On the eve of International Mother's Day (celebrated on November 26), the Russian Ministry of Health published useful information about pregnancy and childbirth.

Every woman with citizenship of the Russian Federation is provided with free medical care during pregnancy, during and after childbirth. Assistance is provided to medical organizations within the framework of the state guarantee program for the provision of free medical care to citizens.

What is the deadline to register?

You should contact an antenatal clinic at 6-8 weeks of pregnancy. To register, you must present a passport and a compulsory health insurance policy.

Itrimester. 1-13 week

Appointment with an obstetrician:

• General inspection
• Assessment of the condition of the vagina and cervix
• Measuring weight, height, blood pressure and pelvic size
• Recommendations for nutrition and regimen
• Flora smear (allows you to identify possible infections)
• Issuing referrals for tests:

1. General urine analysis,
2. General blood analysis,
3. Coagulogram
4. Blood chemistry
5. Screening to determine the risk of chromosomal abnormalities in the fetus (Down syndrome)
6. Blood group and Rh factor analysis
7. Test for HIV, hepatitis B and C, syphilis
8. Blood test for TORCH infections

• Issuing referrals to other specialists:

1. Therapist,
2. Endocrinologist,
3. Ophthalmologist,
4. Otolaryngologist,

IItrimester. 14-27 weeks

• Appointment with an obstetrician:
• Scheduled ultrasound
• General blood analysis
• General urine analysis
• Registration of an Exchange card (22-23 weeks).

IIItrimester. 28-40 week

• Appointment with an obstetrician:
• Measuring the height of the uterine fundus and abdominal volume
• Scheduled ultrasound
• General blood analysis
• General urine analysis
• Cardiotocography (CTG) - study of the functioning of the cardiovascular system of the embryo and its motor activity
• Registration of maternity leave (30th week).

From the 36th week until delivery, the doctor conducts a routine examination weekly.

I, II, IIItrimesters: general physical examination of the respiratory, circulatory, digestive, urinary system, mammary glands (examination, palpation, tapping, auscultation).

What is an exchange card?

The exchange card, which is drawn up in the second trimester, contains three parts:

1. Information about the pregnant woman (personal data, blood type, Rh factor, results of examinations, tests, screenings, ultrasound, etc.). It is filled out by the antenatal clinic doctor.
2. Information from the maternity hospital about the mother giving birth (information about how the birth and the period after it went, about the presence of any complications, etc.). Filled out by the doctor before the woman is discharged from the maternity hospital (give the coupon to the antenatal clinic doctor).
3. Information from the parental home about the newborn (height, weight, Apgar score, etc.). This part of the card must be clamped by the pediatrician at the first visit.

Who issues the birth certificate and when?

Medical care within the framework of the basic compulsory medical insurance program in Russia is provided free of charge. It includes childbirth, the postpartum period, and hospitalization in a gynecological hospital if necessary (before 22 weeks of pregnancy) or in the pregnancy pathology department of the maternity hospital (after 22 weeks).

In addition to the compulsory medical insurance policy, pregnancy management is additionally financed by the state - in the form of birth certificates, which are issued to women after 30 weeks of pregnancy (Order of the Ministry of Health and Social Development of the Russian Federation dated November 28, 2005 “701 (as amended on October 25, 2006) “On the birth certificate”). In case of multiple pregnancy, a certificate is issued to a woman after 28 weeks.

The birth certificate is used to pay for services provided to a woman in an antenatal clinic, maternity hospital, perinatal center, as well as services from a children's clinic for the follow-up of a child in the first year of life. You can get it at the antenatal clinic where you are registered.

Nowadays, people often move, and sometimes they have to be observed during pregnancy and give birth in a place other than where they are registered. Is it possible to give birth for free in another city? How to change antenatal clinic? And what other opportunities does a compulsory health insurance policy provide for a pregnant woman? We answer the most popular questions.

If I have a compulsory medical insurance policy and live in Moscow, can I give birth for free in the city of St. Petersburg or in another city in Russia?

The compulsory health insurance policy is valid throughout the Russian Federation. If a person who has a compulsory medical insurance policy requires medical care in another constituent entity of our country, he is required to provide it within the framework of the so-called basic compulsory medical insurance program, which is uniform throughout the Russian Federation. Subjects of the Russian Federation have the right to expand the basic program for persons permanently registered on their territory. This expansion is called the territorial compulsory medical insurance program.

