The rights of pregnant women in the antenatal clinic. How to change a doctor in a antenatal clinic that does not suit me

Where is the expectant mother usually seen? In the antenatal clinic at the place of residence. And here she often gets into some kind of addiction: you have to go to appointments often, you need to take tests all the time and undergo a lot of examinations, and in some certain deadlines! And God forbid you miss something! Yes, examinations during pregnancy are necessary, but you should not forget about your rights and comfort. Let's talk about what the expectant mother has the right to in the residential complex.

1 be observed anywhere

According to the law Russian Federation, a pregnant woman can choose any antenatal clinic (LC), and not just the one to which she is attached at the place of registration. This means that you can live in one area of ​​the city, and be observed in a completely different one: for example, next to your place of work or just in the antenatal clinic that you like best. Moreover, you can register for pregnancy even in the residential complex of another city. The main thing is that you need a compulsory medical insurance policy valid throughout Russia. To register outside the place of registration, you need to write an application addressed to the head physician of the consultation, bring the original and a copy of the passport, compulsory medical insurance policy, insurance certificate SNILS.
And even if for some reason you stop visiting the LCD, for example, you go to a private clinic, no one has the right to deregister you in the LCD.

2 choose a doctor

Also, according to the legislation of the Russian Federation, you can choose a doctor who will monitor your pregnancy, or change a doctor who, for some reason, did not suit you. To do this, you also need to write an application addressed to the head physician of the LCD.
In addition, every expectant mother in a antenatal clinic or maternity hospital has the right to read medical card or the history of childbirth, see records of examinations. And you don't need to explain why you need it. If you do not understand why you need some kind of appointment or analysis, then the doctor should explain everything in an accessible form.

3 register at any time

You can register with the antenatal clinic at any stage of pregnancy. True, very short term neither a doctor nor an ultrasound scan will yet be able to accurately confirm pregnancy, so it’s still better to register after the 6-8th week. It is at this time that the doctor will be able to reliably establish the fact of pregnancy during the examination.
There is one more recommendation - to come to the antenatal clinic before 12 weeks of pregnancy. This is due to the fact that the first ultrasound is done at 10-12 weeks and at this time it is possible to most accurately determine the gestational age. By the way, those women who register with the LCD for up to 12 weeks receive a cash payment called " lump sum women registered in a medical institution in early dates pregnancy (up to 12 weeks). True, they give nothing at all, but they will come in handy for someone.
But all this does not mean that it is necessary to register strictly up to 12 weeks. No, you can come at any time last trimester), the main thing is to have time to pass the necessary tests before the birth.

4 visit the residential complex at the time you need

If you feel well, the tests are normal and you do not want to go to the antenatal clinic often, you have the right to refuse regular visits to the gynecologist. Just tell your doctor about it, he should respect your decision. Yes, the doctor will warn you that you are responsible for your choice, but he should not intimidate you or threaten to refuse to extradite exchange card. If something like this happens, immediately go to the head physician of the antenatal clinic or contact the health department.
But you need to know that there are studies (ultrasound, blood test for chromosomal pathologies), which must be done within a strictly defined time frame, otherwise their result may be unreliable. Therefore, ask the doctor in advance about the time of some examinations.

5 select surveys

If you want to do all the examinations you need, you have the right to receive them in full. Each antenatal clinic has a list of examinations and consultations required during pregnancy. You can ask your doctor to tell you in detail about them and do everything that you are supposed to. If you, on the contrary, think that you do not need this or that appointment or is unacceptable for you, you can refuse it. No one has the right to force you to do an ultrasound, screening, take any drugs. Even if you refuse something, you cannot be deregistered due to pregnancy, not extradited birth certificate and an exchange card. The doctor will simply record your refusal in the card and write that it was explained to you why this or that study was recommended.
In general, to get an exchange card, you need to pass a series of tests at least once ( clinical analysis blood, urinalysis, smear, tests for HIV, RW, hepatitis B and C) and visit an obstetrician-gynecologist at least twice. The first time you come for an initial examination and in order to get a referral for tests, the second time - to enter the results of the examination into the exchange card.

