Childbirth under a contract: the subtleties of concluding a contract. Childbirth under a contract: how to choose a maternity hospital and conclude a contract Pros and cons of free childbirth
The birth of a child is a wonderful, very significant and at the same time the most important event for every family. Future parents, in order to avoid unforeseen circumstances, take seriously the provision of medical services to them.
In contact with
Therefore, increasingly, caring parents resort to concluding a contract for childbirth, which is provided by many maternity institutions.
This option differs from ordinary free childbirth by creating all kinds of comfortable conditions for you, and from an agreement with medical specialists by guaranteeing compliance with the terms of the agreement. A maternity hospital that practices a similar contract system provides convenience in the form of a TV, refrigerator, telephone, hot and cold water in the room, the ability to choose a doctor, and, if desired, permission for relatives to be present during childbirth and visit them in the room. But the most important thing, of course, when concluding a contract is the guarantee of attentive and professional delivery. Therefore, in order for the above points to be observed, it is necessary to approach the conclusion of the contract with special care.
The contract is drawn up in the maternity hospital at the full 36 weeks of pregnancy. His conclusion may be directly with the maternity hospital itself, a medical institution specializing in the provision of pregnancy and childbirth services, or with an insurance company.
In the first case, from a legal point of view, the contract provides for the provision of all medical services, and in the second, medical insurance.
When concluding a contract directly with a medical institution, it is important to make sure that this organization has the right to provide such services. Therefore, you should ask to provide you with a confirmation license to provide services to pregnant women, as well as to an infant.
In the option with an insurance company, the expectant mother becomes the insured person. By signing the contract, the insurance company enters into a contract with a certain medical institution to organize childbirth. As in the first option, ask to provide you with all the necessary documents, such as concluding an agreement with the maternity hospital, confirming the company’s license to provide permission to provide insurance in the field of medicine.
What is included in the birth contract:
- Duration of the contract;
- Procedure, term, amount of depositing funds;
- List of medical services provided;
- Responsibilities and rights of the parties to the agreement.
Points regarding living conditions, the maternity hospital and doctor you choose should also be specified in the contract.
If the maternity hospital, medical personnel, or a company specializing in health insurance fails to comply with any clauses or terms of the contract, you can demand the return of funds or part of them through the court.
Also, if everything is in order with the contract documents, women can return 13% of the amount spent - this is a tax deduction for paid childbirth, which returns the state for unused free medical services.
How much does paid childbirth cost under a contract?
Paid childbirth requires considerable expenses. As a rule, the cost of the service includes the choice of a specialist who will deliver the child, an obstetrician, a comfortably equipped postpartum ward, and, if desired, an anesthesiologist and pediatrician. The average cost of contract childbirth has a significant range from 50,000 thousand rubles to 400,000 thousand rubles. Prices for paid childbirth in a perinatal center start from 70,000 thousand rubles. This price difference directly depends on the category of the maternity hospital you choose, possible complications during childbirth and the length of stay in the maternity hospital during the postpartum period.
Should I choose paid or free childbirth?
Any married couple decides whether to pay for the provision of childbirth or not, and how much money to give for childbirth, based on their financial capabilities and wishes. The following indicators will help determine the issue of paid or free childbirth:
- A woman in labor should understand what is important for her, medical services or comfortable conditions. For some women, it is much easier to give birth for free with an unfamiliar doctor, and to be in the postpartum ward with several women in labor, while for others this moment is completely unacceptable.
- A preliminary examination of the maternity hospital, its living conditions and communication with a doctor will help in choosing the option of paid or free childbirth.
- In advance, for comparison, the conditions and costs of various maternity institutions studied will also help in this matter.
In conclusion, I would like to add that the decision to choose childbirth under a contract or free depends only on you and your preferences. Most women, in general, believe that there are no bad doctors, rely on their professionalism without extra money and give birth to healthy children without problems.
If you are principled and believe that everything should be at the highest level, both in terms of comfort and in medical professionalism, then contract childbirth is suitable for you. The main thing, regardless of any birth option you choose, is that the day the baby is born will be remembered by you as the happiest, unforgettable event in your life!
About contract childbirth: what is the doctor’s responsibility in the video:
In contact with
Today, an increasing number of Russian women prefer contract childbirth. Our center for expectant mothers offers pregnancy support and paid childbirth under a contract according to the program Natural Childbirth. Many Muscovites prefer to choose a maternity hospital in advance for a successful outcome of pregnancy, and decide on an obstetrician-gynecologist to whom they can entrust such a responsible process. This is understandable, because any mother wants to give birth to a healthy baby without complications.
The expectant mother who has entered into a contract for childbirth is provided with a significant number of advantages and conveniences compared to free childbirth. Maternity hospitals operating under a contract system are distinguished by comfortable living conditions, stay in high-comfort rooms, which have a refrigerator, TV, telephone, and other attributes of home comfort. It is also offered the opportunity to get acquainted with the medical staff in advance and choose the attending physician who will observe the prenatal period and be the first to meet the baby.
It is planned to carry out partner births, when at the important moment of the birth of a baby a close person is present with the woman. The contract form implies the possibility of relatives visiting the woman in labor. The most important benefit that expectant mothers receive is the guarantee of proper attention and adequate measures from the staff. Some maternity hospitals offer the services of a personal midwife.
The nuances of childbirth under a contract
In order for the promised benefits to become a reality, you must be extremely careful when choosing a maternity hospital and concluding a contract. Of course, not everyone has the opportunity to entrust the study of the contract to a personal lawyer, so if you decide to choose a maternity hospital yourself, you will have to familiarize yourself with the legal intricacies.
