Are visits allowed in the maternity hospital? The Ministry of Health has approved regulations for visits to maternity hospitals by fathers and close relatives. Is it possible to choose a maternity hospital yourself?

A week ago, my close friend gave birth to a boy weighing 4.1 kilos in the maternity hospital at the Central District Hospital. Within a day, the young mother came to her senses, and the hero also had no reason to feel unwell. Everything was going well until the mother of the woman in labor decided to visit her daughter and grandson. The medical staff immediately rose to protect the health of the patient and baby: “We won’t let them in - that’s all.” But my friend’s mother is not cut out for it. By that time, she had already heard about the new order of the Ministry of Health, which allows relatives to visit women in labor. After long legal disputes and bickering, the woman was finally allowed in, however, everyone’s mood was pretty spoiled. How are things going with visiting young mothers in the capital’s maternity hospitals? A Respublika correspondent found out the details.

Getting to know the document

The new order of the Ministry of Health, which approved the regulations for visiting maternity hospitals and obstetric departments, was signed several weeks ago - on August 15. The document has already entered into force. The goal it pursues is, first of all, “the formation of a positive image of the maternal and child health service according to WHO recommendations, as well as the openness of the provision of obstetric and neonatal care.” This is how the Ministry of Health explained the innovation.

According to the new regulations, the procedure for visiting mothers and babies in each maternity healthcare facility is determined by local documents. Relatives can visit the mother and baby not only in single rooms, but also in shared ones. The main thing is to comply with all medical requirements. That is, you must come only at the hours established by the internal regulations of the maternity hospital, be sure to leave your outerwear in the wardrobe, use bathrobes and shoe covers, and treat your hands with an antiseptic. Of course, under no circumstances will a relative with signs of an infectious disease or if he is a little tipsy be allowed to see the mother and child.

Of course, the conditions for visiting newborns in each individual maternity hospital will differ, because everything depends on the technical capabilities of the buildings, the staff of health workers and many other internal factors. However, each institution must ensure 100% sanitary and epidemiological well-being of mothers and children.

Relatives are allowed in only upon presentation of an identity document. By the way, the circle of people who will be able to look at the baby will be determined by the mother herself - there can be no more than two people during one visit. And one more important condition - visits are allowed only with the permission of the attending physician or the head of the department if the condition of the mother and baby is satisfactory.

Walking through the “red” corridor

Doctors in maternity hospitals have already noticed: with the signing of the new order, maternity institutions have become crowded. New fathers are the most eager to see mothers and babies. I decided to find out what really happens behind the closed doors of maternity hospitals and whether it is really so easy now to get into the room of a woman in labor.

I’m in a hurry to try out the innovation in maternity hospitals in Minsk. I sit down on the phone and start calling them. First the first maternity hospital. Without keeping you waiting long, a woman with a loud voice picks up the phone.

- Hello. Tell me, can I visit my sister soon, she gave birth to you yesterday...- You can feel the timidity in my voice, that’s what it means I don’t know how to lie.

- Surname? Floor?- the voice asks sternly.

- Ivanova, I don’t know the floor,- I answer with lightning speed the first thing that comes to mind.

- You can visit us only in paid single and double wards from 17 to 19 hours, and the woman in labor must indicate you on the list,- a voice provides information of interest.

- What should those who are in the general population do?

There is only silence in response...

In the help desk of the second maternity hospital, they answer the question with a question: “Should I check on you or give you a parcel?” As a result, the situation is exactly the same as in the first case - visits are possible only in paid individual wards. True, the time frame is a little wider: from 12 to 15 and from 17 to 20.

Finally, in the third maternity hospital I was pleased: visits are possible not only in individual wards, but also in general wards from 17 to 19 hours.

- Just call your sister in advance and agree that she won’t mind. Well, don’t forget the robe and shoe covers,- they warned there.

In the fifth city maternity hospital, the relatives’ visit was also not interfered with. The time is still the same - from 17 to 19 hours. True, here I would have to meet my “sister” and “nephew” right in the hall. If my roommates didn’t mind, they would let me in.