Medical care within the framework of the basic compulsory medical insurance program, which includes childbirth, the postpartum period, and, if necessary, hospitalization in a gynecological hospital (up to 22 weeks of pregnancy) or in the pregnancy pathology department of a maternity hospital (after 22 weeks), is provided throughout Russia for free. That is, if a woman goes to a maternity hospital outside the territory where she was issued a compulsory medical insurance policy, and she has medical indications for hospitalization (for example, pregnancy, childbirth, etc.), then the refusal to provide her with medical care is unlawful, as well as the requirement to pay any fees. or services.

Is it possible to choose an antenatal clinic under the compulsory medical insurance policy?

A pregnant woman has the right to choose any antenatal clinic, and not necessarily at her place of permanent registration, it is also possible in another city. To do this, you need to come to the head of the consultation where she would like to register for pregnancy, and write a statement about this addressed to the head. The manager signs this application, and with it the pregnant woman goes to the office of the insurance company where she is insured under compulsory medical insurance. The insurance company re-registers the expectant mother for a new antenatal clinic. The policy itself does not change, but a new antenatal clinic is included in the annex to the compulsory medical insurance policy.

The head of the consultation theoretically has the right to refuse to admit a woman to her consultation if all the consultation doctors have a workload that significantly exceeds their legal workload, that is, they have many more pregnant women on their register than they should have.

What services under the compulsory medical insurance policy can be obtained free of charge in commercial clinics?

If a commercial clinic operates only in cash or is part of the voluntary health insurance system, then under the compulsory medical insurance policy you will not be able to receive services there for free. However, every year the number of private clinics that operate in the compulsory medical insurance system increases. Therefore, before visiting a commercial clinic, check whether it has joined the compulsory medical insurance system, whether they do the examination you need under the compulsory medical insurance system, whether a specific doctor sees you, etc. If you receive a positive answer, you will receive medical services in this private clinic for free. As a rule, antenatal clinic doctors should be aware of similar opportunities in private clinics and, if necessary, refer patients there under the compulsory medical insurance policy.

Questions and answers

Comment on the article "Pregnancy and compulsory medical insurance policy: what is free?"

They asked me to pay for an additional examination under the compulsory medical insurance policy. I called my insurance company, which issued the compulsory medical insurance policy (ROSNO MS). I told them what and how, they promised to solve my problem. And they decided. Examined for free. So the policy really works and the insurance company is ready to defend its interests.

25.09.2015 17:50:46,

Total 3 messages .

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Many couples put off having children because of the family's financial situation. During pregnancy, childbirth, and the postpartum period, additional costs arise for medical care, medications, and doctor services. Not everyone knows what pregnant women are entitled to for free, and in general, that you can undergo some kind of examination and receive some medications for free.

Normative base

In connection with the decrease in life expectancy and a significant decrease in the birth rate, the all-Russian project “Health” was launched in 2006. An innovation was the introduction of birth certificates, which stimulate improvement in the quality of medical care in antenatal clinics and maternity hospitals.

Articles Art. 41 of the Constitution of the Russian Federation and Art. 20 Fundamentals of the legislation of the Russian Federation on health protection stipulate that all medical care in state and municipal medical institutions should be provided free of charge. Any by-laws must comply with the Constitution of the Russian Federation.

The issue of providing medicines is regulated by orders of the Ministry of Health and regulatory documents of the constituent entities of the federation. The main document is Order No. 748 of October 6, 2008 “On the provision of medicines to pregnant women,” which allows you to receive a number of medications absolutely free or with a 50 percent discount.

Paid services in medical institutions are not prohibited by law, but they should not be provided in exchange for free medical care provided to pregnant women.

It should be

The “Health” project involves a certain sequence of receiving medical care, medications and vitamins for pregnant women free of charge. For this purpose, each future woman in labor is given a birth certificate, which is financed from the local budgets of the constituent entities of the federation.