6 do as you please

All examinations in the antenatal clinic are carried out completely free of charge. And even if there is no specialist or there is temporarily no research, you should be given a referral to another medical institution where all this is available. The doctor does not have the right to refer you to any additional paid tests or consultations if they can be done free of charge under compulsory medical insurance.
If you want to do some research yourself for a fee and in another clinic (for example, to do an expert ultrasound), then you must accept its results at the antenatal clinic (and not say that we believe only our analyzes or specialists).

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

In the antenatal clinic, the doctor with whom I am registered during pregnancy is not satisfied. The head of the LCD refuses to change the doctor for another, citing that she can change for another doctor only with the consent of the doctor himself. I went to 2 doctors and was denied. The manager refused to accept my application, and she also refused to write a written refusal. Sent to the head of the doctor, but I think there will be the same situation. I also don’t accept me because they oblige me to sign some papers at the reception. Is it legal? Can I write a complaint to the Ministry of Health ?, and referring to which law?

Answer

Order of the Ministry of Health and Social Development of the Russian Federation dated April 26, 2012 No. 407n “On approval of the procedure for assistance to the head medical organization(its subdivisions) the patient’s choice of a doctor in the event of a patient’s request to change the attending physician” establishes the obligation of the heads of medical institutions to respond to the patient’s request to change the attending physician. To change the attending physician, you need to write an application addressed to the head physician. The application must indicate the reason why you want to change doctors. There can be any reason: the doctor’s work schedule is not convenient for you, loss of confidence, etc. After these steps chief physician medical institution within three days must acquaint you in writing or orally with the list of available doctors, their work schedule and give you the right to choose.
But the specialist you have chosen is not obliged to take you for treatment. The right to refuse a patient is also spelled out in the above order. In case of refusal to choose a doctor, contact higher authorities: the health department of your city, district, region.

I'm 10 weeks pregnant and it's going well. However, I have delicate issue. The thing is, I can't get in touch with Dr. I don't like coming to the appointment. The doctor is rude, not ready to listen, reluctant to answer questions. It seems to me that if he is inattentive to me, then he is negligent about the issues of my pregnancy, but I cannot allow this. But on the other hand, I'm afraid to go to the head of the antenatal clinic and ask for a change of doctor, as I'm afraid to stumble upon even more misunderstanding and dryness. And also the fact that the doctor will not change me, and the former one will treat me even worse. What should I do? Anna, 23 years old

Alexandra Moskalenko
Psychologist, Moscow

The relationship with your doctor during pregnancy is very important. And yet, first of all, coming to the next reception, you need to pay attention to other essential details.

First of all, evaluate the cleanliness of the room and the tools used. This is a prerequisite for your physical health and psychological comfort, because you must be sure that no infection will stick to you in the doctor's office.

Then check if all required procedures are being followed. The doctor must look at you on the chair, measure the pelvis, weigh you, fill out a card, give directions for tests and appointments with other specialists. Negligence or failure to perform these actions - warning sign. And last important point- polite treatment. The doctor leading the pregnancy can be dry, communicate formally, without emotion, but at the same time politely. Quite another thing is the frank rudeness and rudeness of a doctor during pregnancy. It is also an unfavorable indicator if the doctor intimidates the patient with various complications and is generally skeptical about the successful course of her pregnancy.

But to expect admiration from the doctor of the usual district antenatal clinic for the fact of your pregnancy, to seek psychological support, assurances that the pregnancy will proceed perfectly, is not worth it. As well as the willingness to listen to long stories about childbirth from your friends. After all, he is guided by the fact that there are probably still many patients in the corridor, and therefore interrupts conversations that are not relevant to the case. Also, many doctors themselves do not take the initiative in explaining, because they believe that such information may simply be of no interest to the patient. Therefore, if you have questions, you need to ask them, and, most likely, the doctor in charge of the pregnancy will try to provide clarifications on the topic that concerns you. If you still have doubts, you can go to an appointment with the head of the department. But not for the purpose of mandatory changing the doctor during pregnancy, but to clarify information about whether your pregnancy is being conducted correctly.