As it turned out, the sixth maternity hospital was also already fully occupied by relatives of women in labor. The visiting schedule is approximately the same as in other maternity hospitals. True, the visit time is limited - no more than a quarter of an hour. Here, entry into the general ward is prohibited; a special room is equipped for visits with relatives.

- Three days ago I gave birth to a boy. My health is already more or less normal, but the child’s is so-so. Upon admission, I signed a paper in the reception room that allowed close relatives to visit me and the baby after birth. Before the birth, I even prepared a robe with shoe covers for my husband,- Alena Ivanova, a woman in labor from the “six”, smiles. - True, you can visit us only with the written permission of the pediatrician, so for now you can’t visit us. I gave birth free of charge, under general conditions, I am in a general ward. None of the relatives of my roommates bother us; there is a separate room for all meetings.

New fathers are the most eager to see mothers and babies. Roman and Anastasia VOLODKO with their daughter Anna, doctor Elena BOLBATOVSKAYA.

- Now the document has arrived at all maternity institutions in the city, and our main task for the near future is to thoroughly work it out and adapt it to each individual institution. Of course, a lot here depends on the material and technical base of each maternity hospital. Despite all the difficulties, the new order will help make obstetric and neonatal care more open and accessible to the population- this is the opinion of the head of the department of medical care for mothers and children of the health care committee of the Minsk City Executive Committee, Svetlana Manysheva. - It’s good that the last word on the issue of visits to mothers and children by relatives remains with the doctor, the mother’s opinion takes second place. In general, such a novelty is normal practice in many countries around the world. The earlier a child encounters healthy flora, the better for him.

The specialists of the Clinical Maternity Hospital of the Minsk Region also thoroughly familiarized themselves with the order of the Ministry of Health. Now the institution is creating conditions for visiting women in labor.

- The document provides for the arrangement of separate rooms for visiting women in labor, and wardrobes for visitors’ outerwear. But most importantly, women themselves should be ready for such a new product,- Tatyana Basalai, deputy chief physician for the medical department of the Clinical Maternity Hospital of the Minsk Region, expresses her opinion. - Imagine the condition of mothers who have just given birth. Often they don’t want to see anyone at all, and depression occurs. Therefore, we need to start from the question - does a particular mother need this so that crowds of relatives come to her? And, of course, if yes, then for this we, healthcare institutions, must comply with all safe conditions.

But the Republican Scientific and Practical Center “Mother and Child” is developing its own internal document defining the rules for visits.

“Women in labor from all over the country flock to us, only 10-15 percent are Minsk residents, so the number of people who want to visit women is not very large compared to other institutions in the capital. We are in no way against such an initiative, but everything should be within reasonable limits. Not every dad or relative should be eager for a wife. We think we should start with partner childbirth, where the father has undergone the appropriate examination and is trained in everything,- Svetlana Nagibovich, Deputy Director for Obstetrics and Gynecology, talks about the internal “kitchen” of her institution. - We are preparing an internal document that will allow visits only to fathers who have completed partner childbirth courses. We intend to allow visits only in single rooms. But if necessary, we will admit you to the intensive care unit and intensive care unit.

As we can see, the issue of visiting mothers in labor with babies is still controversial and not fully worked out. In fact, only three maternity hospitals out of seven located in Minsk allow visits from relatives to general wards. And even then, provided that it does not disturb the neighbors. Whether this is right or wrong is not for you and me to decide, we can only monitor further developments...

The wide range of opportunities provided to today's women in labor makes childbirth more individual, comfortable and, of course, less painful.

Freedom for women!

The popularity of free behavior during childbirth is growing every year. More and more medical centers and maternity hospitals are opening departments for “soft” or “home” births, and family rooms are appearing. All these innovations help a pregnant woman feel more comfortable in this process and contribute to a more active participation of her husband in obstetric care. For 5 years now, the presence of the husband or any other family member at the birth has been legally permitted (if the maternity hospital has individual delivery rooms). The institution should not charge money for this. A certificate confirming the absence of infectious diseases in relatives is required.

Once upon a time, obstetricians strictly forced women in labor to lie down without rising from the couch. Today, fortunately, such repressions are no longer used. A woman in labor can simply walk around, lie down, and in some places even soak in a jacuzzi - the water soothes, relaxes and relieves pain. True, water birth itself is not yet officially practiced in our country.