The general procedure is as follows:

• You should try to register with your local antenatal clinic in the first 12 weeks of pregnancy. For early registration, incentive payments are provided in the amount of 500-1000 rub.. (depending on the region of the Russian Federation, residents of the North are given a premium depending on the category of the region);
• Regularly undergo examinations and tests prescribed by your gynecologist;
• At the 30th week (in the case of a multiple pregnancy - at the 28th week), the pregnant woman is given a birth certificate, which is used to pay for medications, childbirth, as well as pediatrician services for examining the baby in the first year of his life.

How much can you get for early registration?

According to the Procedure for the appointment and payment of state benefits to citizens with children, every woman who registers with the local antenatal clinic in the first 12 weeks. pregnancy, receives a lump sum benefit. This is done to encourage women to start visiting a doctor as early as possible, which will allow them to identify abnormalities in the development of the fetus in the early stages of its development and take the necessary measures.

To receive benefits, you need not only to register on time, but also:

• be a student paid for by the state;
• be employed, then the employer makes payments to the Social Insurance Fund
• contribute funds independently to your social insurance policy.

Thus, you either need to have an official job, or be a student at an educational institution, or be a woman entrepreneur. Also eligible for payment are women who were fired for good reasons (moving, caring for a seriously ill family member, illness, etc.) no more than a month ago.

• The certificate can be obtained at the antenatal clinic registry at the place where the pregnant woman is registered.
• Then the certificate must be provided to the employer at the place of study or go to the Social Insurance Fund at the place of registration to draw up a social contract.
• The payment will be made simultaneously with the payment of maternity benefits.

The procedure for receiving incentive payments is regulated by the Law “On State Benefits for Citizens with Children” dated May 19, 1995 and the Order of the Ministry of Health and Social Development of Russia “On Approval of the Procedure and Conditions for the Appointment and Payment of State Benefits to Citizens with Children” dated December 23, 2009

Why do you need a birth certificate?

The birth certificate was created with the aim of improving the quality of medical care in maternity hospitals and antenatal clinics, since the money is received directly by the medical institutions to which the woman turns.

The certificate consists of three separate coupons for certain amounts:

• 3000 rubles – to pay for services in the antenatal clinic;
• 6,000 rubles – to pay for services in maternity hospitals and perinatal centers;
• 2000 rubles - to pay for the services of a children's clinic for examination and monitoring of a child until he reaches one year.

A woman can spend 20-35% of the total amount on medications prescribed by a doctor.

What free services are available to pregnant women in 2016?

Doctors' services

• First of all, pregnant women are guaranteed to receive full medical support from the supervising gynecologist.
• In addition, free services are provided by other specialists, including a therapist, otolaryngologist, ophthalmologist and dentist. Referrals to doctors of other specializations are issued by a gynecologist.
• It is also stipulated that all medical or physiotherapeutic procedures are provided free of charge.
• A woman can receive free care in a hospital regardless of the method of treatment: independently, by referral from a doctor, or by being delivered by ambulance.

General studies

Maternity clinics provide free examinations:

• Ultrasound three times during the entire period of pregnancy (10-14 weeks, 20-24 weeks, 32-34 weeks) or more often in the direction of a gynecologist;
• fluorography for all relatives of a pregnant woman living with her.

You do not have to pay not only for the study itself, but also for consumables used during work (for example, alcohol, syringes, cotton wool).

Laboratory research

Orders of the Ministry of Health and other regulations provide for free tests for pregnant women, including:

• General clinical tests: flora smear, general blood and urine test, Nechiporenko and Zimnitsky tests, coagulogram (bleeding duration, platelets, blood clotting time).
• Biochemical: bilirubin, fibrinogen, total protein, urea, blood sugar, creatinine, prothrombin index.
• Serological: blood group, blood test for syphilis, hepatitis, Rh factor, determination of antibody titer if Rh is negative.
• Antibody titer to infections affecting fetal development
• Cytological: oncocytology
• Additional (according to indications): bacteriological studies, colpocytology, serum iron, external hysterography, cardiotachography, etc.

Manipulations and physiotherapy

• Physiotherapy (according to indications): electrosleep, electrophoresis and others
• Manipulations (as prescribed by the doctor: intravenous injections, intramuscular injections and others.

Free some medications and vitamins

The list of medications provided to pregnant women free of charge is provided for by Order No. 748 of October 6, 2008 “On drug provision for pregnant women.” It contains a small list of medications and multivitamin complexes that will help a woman bear and give birth to a healthy baby (taken according to indications).

