the expectant mother one must be mentally prepared for the fact that literally from the moment of arrival at the maternity hospital and almost until discharge from it, doctors will bring various documents for her to sign and they will be called the same: “Voluntary Information Consent.” Let the word “consent” not confuse anyone: any medical intervention can be refused before it begins. And if the doctor is obliged to explain why this or that manipulation is being performed, a woman, refusing medical intervention, is not obliged to explain anything to anyone. The right to this is enshrined in another law of the Russian Federation - “Fundamentals of the legislation of the Russian Federation on the protection of the health of citizens,” signed in 1993. So what is written in the texts of the documents that are brought to the expectant mother, when and for what specific medical interventions will a consent or refusal be written?
Emergency
IN emergency situation, when a woman’s life is in danger, and she is categorically against surgery or manipulation, doctors can turn to her closest relatives: her husband or parents. If they support the patient’s persistence, the final decision is made by a council of at least three doctors. Despite objections and protests from the woman in labor and her relatives, everything possible will be done to save lives. Unfortunately, in the case of a child, the procedure is different. When they can't convince mom, doctors turn to dad. If the parents are at the same time, the law provides for going to court in case of a threat to life. By court decision the baby vital signs they can, for example, undergo a blood transfusion (there has already been such a precedent) or even an operation.
Just in case
A hefty stack of documents appears in front of the expectant mother already in the emergency department. First of all, you must sign the “Voluntary Consent to Provide Information about Your Health Condition.” If a woman does not want to make such data public and transfer it to the general help desk, the corresponding line says: “Data transfer is not possible, except...”. Phone numbers or other contacts of people to whom the expectant mother is ready to entrust this kind of information are also given.
Another paper is “Voluntary informed consent to medical intervention" Very often this document is combined with the previous one, so it has about five pages, or even more, and does not contain any specifics. It explains the patient's rights and why the patient's signature is needed. For example, it is reported that “all diagnostic and therapeutic measures will be carried out only with your voluntary consent. Necessary procedures, manipulations are in some cases invasive in nature and can cause the development of discomfort, side effects, and complications.”
Attention: the same document states that any procedure can be refused, and the refusal must be documented and in medical card an appropriate note must be made specifically indicating the intervention you refused. It will not have administrative consequences, but may affect the correct diagnosis and reduce the effectiveness of treatment.
By signing such a document, the expectant mother confirms that she agrees to the provision of medical care exactly in this maternity hospital.
better in advance
During childbirth, a woman is often unable to carefully study documents and delve into details. Therefore, doctors strongly advise expectant mothers, when choosing a maternity hospital, to meet with medical personnel and find out all the details first-hand. It also wouldn’t hurt to take samples of all the documents at the maternity hospital or download them from the Internet and study them at home in a calm environment, if you wish, fill out the forms after consulting with your relatives.
An equally important document is “Voluntary informed consent for examination and treatment.” It is needed so that the attending physician can ask questions about the state of health (collect an anamnesis - medical history), if necessary, advise the woman, examine her, and invite specialist doctors to see her. The expectant mother also reports that she does not object to taking general clinical, biochemical, bacteriological and immunological tests. It also mentions oral (by mouth) administration of medications, their administration subcutaneously, intramuscularly, intravenous injections and infusions, physiotherapeutic procedures, bandaging. Below you can list the manipulations that you do not agree to.
Attention: if consent (or refusal) to take a coagulogram (blood clotting test), a general clinical blood test and for antibodies to syphilis, hepatitis B and C is signed in one document, then there is a separate paper for a blood test for antibodies to HIV. This a special case, the results of the study are not subject to disclosure, therefore consent or refusal is signed separately.
Having read “I give voluntary consent to carry out, if necessary, surgical intervention", don’t rush to grab your heart, it’s better to read to the end, where very important condition: additional information about this. The doctor is obliged not only to inform about the need for an operation, but also to tell about it in detail and give a document of consent to this particular intervention for signature. And you again have the right to refuse everything. In the same way, when carrying out specific procedures, a separate “Voluntary Informed Consent” is signed, which lists not only the manipulations, possible side effects and unpleasant sensations, but also justifies the need for the procedure and possible consequences refusing it.
In the emergency room, consent (or refusal) for catheterization of a peripheral vein is also signed. Such a manipulation, if the woman has nothing against it, will protect her from repeated injections into a vein, because during childbirth there may be a need for intravenous administration medicines. And since during the birth of a baby any unforeseen situations can arise, here, in the emergency room, it is very often proposed to sign a consent for the manual separation of the placenta, as well as for a caesarean section and for the transfusion of components donated blood(these are three separate documents). Such foresight allows doctors, if something happens, to immediately take active action without wasting time on paperwork.
