We told about how sometimes you have to deal with women in the maternity hospital. And now let's go from words to business. Maria Moltartova, who prepares an online course for mothers on how to protect his rights in the hospital (based on the groon site), shared instructions with us on handling medical professionals.
Attention! All of the following are tips for those who want to use them. If you do not need it, please do not think that we are aging to give up the medical services.LCD and Life
Problem. I do not want from the early terms to be observed in the LCD, there are evil doctors, there are unnecessary analyzes, I want tenderness and care!
Actually. You are completely optional to pregnancy to stand in terms of the LCD, you can not appear there, but to be observed under the contract or ongoing visits and manipulations in the Paid Medical Center. The main thing is to immediately clarify whether this center has a license for the issuance of hospital sheets (for maternity leave) and the exchange card - for the maternity hospital. Without an exchange card, a woman will put in a observative (infectious) branch of the maternity hospital, where the rules are stricter, everything is sterilized, visits are prohibited.
Problem. And in the LCD they said if I want a normal exchange card, I have to go to them regularly and register up to 12 weeks, otherwise they will not give!
Actually . If you plan to give birth in the chosen maternity hospital and not in the infectious compartment, you will need to have time to use the services of the LCD or a paid clinic to get a exchange card. But! No regulatory act requires the regularity of observation and the presence of all screenings, analyzes offered by doctors. None of the document says that the insufficient number of visits to one of the specialist doctors (gynecologist, dentist, and so on) may be the cause of refusal to issue "Exchanging".
Before entering the hospital, it is important to have time to pass and enter into excavation only a number of analyzes. The map should have evidence that you do not suffer from infections dangerous for newborn and neighbors in the home branch, at a minimum. And that you are not sick with something serious, requiring a delivery in a specialized institution (for example, a maternity hospital for suffering from cardiovascular pathologies).
In any case, you should not neglect a visit to an ophthalmologist, since the doctors are always afraid of retinal detachments in childbirth and may insist on this unnecessary healthy woman interventions. It is better to have a certificate from the oculist, that there is no resinuction risk.
Thus, if you want to do with a minimum of obstetric observation for a period of pregnancy and confident in his health (but at the same time, homework is not your choice), then the main analyzes with the help of which the doctor will be able to determine the absence of infectious diseases and the opportunity to give birth in any maternity hospital, This is a clinical blood test, urine analysis, gynecological smear for infections, HIV tests, RW, Hepatitis B and C tests, also need a certificate of "general health" from the district at the place of residence or the therapist constantly observing you. Based on the listed doctor in the LCD or other clinic, it will be able to conclude that your health status does not carry a threat to others, after which it will be obliged to give the exchange card, allowing you to give birth in any hospital of your settlement. Yes! - Even if you registered in 28 weeks of pregnancy or in 30.
Problem. In the LCD they said that I came at 31 week, and now I will not give me a "decret" sick-minded. I have to go to the maternity hospital right from the meeting?!
Actually . Exactly 30 weeks of pregnant are required to issue a hospital sheet for pregnancy and childbirth. Again, they are obliged, even if she came to register at 29 weeks. If it came to 31, they must give immediately, the date of the visit: the issuance of hospital hollows is prohibited by law. No failures in the issuance of hospital for pregnancy and childbirth legislation are not allowed. The hospital sheet is issued for a period of 140 days, it can be extended in the case of complicated or multiple pregnancy.
Urgent question. "How much will I get" maternity "?"
Answer. In accordance with Part 1 of Art. 11 of the Law No. 255-FZ "On compulsory social insurance in case of temporary disability and due to the motherhood" of pregnancy benefits and childbirth is paid to the insured woman in the amount of 100% of the average earnings, but within the limits established by the same law. In 2016, as in 2015, the "Ceiling" of the manual is 248,164 rubles for 140 days "Decree" (the amount is calculated in accordance with the Federal Law "On the Federal Budget for 2016").
That is, the ceiling for the month of "Decree" (do not confuse with leave for child care to 1.5 years!) - Currently a little more than 53 thousand per month. The amount of the hospital may be less if the salary of a woman is less than 53 thousand per month; More - the state no longer pays. Alas, even if there is absolutely white earnings of several hundred thousand, we have a completely nonilyusent ceiling. Sometimes good employers add "decreh" to real earnings at their own expense, but according to the law they are not obliged, unfortunately.
Problem. But in the LCD they still talked, only they can give a generic certificate, he is needed for the maternity hospital!
Actually . The generic certificate is needed by the maternity hospital to account for a budget basis (not under the contract). And if you came to give birth without him, you will immediately write it in the presence of an OMS policy, passports and SNILS. And if you gave birth by contract, then ... anyway can write down in the hospital or then in the children's clinic
Creator I'm trembling or giving life?
So far, LCD, move to the maternity hospital. It is clear that it is possible to make a decision on domestic childbirth, but the topic is your rights in medical institutions, so we will talk about them.
Problem . And what if I give birth for free, I can not take anyone with you for childbirth for support?
Actually. The woman has the right to give birth to her husband or mom and including if he gives birth for free. The main thing is that in the hospital chosen by the maternity hospital were individual labor halls.