To receive a free medicine or purchase it with a 50% discount, you must:

1. Register with your local antenatal clinic;
2. After the examination, obtain a prescription from your doctor and a list of pharmacies where you can purchase it.

The list includes only vitamins, drugs for anemia and iodine deficiency with a list of trade names of drugs:

• Multivitamins (revit, gendevit, complivit, vitrum Prenatal, zithrum Centuri, Megadin Pronatal, multi-tabs, supradin, teravit, ferravit, elevit prenthal);
• Iron supplements(maltover, fenyuls, ferretab complex) - with low hemoglobin;
• Folic acid(folacin) - in the first 3 months of pregnancy;
• Vitamin E (vitrum, zithrum vitamin E, tocopherocaps, alpha-tocopherol acetate);
• Potassium iodide (iodomarin, iodine balance, potassium iodide, microiodide).

It is impossible to get medicine on preferential terms at the first pharmacy you come across, since for this, health authorities must enter into an appropriate agreement with the pharmacy. Check with your gynecologist where exactly you can take advantage of the benefit.

Is it possible to get benefits when being seen in a private clinic?

The draft stipulates that a woman can receive benefits only if she is registered with a state/municipal antenatal clinic. But some women are observed and give birth in private clinics. However, a birth certificate and free medications are issued only if you register with a government agency.

In this case, in order for a woman to receive the necessary medications and vitamins absolutely free of charge or at a minimal cost, she should simply be observed simultaneously both at the state antenatal clinic at her place of residence and at a private doctor.

Benefits at work

In addition to medical benefits, pregnant women are also entitled to benefits at work. Many of them are known to most workers:

• prohibition of dismissal of a pregnant woman at the initiative of the owner (Article 261 of the Labor Code of the Russian Federation);
• reduction of production standards (Article 254 of the Labor Code of the Russian Federation);
• prohibition of overtime, night work, business trips (Article 259 of the Labor Code of the Russian Federation);
• prohibition of working with harmful factors with the obligatory preservation of previous earnings (Article 254 of the Labor Code of the Russian Federation);
• availability of paid leave for pregnancy and childbirth (Article 255 of the Labor Code of the Russian Federation);
• leave until the child reaches three years of age (Article 256 of the Labor Code of the Russian Federation);
• the ability to establish a part-time or weekly work schedule (Article 93 of the Labor Code of the Russian Federation).

But there are a number of benefits that not all pregnant women know about. For example, a pregnant employee has the right to use her annual leave at a time convenient for herself (even violating the vacation schedule) or tying it to the beginning or end of maternity leave (Article 260 of the Labor Code of the Russian Federation). Also, an employee can use vacation before six months of work at the enterprise in the first working year (Article 122 of the Labor Code of the Russian Federation).

And one more rule can greatly help pregnant women. According to Part 3 of Art. 254 of the Labor Code of the Russian Federation, pregnant women retain their average salary during outpatient examinations. This means that, firstly, the boss cannot prohibit going to the antenatal clinic during working hours, and secondly, he is obliged to pay for the examination time in the amount of the average salary. You just need to remember to take a certificate that you really were in a medical institution

Requirements for working conditions for women during pregnancy

According to SanPiN 2.2.0.555-96

How to exercise your rights

So, the legislation provides some benefits for pregnant women; you just need to know your rights and insist on providing benefits. If your rights are violated, do not hesitate to argue and write complaints to various authorities.

• As a rule, immediately after the threat to write a statement to the Department of Health, the Labor Inspectorate or the prosecutor's office, the whole problem instantly disappears, and the issue is resolved very quickly.
• First, you should go to the head doctor or the head of the antenatal clinic. It is quite possible that the conflict will be settled fairly quickly.
• If you cannot resolve the issue, then you should write a complaint to the regional health department, the Social Insurance Fund, the Ministry of Health, or the prosecutor's office.
• You can also call the hotline or send an email request through the online form.

It is advisable to indicate all recipients in the request. This reduces the chances of unsubscribing, since the authority’s management sees that the request was sent not only to them. As a rule, after such requests, the attitude towards the patient instantly changes, and everyone suddenly “remembers” the benefits provided.