Along the way
Doctors often say that childbirth is an unpredictable process. It’s good when everything goes according to plan, but at any moment events can take a different turn. For example, there may be a need to stimulate contractions. In this case, the doctor must explain to the expectant mother why this is being done, tell what medications she will be given, how they will act and what side effects and discomfort there may be. The same is indicated in the document that the woman is asked to sign. The need for amniotomy (puncture of the amniotic sac) should also be explained to her in detail. The paper should describe exactly what manipulations the doctor will perform, what unpleasant sensations and they may be accompanied by side effects, what complications may arise from refusing this procedure.
Another document is consent to the use of antibiotics. Before signing it, make sure that the type, dosage and frequency of medications are indicated. The doctor must also indicate for what reasons antibiotics are prescribed and list the drugs already prescribed, and the woman must inform the doctor about the allergies.
Consent (or refusal) to anesthesia must also be documented. The doctor describes the type of anesthesia he has chosen, possible side effects from its use, and specifically stipulates that the choice is made by the anesthesiologist, taking into account contraindications and the condition of the expectant mother.
Legal representative
Among the voluntary consents there are also those that concern the baby. In most maternity hospitals, such documents are offered to be signed after the baby is born. The most important of them are consent to provide medical services, blood sampling for perinatal screening and vaccination of the newborn against hepatitis B and tuberculosis, or refusal of the listed manipulations. Each of these consents is issued separately.
who is responsible?
Signing the “Voluntary Informed Consent” does not mean that doctors abdicate their responsibility. By signing such a document, a woman only confirms that all the risks have been explained to her, she is informed about the consequences that refusal may have, she knows how the manipulation will take place, she is familiar with the treatment plan (the intended delivery tactics) and agrees or refuses the offered services of her own free will , without outside pressure.
The documents list in detail what exactly the baby will have to endure. For example, the provision of medical services involves a daily examination of the newborn, consultation with the mother on issues of interest to her, measurement of height, weight, chest and head circumference, inviting specialist doctors to the child if necessary, conducting x-ray examination etc.
Perinatal screening refers to taking blood from the heel to determine the presence of severe hereditary diseases, which cannot be “seen” during pregnancy.
Vaccination will protect your child from very dangerous infections threatening his life. If there are contraindications, then, of course, vaccinations will not be given. The neonatologist will definitely inform the mother about this.
If your baby needs additional research or intervention, the mother will be informed about them and will also be asked to sign a voluntary informed consent or refusal. For example, a document for catheterization is signed separately central vein, and the paper must state what caused the need for such manipulation and which vein (umbilical or other) the catheter will be installed on. Excision of the umbilical cord, carrying out antibacterial therapy are also impossible without the consent of the mother.
9 months of pregnancy are over, the long-awaited due date has arrived. There are no women who do not worry at this point in their lives, and for some, arriving at the maternity hospital becomes a particular stress. We'll tell you what awaits you behind the sign " Reception department", who and how will meet you where a natural miracle will happen - the birth of your child.
Just as a theater begins with a hanger, a maternity hospital begins with an emergency department. You should have an exchange card with you, a mandatory or voluntary policy health insurance and birth certificate. The admission department usually consists of two reception and examination rooms isolated from each other: one receives patients admitted to the maternity ward or pathology department, the other receives those who need to be admitted to the observation department (unexamined or with an infection). In each of the reception and examination rooms there is a doctor’s office and a room for hygiene procedures with a shower and toilet. Here, the obstetrician-gynecologist examines the pregnant woman, collects anamnesis, measures blood pressure, temperature, pelvic dimensions, listens to the fetal heartbeat and makes a decision on labor management tactics. Then the midwife will help the expectant mother to do the necessary hygiene procedures and will offer a set of linen robe, shirt, disposable slippers. Depending on the result of the examination, the pregnant woman is sent to one of the departments of the maternity hospital: the maternity unit, the operating unit, the department of pathology of pregnant women or the observation department.
If labor activity If contractions have already begun, contractions have become regular, or amniotic fluid has ruptured, the expectant mother will be sent to the maternity ward. Women come to it with contractions. In modern maternity hospitals, the birth block consists of individual boxes, in each of which only one woman gives birth. The box has a multifunctional transforming bed, on which a woman in labor spends the 1st stage of labor (contractions) and the 2nd stage, when the baby is born. The transforming bed is very convenient for both the woman and the obstetricians; in addition, it is possible vertical birth. In the box there is a CTG machine, which helps control the fetal heartbeat, and a changing table with a heating lamp; here the newborn baby will be weighed, measured, and here he will perform his first toilet. In addition, the box has a separate bathroom and shower. Thanks to this system of boxes, childbirth becomes an individual event: even if several women give birth at once, they do not interfere with each other, and future dads can be present at the birth of the baby. IN maternity hospitals The old design of the birth block consists of prenatal wards and a general delivery room. Several women in labor can be in the prenatal ward at once; the 1st stage of labor (contractions) takes place here, and before the start of the 2nd period (pushing), the pregnant woman is transferred to maternity room. Both the prenatal ward and the delivery room are fully equipped with everything necessary for the mother and baby.