Article 51 of the Federal Law 323 "On the Fundamentals of the Health of Citizens in the Russian Federation" is indicated: "Father a child or other family member is given the right if there is a consent of a woman, taking into account the state of its health, attend the child's birth, with the exception of cases of operational delivery, subject to the establishment of the relevant Conditions (individual generic halls) and the absence of a family of infectious diseases at the father or other family. The implementation of this right is carried out without charging the fee from the father of the child or another family member. "
And who are family members? According to Art. 2 Family Code are spouses, parents and children. That is, these people can freely come to childbirth - if they are more than 14 years old - having a certificate from the therapist about the absence of infectious diseases, the result of analyzes for HIV-syphilis-hepatitis (negative) and the result of fluorography. However, as we can see, close can participate in childbirth only in the presence of individual generic halls, and such conditions are far from all hospitals. If the place of residence allows, try to choose a hospital in advance.
Problem . Well, horror after all. I will act in the maternity hospital and I will not even know what they are running there and why. Complete defenselessness in the face of indifferent physicians!
Actually . Know and love your rights. Before childbirth, it is mandatory to sign the so-called "voluntary informed consent to medical manipulations" (Art. 20 of Law No. 323-FZ), you read it carefully. If something does not suit - you can delete (of course, I am sure that you do not want this manipulation under any circumstances; naturally, we do not advise you to make such decisions without the participation of trusted doctors' specialists!)
We do not undergo psychological pressure: "If you do not sign - we will not provide you with medical services." Doctors have no right to such a refusal "in punishment" for your, for example, the reluctance of childbirth stimulation without additional agreement. In accordance with Art. 124 of the Criminal Code, if the doctor refused to help you, and it led to health problems - yours or kid - the doctor is criminal pricing.
After childbirth
First of all: Mother is you (and the father is he), and only you or you two of the final decisions on what manipulations will be carried out in the hospital (and any medical institution) with your child. No injections, vaccinations, screenings, premises under the lamp - without your written consent.
We will make it boring, but useful and quote the order of the Ministry of Health of the Russian Federation of November 1, 2012 N 572n "On approval of the procedure for providing medical care for the" Obstetrics and Gynecology (except for the use of auxiliary reproductive technologies) "(as amended from June 2015) : "32. In postpartum departments, a joint stay of the pants and newborn, free access of family members to a woman and a child is recommended. The recommended time stay of the parental in a medical organization after physiological genera - 3 days. 33. At the deployment of the parental, the attending physician is explained about the benefits and recommended duration of breastfeeding (from 6 months to 2 years from the date of the child) and the prevention of unwanted pregnancy. "
Note! Breastfeeding up to 2 years - the official position of our Ministry of Health, no "backward countries", as we often can hear in the maternity hospital and clinics. We also mention the order of 30 of the order: "In the maternity hospital, it is recommended to provide the first attachment of the child to the chest no later than 1.5-2 hours after birth in a duration of at least 30 minutes and support for breastfeeding."
Problem. In the maternity hospital, everything is terrible, they cannot provide a joint stay, they are trying to impose me that they do not correspond to my worldview and the opinion of my physician practice. I have to sit there for 3 days, once in the order it is said so?
Actually . No, it is not obliged. Three days - precisely recommended, optional. You can take your personal baby to the armpit and leave for receipt ("Responsibility for everything for yourself" and any such) at least 12 hours after childbirth. Doctors are obliged to offer you an ultrasound before discharge. Again: Agree - not your duty, but the right. Maybe you should not neglect checking: but it was not left in you after the birth of something extra.
Problem . In the maternity hospital, it seems nothing, but I strongly do not like neonatologist, and I know that there are doctors better in the department.
Actually . To help you. 5 tbsp. 19 of the Law 323-FZ. The patient has the right not only to choose a physician in a medical institution, but also on the requirement to invite specialists from other clinics for consultation. Yes, right in the hospital.
Important to remember ! For himself and the child, we are responsible First of all, we ourselves are the legal representatives of this very child. This is written in Article 20 of the Law 323-FZ: Mother and Father are legal representatives of the child, and all manipulations are made only with their written consent. Even those that to save lives and health.
Part 5 Art. 20 of the Law 323-FZ reads: "If one of the parents or other legal representative of the person specified in part 2 of this article, or the legal representative of the person recognized in the procedure established by law is incapable, from the medical intervention necessary to save his life, medical organization It has the right to apply to court to protect the interests of such a person. The legal representative of the person recognized in the procedure established by law is incapacitated, informs the body of the guardianship and guardianship at the place of residence of the ward about the refusal of the medical intervention necessary to save the life of the ward, no later than the day following the day of this refusal. "
Accordingly, your solutions do not like physicians, seem to be dangerous for the child's life - ahead, a medical organization can sue. In practice, this happens almost exclusively in cases of the death of a child due to the refusal of certain interventions: the court of physicians insure themselves.
Problem . What about vaccinations? They are told that you need to do everything right immediately.
Actually. You have the right to refuse any vaccinations. Part 1 Art. 5 of the Federal Law No. 157 "On the Immunoprophylaxis of Infectious Diseases". There are no mandatory vaccinations. Preventive vaccination calendars are advisory.
P.S. . Everything to a single manipulation with a child should be recorded in the medical care, with which you have the right to meet at any time, get copies and extracts from it! And the children's clinic also concerns (the same law 323-ФЗ).