If you have questions about the topic of the article, please do not hesitate to ask them in the comments. We will definitely answer all your questions within a few days.

80 comments

Pregnancy and childbirth under compulsory medical insurance

Pregnancy is a wonderful period in the life of every woman. Expectant mothers approach this issue with all responsibility and want to know in advance when to go to the doctor, when to do an ultrasound, when to go on maternity leave and, finally, what to take to the maternity hospital for themselves and the baby. Information about pregnancy management can be found in various sources and, sometimes, there is even too much of it. To help expectant mothers, SOGAZ-Med specialists have collected the most up-to-date information about examinations during pregnancy, necessary procedures and documents for mother and child.

It is important

SOGAZ-Med employees remind you that the compulsory health insurance policy (CHI) is valid throughout the Russian Federation. Medical care within the framework of the basic compulsory medical insurance program, which includes pregnancy monitoring, delivery, and examinations in the postpartum period, as well as (if necessary) hospitalization in a gynecological hospital (up to 22 weeks of pregnancy) or in the pregnancy pathology department of a maternity hospital (after 22 weeks ), throughout Russia it is free. If a woman goes to a maternity hospital outside the territory of registration, and she has medical indications for hospitalization (for example, threat of termination of pregnancy, childbirth, etc.), then the refusal to provide her with medical care is unlawful, as well as the requirement to pay for any medical services.

In addition to funding from the compulsory medical insurance system, the management of pregnancy and childbirth is additionally supported by the state through the “Birth Certificate” program. A birth certificate is a document on the basis of which settlements are made with the medical institution that provided the woman and her child with relevant healthcare services. The certificate is issued at the antenatal clinic where the pregnant woman is being observed. If a pregnant woman is observed in a private clinic, but wants to receive a birth certificate under compulsory medical insurance, she needs to go to the antenatal clinic to which she is assigned for up to 32 weeks and ask to be issued a document based on the exchange card issued in the private clinic. Remember, you cannot pay for a private clinic or cash out a birth certificate!

Examinations during pregnancy

The duration of pregnancy is determined by 3 trimesters.

In the 1st trimester to 12 weeks, at the first appearance of the pregnant woman, the obstetrician-gynecologist collects anamnesis and conducts a general examination of organs and systems; anthropometry (measurement of height, body weight, determination of body mass index); measuring the size of the pelvis; gynecological examination. In addition, the woman undergoes examinations and consultations with specialized specialists: a therapist, a dentist, an otolaryngologist, an ophthalmologist and other doctors, as indicated. And he takes a clinical and biochemical blood test, a coagulogram, a blood test for HIV, syphilis and hepatitis, TORCH infections, a vaginal smear and a general urine test. In addition, the doctor fills out the necessary documents, gives recommendations on nutrition and taking vitamins.

At a period of 10–12 weeks, prenatal screening is carried out - this is a mass examination of pregnant women, which is carried out in order to identify a “risk group”. This group includes expectant mothers who have a high probability of having a child with a hereditary disease or congenital malformations. Prenatal screening allows you to suspect Down syndrome, Edwards syndrome and neural tube defects in the fetus already in the early stages of pregnancy. The examination also includes biochemical (blood test) screenings. These studies are safe, that is, they do not affect the health of the expectant mother, the course of pregnancy and the development of the baby, and they can be performed on all pregnant women.

In the 2nd trimester, parents can already find out the sex of the child if they wish. Also at this time, the risk of the threat of miscarriage is reduced, in most cases toxicosis passes (if it was in the 1st trimester) and the expectant mother can enjoy her position and the emerging tummy. At 13–24 weeks, a urine test is performed before each visit to the doctor (once every 3 weeks).

The second screening during pregnancy is carried out at 18–21 weeks in a medical organization that provides prenatal diagnostics to exclude congenital anomalies of fetal development. Like the first screening, it consists of two stages - ultrasound and blood tests.

In the 3rd trimester, at 24-28 weeks, an oral glucose tolerance test (OGTT) or glucose tolerance test is performed, which allows you to identify disorders of carbohydrate metabolism during pregnancy, that is, to check how well the body regulates sugar levels. This test determines the presence gestational diabetes mellitus (GDM)– pregnancy-related increased levels of glucose (sugar) in the blood.