Let me stand up!

Vertical childbirth is in fashion today. They are considered more physiological and favorable for women and children. Here are their advantages.

1. Improves uteroplacental blood circulation and oxygen supply. After all, with a vertical posture of a woman in labor, the pressure of the uterus on large vessels decreases.

2. Reduces pain and the risk of perineal ruptures. The baby is protected from injuries to the cervical spine. After all, moving vertically, the fruit moves down more slowly and smoothly.

3. Reduces the risk of postpartum hemorrhage - the placenta in a woman in a sitting position separates faster.

4. They speed up and facilitate childbirth due to the fact that the woman has the opportunity to more actively participate in the process.

Transformers are coming

In addition to the classic - the Rakhmanov bed, which has been in every maternity hospital since the end of the 19th century and still stands - there are other devices. For vertical birth, a stool with a hole in the seat or a toilet-like chair can be used. Or a transforming bed that allows a woman in labor to take any comfortable position. So far, only expensive foreign transformers exist, but today a similar Russian-made bed is being tested at one of the Moscow maternity hospitals. It is based on a classic model of a couch with footrests, but with the ability to transform the main part by 90 degrees. Tests will take place until the end of this year. When the experiment is completed, the design will receive a patent. And then, perhaps, such models will appear in all maternity hospitals.

It won't hurt

Today, various methods of pain relief are actively used during childbirth. In the early stages of labor - intramuscular and intravenous analgesics with sedatives. During dilatation of the cervix, a paracervical blockade can be used, that is, an injection of an anesthetic into the submucosal layer of the vagina. At any stage of labor - inhalation anesthesia, the so-called laughing gas (nitrous oxide). It is safe for the child, is eliminated instantly, but when inhaled, it blocks the transmission of pain impulses.

And of course, one cannot fail to mention epidural and spinal anesthesia. "Epidural" is used for natural childbirth, the second method is for caesarean section. During spinal anesthesia, one injection is given in the lower back, which shuts off the sensation of the body below the waist for about three hours. The patient remains fully conscious and calmly gives birth with the help of a surgeon.

With epidural anesthesia, painkillers are continuously delivered through a catheter in small doses. This influence can be suspended at any time. Both types of pain relief are considered safe for babies, because the most gentle medications are selected and injected into the interthecal space of the spinal cord, so their concentration in the mother’s blood is low. But there are also disadvantages: for example, an epidural worsens uterine contractions, so by the time of pushing it is turned off. This type of anesthesia can be done either at the request of the patient or for medical reasons. For example, it is necessary if, despite intense uterine contractions, the cervix does not open, which can lead to acute hypoxia in the child. Epidural anesthesia is also used during childbirth in patients with high blood pressure, as it reduces blood pressure.

Important

These innovations are ideal for uncomplicated childbirth. If any complications occur (signs of chronic hypoxia, premature birth, labor abnormalities, etc.), more careful monitoring of the condition of the woman in labor and the fetus is required, which may interfere with the implementation of the chosen labor management plan. Therefore, unfortunately, it does not always work out as the woman planned in advance.

Not all expectant mothers know when and how to choose the right maternity hospital.

In Soviet times, our parents went to the medical institution closest to their home. Modern medicine gives pregnant women the right to choose any maternity hospital depending on their requirements and taste preferences. A woman is not limited in her choice; she just needs to fulfill several conditions.

Is it possible to choose a maternity hospital yourself?

In the last months of pregnancy, a woman is puzzled by the question of whether the ambulance will take her to the chosen maternity hospital.

Many expectant parents make arrangements with the doctor in advance while the pregnant woman is registered. It is considered normal practice to first meet with your doctor and obstetrician 1-2 months before the expected date of birth.

During such a period of time, you can have time to meet with the doctor several times, he will be able to carefully look at the medical (exchange) card and find out about possible complications. In this case, you will be able to establish contact with a professional doctor.

When visiting the maternity hospital for the first time, the expectant mother is often asked to sign a contract on a paid basis, and she is introduced to the list of additional services. They require comfortable living conditions, necessary medications and attentive attitude of workers. So, you will be able to choose a separate room and stay in it with your husband, mother and other close relatives.