The duty team of the maternity unit includes an obstetrician-gynecologist, an anesthesiologist and a midwife. All these specialists constantly monitor the woman in labor and take an active part in the process of the birth of the long-awaited baby. The newborn is immediately shown to the mother so that she can loudly pronounce the sex of the child. After this, the baby is given to the hands of a neonatologist. The neonatologist determines the condition of the newborn using the Apgar score at the 1st and 5th minute of life. This test evaluates heartbeat, breathing, muscle tone, color skin, reflex excitability. After the initial treatment, the child is measured, weighed, wrapped in warm diapers and, if there are no contraindications, placed on the mother’s chest.
A woman spends the first two hours after giving birth in the maternity ward with ice on her stomach and under constant medical supervision. Then, after making sure there are no complications, doctors transfer the young mother to the postpartum ward.
Operating unit childbirth takes place there with the help of caesarean section. A woman can be referred to the operating room from the emergency department if she requires a planned caesarean section, or from the pathology department when she is about to undergo surgery. The operating unit consists of several operating rooms and a preoperative room, where doctors and midwives prepare for surgery. If there are indications, a cesarean section is performed under spinal or spinal-epidural anesthesia. The patient is observed in the ward for 68 hours after surgery intensive care. Everything is taken here necessary tests, control uterine contractions, measure arterial pressure and in the absence of contraindications, the woman is transferred to a regular postpartum ward.
Postpartum ward already accomplished mothers are admitted here: straight from the maternity ward or from the intensive care ward after a cesarean section.
An important task postpartum period is careful care of the mother and newborn. A woman who has given birth is examined daily by an obstetrician-gynecologist, and on the 1st-2nd day after birth she undergoes an ultrasound. If the maternity hospital does not provide for the mother and baby to stay together, then in the postpartum department there is also a children’s ward, where, under the round-the-clock supervision of pediatricians and children’s nurses there are newborn babies. In the absence of contraindications and with the consent of the mother, during the first day of life the baby is vaccinated against hepatitis B, and on the 3rd-4th day BCG vaccination(from tuberculosis). Every 3 hours (except
6-hour night break) children are brought to their mothers for feeding. However, today in many maternity hospitals there are “mother and child” wards, where the mother constantly lies with the baby. In addition, women who have entered into a contract for childbirth can live in comfortable “family” rooms with their father or someone close to them.
Also in the postpartum department there must be examination and treatment rooms, and an ultrasound room.
Department of pregnancy pathology it houses women with such complications of pregnancy as threatened miscarriage, gestosis, fetal hypoxia, Rh conflict, post-term pregnancy, placenta previa, multiple pregnancy, as well as in preparation for elective surgery caesarean section. It is convenient that modern maternity hospitals, for example Perinatal medical Center, are built in such a way that they do not need to be closed for preventive “washing” and pregnant women can lie there for “preservation” for as long as they need for medical reasons. Here, expectant mothers are examined daily by an obstetrician-gynecologist, a CTG of the fetus is performed, an ultrasound scan is performed if necessary, and procedures are performed when indicated to prepare for the upcoming birth. The department usually includes individual rooms, treatment rooms, examination room, shower and toilet in each room. Patients order meals individually and the food is brought to their room.
There is a post in all departments of the maternity hospital nurse(midwives), who is on duty there around the clock. And if the patient needs help, she can always turn to a specialist for it.
It is known that expectant mothers are very afraid of the words “observation department” - this is the name of the department where there are underexamined patients or women with any disease (ARVI, influenza, etc.). In fact, there is nothing wrong with this department. The observation department is a mini-maternity hospital within a maternity hospital: with its own maternity ward, operating room, and postpartum ward. The observation department may also have “family” wards.
If postpartum period proceeds without complications and the child feels satisfactorily, then after spontaneous labor the woman is discharged on the 4th-5th day. If the birth was carried out by cesarean section, then on the 5th day the staples or sutures are removed and ultrasonography the uterine cavity and discharge the mother and child on the 6th-7th day.
Before discharge, the obstetrician-gynecologist and pediatrician will give you all the necessary advice and recommendations. You will receive a certificate of birth of the baby for submission to the registry office and social security and two exchange cards to the antenatal clinic and children's clinic. In a solemn atmosphere, a kind of ritual takes place - the ceremony of handing over the child to the father. You go home and now a new happy chapter begins in your life.
Markova Yulia Evgenievna,
obstetrician-gynecologist of the Perinatal Medical Center