When the pregnancy is 30-34 weeks, an ultrasound is performed at the place where the pregnant woman is observed. At this time, a study of blood circulation in the placenta and in the baby is carried out. At the 30th week of pregnancy, a certificate of incapacity for work is issued for maternity leave.

After 32 weeks, regular recording of fetal cardiotocography (CTG) begins. This is a modern technique for assessing the condition of the fetus by the nature of its heartbeat.

Starting from the 36th week, a doctor’s examination is carried out every 7 days. At 40-41 weeks, planned hospitalization for delivery is carried out. If there are medical indications, pregnant women are offered earlier antenatal hospitalization. By this time, the mother should have her “maternity hospital bag” ready with certain documents and things for herself and the child.

What documents and things to take to the maternity hospital

Passport, compulsory medical insurance policy, birth certificate, exchange card from the antenatal clinic, SNILS. Mom will need personal hygiene items (soap, toothpaste and brush, etc.), rubber slippers, clothes (robe, socks, etc.). For a newborn you need to prepare: hats (1-2 pieces each, flannel and cotton), baby vests/bodysuits (1-2 pieces each, flannel and cotton), rompers (2-3 pieces), diapers for newborns, booties and scratchies, regular and disposable diapers (from 3 pcs.), diaper cream, wet wipes.

Before being discharged from the maternity hospital, the mother will undergo an ultrasound of the pelvic organs and will be advised about the benefits and recommended duration of breastfeeding.

What documents to take from the maternity hospital

Upon discharge from the maternity hospital, the mother or immediate relatives must receive the following documents: a page from the birth certificate about the mother’s health status, the child’s exchange card, a vaccination card (if vaccinations against viral hepatitis B and tuberculosis were given in the maternity hospital), a certificate for the registry office about the birth of the child.

One of the first concerns of parents will be the preparation of documents for a newborn child. SOGAZ-Med reminds that the compulsory medical insurance policy is a document that gives the child the right to receive all basic types of medical care free of charge in medical organizations operating in the compulsory medical insurance system. From the day of birth until the expiration of 30 days from the date of state registration of birth, a newborn child receives all necessary medical care under the compulsory medical insurance policy of the mother or other legal representative.

To apply for a compulsory medical insurance policy, you must contact the insurance company. The SOGAZ-Med insurance policy can be obtained by visiting one of the company’s offices, or by leaving a request on the website.

To apply for a compulsory medical insurance policy for a child, you will need the following documents:

Child's birth certificate;

SNILS number of the child (if available);

Identity document of the child's legal representative.

For questions about the procedure for receiving medical care under the compulsory medical insurance system, SOGAZ-Med insured persons can contact their insurance representative by calling the 24-hour call center 8-800-100-07-02 (calls within Russia are free) or check the information on the website.

Company information

The insurance company SOGAZ-Med has been operating since 1998. The number of insured people is more than 19 million people. Regional network - more than 660 units in 40 constituent entities of the Russian Federation. SOGAZ-Med carries out compulsory medical insurance activities: monitors the quality of service for the insured when receiving medical care in the compulsory medical insurance system, ensures the protection of the rights of insured citizens, restores the violated rights of citizens in pre-trial and judicial proceedings. In 2018, the Expert RA rating agency confirmed the rating of reliability and quality of services of the insurance company SOGAZ-Med at the level of “A++” (the highest level of reliability and quality of services within the compulsory medical insurance program on the applicable scale). For several years now, SOGAZ-Med has been assigned this high level of assessment.

Pregnancy is a time of special female vulnerability, when the expectant mother is worried about both her health and the health of the baby. Therefore, it is not surprising that many of us decide to follow the established stereotype: it is better to pay and even overpay for medical care, but save both the pregnancy and the nerves. This position, unfortunately, is supported by the frequent silence on the full list of services provided by the pregnancy management program under the compulsory medical insurance policy. And yet, before choosing a private clinic, it would be good to have a full understanding of what exactly and to what extent can be obtained for free, in accordance with the procedure and standards of medical care approved by the Ministry of Health.

The right of pregnant women to free medical care is given by the compulsory health insurance policy (CHI). Within the framework of this document, the patient has every right to choose for medical care and pregnancy monitoring any clinic operating under the compulsory health insurance system. This means that every expectant mother can be observed completely free of charge, not only at the district antenatal clinic at her place of registration, but also at any other public clinic in her city.