In the process of getting to know a doctor, it is strongly recommended to take his phone number and also clarify the possibility of calling at any time of the day if necessary. Such an agreement implies a monetary reward.

It is important to understand that even paid childbirth does not guarantee its easy resolution. Often, on a paid basis, the conditions for the expectant mother in the maternity hospital are improved.

If you are unable to pay for childbirth, you can use a birth certificate, which allows a mentally vulnerable woman to be confident in the future and not worry about the upcoming event.

In 2006, a state program was adopted that allows pregnant women to choose a consultation and maternity hospital. Its action has significantly improved the medical care of the population.

At the same time, young mothers and their children are provided with high-quality medicines completely free of charge. Having a birth certificate greatly simplifies financially the management of pregnancy, childbirth and further monitoring of children by pediatricians in the first year of their life. It allows a woman to choose in which maternity hospital she would like to give birth to her baby. The expectant mother has the right to come to any medical institution and declare her desire to become its patient.

When is it impossible to choose a maternity hospital on your own?

Today, there are a number of cases that do not allow a woman in labor to choose a maternity hospital according to her wishes.

1. The first reason is the lack of a birth certificate when contractions begin. In this case, the ambulance will take the woman to the nearest facility. The occurrence of such a situation sometimes leads to the most unfavorable consequences in the form of a lack of urgent qualified assistance from medical workers and the necessary equipment.
2. Secondly, all maternity hospitals are forced to close one or more times a year for sanitary treatment. Therefore, when the day of birth coincides with this procedure, the expectant mother will not be able to get to the chosen clinic.
3. Many maternity hospitals specialize in providing certain types of care. If complications arise during pregnancy, it would be advisable to contact an institution that meets the necessary requirements. Not all clinics are equipped with everything necessary to attend births for women suffering from diabetes, problems with the cardiovascular system, and so on.

The essence and purpose of the birth certificate

The state program “Health” organizes competition between medical institutions that strive to provide comprehensive care to a large number of pregnant women. At the same time, it is possible to improve the quality of medical services provided in all clinics.

Registration of a birth certificate helps to stimulate the desire of all health care institutions to provide assistance in gynecology, obstetrics and pediatrics. Hospitals are becoming interested in equipping them with certified medicines, as well as modern equipment.

To obtain a certificate, you must complete the following steps:

• register (in the 1st trimester) at the antenatal clinic;
• Regular visits to the clinic (for at least 12 weeks);
• monthly visit to the pediatrician with an infant.

Who can issue a birth certificate:

1. All citizens of the Russian Federation, regardless of age, official employment or registration.
2. Women with any fetal condition, with or without a legal spouse.
3. Citizens of other states with a temporary residence permit or residence permit also have the right to obtain a certificate.

The need to obtain a birth certificate

A birth certificate is a kind of financial incentive for modern clinics, maternity hospitals and antenatal clinics, which provide the population with quality medical care on favorable terms. They receive cash payments of a set amount from a special fund (FSS), ensuring interest in each expectant mother, as well as her baby.

According to the birth certificate, a woman chooses a maternity hospital for herself, taking into account the characteristics of the course of pregnancy. The presumable nature of the birth (complicated or uncomplicated) is also taken into account. When choosing a maternity hospital, it is strongly recommended to take into account the territorial criterion (the nearest place where contractions began).

You can receive a birth certificate absolutely free at 28-30 weeks of pregnancy at a consultation or obstetric center where the expectant mother is registered. The document allows you to choose the best medical institution.

You will need to obtain a birth certificate to select:

• pregnancy monitoring consultations;
• maternity hospital;
• children's clinic for patronage monitoring of your child up to 1 year.

Having a certificate in hand, a woman has the right to contact any maternity hospital she likes (with an exchange card) and agree on the upcoming birth. The manager is required to sign the card, so on the expected day of birth, the expectant mother can come to the selected hospital. When contractions occur at home, emergency doctors will take the woman in labor there.

The certificate cannot be sold or cashed out; it does not constitute financial assistance. The main purpose of the document is to pay for medical services in government institutions. The certificate will not be accepted by commercial private clinics.