The compulsory medical insurance program includes both consultations with a doctor and the necessary list of examinations and diagnostic procedures. A medical insurance policy and a copy of it will be needed both when visiting the antenatal clinic and when entering the hospital. Unfortunately, without a compulsory medical insurance policy, an expectant mother can only receive emergency medical care free of charge.

The compulsory medical insurance pregnancy management program includes:

• therapeutic and preventive procedures;
• active home visits (patronage);
• instrumental and laboratory examinations with the necessary clinical, laboratory and instrumental studies;
• hospitalization (if necessary), including day hospitals;
• early diagnosis of fetal malformations;
• psychological and physical preparation for childbirth, the formation of motivation to give birth and raise a healthy child;
• breastfeeding education;
• examinations and consultations with other specialists;
• referral, if necessary, to receive free medical care to other medical institutions.

Also in accordance with Art. 19 Federal Law “On the Fundamentals of Protecting the Health of Citizens in the Russian Federation”, when seeking medical help and receiving it, the patient has the right, inter alia, to:

• choice of a doctor, taking into account the doctor’s consent, and choice of a medical organization;
• prevention, diagnosis, treatment, medical rehabilitation in medical organizations in conditions that meet sanitary and hygienic requirements;
• obtaining consultations from medical specialists;
• relief of pain associated with a disease or medical intervention with available means and medications;
• protection of information constituting medical confidentiality;
• refusal of medical intervention;
• admission of a lawyer, clergyman or legal representative to protect their rights; For pregnant women, this means, in particular, that you can come to any maternity hospital with your husband or girlfriend, if you have knowledge of your rights and a power of attorney beforehand.

Physiological course of pregnancy

Doctor visit

In a normal, that is, physiological, course of pregnancy without complications, according to the compulsory medical insurance program, a gynecologist invites you for an examination during the first half (up to the 20th week) once a month, during the second half of pregnancy - twice a month, and in the last month of pregnancy - weekly.

Also, during pregnancy, an examination by a general practitioner should be carried out twice: the first time - after the first examination by an obstetrician-gynecologist; the second - at 30 weeks of pregnancy.

When a pregnant woman first contacts the antenatal clinic, the obstetrician-gynecologist is obliged to issue referrals for a free examination by the following doctors: an ophthalmologist, an otolaryngologist, and a dentist.

Analyzes, laboratory tests, ultrasound

All studies for a pregnant woman, including ultrasound, laboratory tests, tests for intrauterine infections, genetics and hemostasis, should be carried out free of charge, under a compulsory health insurance policy.

If the antenatal clinic is not able to conduct the necessary research, then the doctor must give a referral to another antenatal clinic or hospital.

Also, according to the compulsory medical insurance program, two screening ultrasounds are required during pregnancy (as part of a screening test): at 11 - 13 weeks and 16 - 20 weeks. This test is also free: it is funded by the state program for improving the health of the nation, as it allows you to identify abnormalities in the development of the fetus.

Vitamins and medications

During pregnancy, the compulsory medical insurance program provides free vitamins and, if necessary, medications. In 2015, the list of such vitamin preparations included:

• folic acid;
• multivitamins;
• multivitamins + minerals;
• iron (III) hydroxide polymaltosate;
• iron fumarate + folic acid;
• iron (III) hydroxide polymaltosade + folic acid;
• potassium iodide;
• vitamin E;
• calcium carbonate.

The list of free medicines for pregnant women is similar to the list of vital and essential medicines (VED), which is approved by the Government of the Russian Federation. It can be found on the websites of the Russian and regional Ministry of Health.

Treatment of pathologies during pregnancy

No one is immune from surprises, and it happens that a physiological, that is, normally proceeding, pregnancy suddenly turns into a pathological one. During pregnancy, problems arise quite often, and there are many reasons for this: poor ecology, various infectious diseases of women or men, hidden inflammatory processes and chronic diseases, poor nutrition and, of course, stress. Problems can be either serious, posing a danger to the child and requiring in-depth examination and treatment, or caused by an elementary deficiency of vitamins and minerals, immunodeficiency or disorders of the body's microflora.

In any case, the compulsory medical insurance program provides free treatment and assistance to maintain pregnancy, and therefore a number of additional studies and manipulations.

Examinations and laboratory tests

Thus, in case of a complicated pregnancy, the number of examinations, including by various medical specialists, is determined by the obstetrician-gynecologist, taking into account the state of health. According to his instructions, such examinations are carried out free of charge, as well as additional ultrasound and screening studies, Doppler sonography, etc.

In the case of a pathological pregnancy, many examinations, which are usually offered for a fee, are required to be provided to the woman free of charge, if this is necessary to identify any abnormalities in the health of the mother and child. If the housing complex does not have the necessary equipment, then, according to the law, the housing complex must find an institution that will perform this examination on their behalf using compulsory medical insurance funds. That is, any examination prescribed by a doctor as necessary during the normal course of pregnancy, as well as if any abnormalities are suspected, should be provided free of charge.

Negative Rh factor

In Rh-negative women, the father of the child is additionally examined for group and Rh affiliation, and if the father is Rh-positive, the pregnant woman's blood is tested monthly for Rh antibodies.

Emergency hospitalization and inpatient treatment

According to the testimony of the supervising doctor, the expectant mother may be prescribed treatment in a hospital. Planned treatment, as well as emergency hospitalization, should be provided free of charge under the compulsory medical insurance program. In the clinic, the expectant mother must undergo a full examination and be offered tactics for managing and maintaining the pregnancy, as well as a method of delivery. At the same time, the hospital providing the necessary treatment must work under the compulsory medical insurance system.

Typically, the maternity hospital conducts examinations and treatment of pregnant women with the following pathologies:

• habitual miscarriage;
• toxicosis of the first and second half of pregnancy;
• placental insufficiency;
• pregnancy with pathological features of the genital organs;
• presence of a scar on the uterus;
• uterine fibroids.

Assistance is provided using ultrasound examinations, CTG - computer monitoring of the condition of the fetus, examinations for genital tract infections and laboratory tests.

Inpatient treatment of other diseases, including chronic and infectious diseases that threaten pregnancy and the child, is carried out in specialized hospitals, with the direction of a doctor.

Just like a clinic, a hospital, an expectant mother has the right to choose at her own discretion if she is not satisfied with the institution to which the referral to the LCD was issued.

Sanatorium for pregnant women

In addition to inpatient treatment, every expectant mother has the right to free sanatorium-resort treatment, subject to indications and a referral from the attending physician.

You can count on a ticket in the following cases:

• miscarriage;
• infertility;
• fibroids;
• malformations of the uterus;
• caesarean section or other stitches on the uterus;
• primigravida under the age of 18 or over 28 years;
• anemia;
• hormonal imbalances;
• a history of diseases that are at risk during pregnancy.

The total duration of such spa treatment can be 21 days.

IVF procedure

It is enough to have a compulsory medical insurance policy to get on the waiting list for the IVF procedure, since infertility is considered an insured event.

Conditions for free IVF:

• availability of compulsory medical insurance policy;
• medical indications for IVF;
• age of the expectant mother (from 22 to 39 years);
• no contraindications to IVF procedures;
• normospermia in the father of the unborn child;
• completing a course of infertility treatment prescribed by a doctor.

Under the new conditions, you can make an unlimited number of IVF attempts until a positive result is achieved.

The federal quota provides for expenses of up to 106,000 rubles, that is, unexpected expenses exceeding the preferential limit will have to be covered independently.

The cost of the benefit includes:

• hormonal stimulation of follicle growth;
• collecting the required number of cells;
• in vitro fertilization procedure.

According to the compulsory medical insurance program (or quota), there is also an IVF protocol, where, after rescheduling the procedure, support is mandatory, individual for each patient. Usually these are vitamins and progesterone - its dosage is prescribed by the doctor. If necessary, based on test results (blood, hormones), additional medications, hormonal and vitamin preparations are prescribed. After pregnancy is confirmed, the level of the hormone progesterone (and the patient’s individual indicators) is monitored and the dose is adjusted. After confirming the pregnancy and adjusting the support, the expectant mother is registered with the LCD, where she is observed as in a normal pregnancy, but taking into account the peculiarities. At the slightest problem, she is placed on continued pregnancy.