Is an ambulance required to take you to the maternity hospital and admission without a certificate?

A birth certificate protects a pregnant woman from the provision of poor-quality and hazardous medical services. She has the right to choose any antenatal clinic (maternity hospital), even if the medical institution is located in another city or region of our country. The issuance of the document helps women receive comprehensive support during pregnancy and early after childbirth.

Even in the absence of a certificate, a pregnant woman will not be denied medical care. She will be able to go to the maternity hospital only at her place of residence. The document gives the right to choose any maternity hospital, regardless of registration. Moreover, in the hospital itself, if the woman has all the necessary documents, they will help her obtain a certificate on the spot. If a document is lost, it can be easily restored. The antenatal clinic will be interested in the efficiency of this process, since based on it, funds for the services provided are transferred to the institution’s bank account.

Modern maternity hospitals are divided into 3 types:

• the predominance of uncomplicated births (up to 500 babies are born per year), they do not provide for a 24-hour presence of an obstetrician;
• birth of up to 1,500 children per year (the department has intensive care and intensive care units);
• regional and federal institutions providing assistance during pregnancy and the postpartum period (often there is a pathology department).

Depending on the characteristics of bearing a child, the gynecologist issues a referral to a maternity hospital in one of the above categories. With such documents, you can go to the selected hospital during contractions. In case of post-term pregnancy (from 40 weeks), you can be admitted to a hospital in such an institution until you wait for the onset of labor.

How to choose a maternity hospital?

Which maternity hospital is better to choose? This question puzzles many women in labor starting from the first trimester of pregnancy. Expectant parents often visit several institutions, learn about the conditions offered, communicate with doctors and choose the most optimal option. It is important that an agreement is concluded between the pregnant woman and the maternity hospital. The attending physician makes appropriate notes in the pregnancy chart. Only in this case, when the water breaks or contractions begin, can the ambulance be required to take the woman to the maternity hospital of her choice.

To understand how to choose the right maternity hospital, you need to study its following criteria:

• proximity of the institution to home;
• living conditions (availability of a separate shower, cleanliness, sterility, etc.);
• availability of good medical equipment;
• qualifications and experience of personnel;
• the possibility of partner (joint) childbirth;
• 24-hour stay with the baby.

When choosing a maternity hospital, it is necessary to study the attitude of all staff towards natural childbirth.

Domestic medical institutions focus mainly on natural childbirth. In this case, planned caesarean section is used exclusively according to indications.

Sometimes emergency situations occur when weak labor occurs when the water breaks. In this case, additional stimulation cannot be avoided, and the life of the newly born person will depend on the highly qualified personnel and the availability of modern medical equipment. After a successful birth, it is advisable for the mother and newborn to be cared for by experienced gynecologists, neonatologists and polite medical personnel.

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The Ministry of Health has approved the Regulations for visits to maternity hospitals and obstetric departments by fathers and close relatives, developed according to WHO recommendations. They will continue to familiarize themselves with the document in medical institutions; it is expected that it should serve not only patients and their families, but also doctors, and help form a system of friendly perinatal care for mothers and children.

In fact, the news that the rules for visiting maternity hospitals will change, and close relatives will be able to freely visit women after childbirth, sounded at the beginning of the year. It would seem that what the new parents have dreamed of for so long has come true. After all, it’s one thing to see each other and communicate in person, and quite another to see them through a window or mobile phone screen. Of course, today in perinatal centers and maternity hospitals you can choose partner births. Or stay in a paid ward, where visits from relatives are allowed (our mothers and grandmothers never even dreamed of this!). But not everyone has such a desire or opportunity.

Just imagine, more than 100 thousand babies are born in the country every year. At least several relatives want to visit each of them. This means that, logically, special conditions should also be created for those who want to meet and spend minutes or hours together. What will they be like? Is it possible to come to the general ward or will there be separate places for meetings or shared stays? Will they be allowed to see mother and newborn in the first hours after birth? Will I need any health certificates for this? The regulations state that visiting a woman in labor and a newborn is possible only if they are in satisfactory condition with the permission of the attending physician. It is assumed that the mother will independently determine those persons who will be able to visit her and the child. But no one will oblige or force her to receive guests within hospital walls. Those who do not have signs of infectious diseases will have access to mommy. Those who show up drunk will be denied an audience. The document also defines the requirements for visiting patients in the neonatal intensive care unit, pathology of newborns and premature infants.

How do doctors feel about this decision? For example, in the Grodno Regional Clinical Perinatal Center, where more than 4 thousand babies are born per year, mothers come from all over the region to give birth. Doctors have heard about the regulations, but have not yet studied them. Accordingly, a little later, based on it, they will develop a document on when and how it will be possible to visit women in labor and babies. Here, by the way, there are already wards for shared stays, in which you can not only visit, but also constantly be close to the woman. There is also an office for everyone, where spouses can meet and chat. Fathers are still allowed into the intensive care unit or department for premature babies (of course, if there are no health contraindications). In general, it’s clear that there will be more hassle... But you’re not used to them here. As in other maternity hospitals, the center is always open to communication. For example, if questions arise regarding the child’s health, the mother is invited to medical consultations so that she can directly ask the specialists. In addition, such openness helps to ensure how much attention and effort doctors spend on patients.

The birth of a child is a colossal physical and emotional stress for a woman. But most of it, even for many husbands, happens as if “behind the scenes”: he took his wife to the maternity hospital, heard the good news, delivered a package, talked on the phone, and a few days later he picked up a beautiful package tied with a pink or blue ribbon. And so you look - thanks to meeting your daughter or son in the first days, the paternal instinct will wake up earlier...

Remember the times when no one was allowed into the maternity hospital? It was the kingdom of mother and child, and happy fathers stood with flowers under the windows and vigorously expressed their joy.

Visits to women in labor are now allowed. And all “fans” can visit the new family member immediately after the birth. Abroad, this has been accepted for a long time and does not surprise anyone. There, all the friends bring gifts straight to the happy mother’s room. But I often wonder if this is right.

When I gave birth to my daughter, she seemed tiny, fragile and defenseless to me. That's how it really was. After all, a child’s immunity is formed gradually throughout life. It comes with mother's milk. That’s why it’s so important to breastfeed for the first six months, when the baby doesn’t have immunity yet, and you pass on yours to him.

First acquaintance with microbes

For the first hours of life, the baby has enough to get acquainted with his mother’s microbes. Imagine how stressful it is for a small organism to move from a sterile womb to our imperfect world. The child’s body is immediately populated by a huge number of bacteria.

These were the thoughts that came to me when visitors came to my maternity hospital. These were close and beloved people whom I am always glad to see, but this time their arrival made me anxious. At that moment, I only cared about my baby and her health.

I gave birth to my daughter in 2007. Visitors were allowed into my paid ward in groups of two. And there was a second bed for a visitor staying overnight. Everyone was given clean gowns. There was no requirement to purchase disposable capes and shoe covers back then. But in vain! I am both in favor of such security measures.

New trends

But there are maternity hospitals where the visiting regime is even less strict. We have one of these, recently restored and filled with sponsorship purchases. They use new approaches to women in labor; they give birth sitting, standing and in the bath.

But all the relatives who came from the region walk in crowds along the corridors and celebrate in the wards. And some of them are designed for two women in labor.

For me this is overkill. I understand that there are women who simply need the help of relatives, I myself was one of them. You can't really count on the hospital staff. After all, there are many more young mothers than nurses and doctors. Therefore, visits cannot be prohibited.

But before turning them into a source of income, it is worth creating conditions to make everyone comfortable. Separate rooms with a toilet and washbasin, so that the woman in labor does not have to stand in line with other people’s coughing aunts.

One of my friends works at the sanitary and epidemiological station, she scared me with a scary story. They worked on a case where one of the guests infected a baby. The adult only had a runny nose, and the child developed meningitis (inflammation of the brain). It was not possible to save the baby.

This, of course, is an isolated case, but no one is safe from such irresponsible relatives.

So it turns out that letting visitors in is dangerous, but not letting them in is bad. Here every mother chooses for herself. What do you think about guests in the maternity hospital?

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