In order for the transaction to be completed without incident, the employees of our center, within the framework of the Natural Childbirth program, are ready to assist our clients in this important step. Over 7 years of work in this segment of services, during pregnancy support activities, we have studied, compared and analyzed the terms of contracts of most Moscow maternity hospitals. We will help you conclude a contract that is beneficial for you directly with the maternity hospital, where all individual wishes will be taken into account.
It is impossible to predict how the birth will go, and in case of any complications in the woman in labor or in the baby, it is necessary to find out whether you will have to pay for additional measures taken separately. For this purpose, you should clearly know what standard list of services a specific contract implies - accordingly, all other activities will be additional services.
You should know that without the consent of the patient of the maternity institution, the medical organization has no right to perform any paid services. Even if the woman is subsequently presented with the fact that they have been completed, she may not pay for them, and if they are paid, she may demand a refund of their cost in accordance with the legislation of the Russian Federation.
The contract must strictly stipulate the length of stay of the mother and child in the hospital. The cost of additional stay must be specified separately in the contract.
All living conditions that are guaranteed to the mother in labor must be clearly stated in the contract, including: the type of room, the presence of household appliances in it, etc.
Natural childbirth is a great choice
In order not to overshadow the wonderful days in anticipation of future motherhood, avoid paperwork, save time and money, entrust all the troubles to our specialists. We will help ensure that your stay in the maternity hospital is remembered for the birth of a small miracle into the world, and not for the indifference or rudeness of the medical staff.
Let your baby be born in comfortable conditions in an atmosphere of goodwill and cordiality! We offer childbirth not in the most expensive, but in the most comfortable conditions, in those maternity hospitals where highly qualified specialists work. If you dream of an ideal contract birth, call tel. +7 (495) 741-80-02 or submit an online application (open 24/7).
Paid childbirth, which is increasingly becoming the choice of modern women, involves signing an agreement between the expectant mother and the maternity hospital or insurance company. Pay attention to all its points - this will save you from many misunderstandings and disappointments.
October 9, 2015· Text: Svetlana Lyuboshits· Photo: GettyImages
lawyer
A contract for childbirth is a contract for the provision of medical care, guaranteeing the expectant mother not only service in the institution of her choice during childbirth and in the postpartum period, but also a certain set of benefits. It can be concluded either with the maternity hospital itself (medical, perinatal center, etc.) or with the insurance company. What nuances should be taken into account when signing this document?
Birth contract options
If the contract is signed directly with the maternity hospital, then an agreement is concluded for the provision of medical services. Relations between the parties are regulated, among other things, by the law “On the Protection of Consumer Rights”, because the expectant mother is a consumer of services. And in this case, the woman has more opportunities to make claims to the maternity hospital.
If the contract is concluded with an insurance company, the situation becomes more complicated, since insurers are intermediaries between the expectant mother and the maternity hospital. The guiding and guiding force in this case will be another law - “On medical insurance of citizens in the Russian Federation.”
A typical maternity contract from insurance companies begins to operate at different times - from the 31st, 34th or 36th week of pregnancy. Its effect ends approximately a month after birth.
You can sign the agreement either at the company’s office or with its representative in the selected maternity hospital. In the first case, the expectant mother buys a voluntary health insurance policy and receives a list of maternity hospitals with which the insurer has contracts. When contacting any of them, a woman in labor is placed in a paid department. Choosing a specific doctor in such a scenario is difficult.
The second case provides more benefits. The insurance agent and employees of the paid department of the maternity hospital will be able to give detailed answers to all questions, give a tour of the maternity hospital, and advise the team on duty or a personal doctor. And although the expectant mother receives the same VHI policy, the accompanying contract will be more detailed.
But there is also a fly in the ointment: the client pays not only the insurance policy, but also the agent’s remuneration, which makes the contract more expensive.
Agent check
When signing a contract for childbirth with an insurance company, check whether it is licensed to provide health insurance. If the contract is concluded with a representative of the insurance company in the maternity hospital, make sure that he has the appropriate authority. First of all, he must have a power of attorney to sign the agreement, and the insurance company must have the already mentioned license. You must also be shown the agreement between this organization and the maternity hospital. Pay attention to the validity period of the document: what if it expires tomorrow, and the birth should take place in 2 months. In addition, the maternity hospital must have a license for medical activities with an application. Please note that it is issued for no more than 5 years, and pay attention to the dates.
By concluding a contract for paid childbirth, a woman has the right to choose a doctor, a ward, if she wishes, her husband or another close person can be present at the birth. In addition, relatives can visit the young mother immediately after the baby is born. The document stipulates the conditions of stay in the postpartum department: the type of room (for 1 or 2 people, “luxury”, room for a mother and child), the presence of a telephone, TV, refrigerator, etc.
And then there are the nuances. And in order for paid childbirth to be as comfortable as possible, when signing the agreement, one must not forget about the details. And first of all, immediately find out whether the expected date of birth coincides with the planned closure of the maternity hospital for sanitation. In this case, you will have to choose another institution.
When the birth contract does not specify force majeure circumstances (emergency cesarean section, additional pain medications, cost and timing of payment for other medical services), you are not obligated to pay for them. If you have already given the money, you can demand its return (Clause 3 of Article 16 of the Law “On Protection of Consumer Rights”).
When a contract is signed with an insurance company, the contract or an appendix to it must contain a list of proposed medical facilities. If a woman chooses a specific maternity hospital and a specific doctor, she must indicate the name of the institution and the surname, first name, and patronymic of the doctor. Otherwise, it will most likely be written in the agreement that the birth will be conducted by a doctor of the highest category who is on duty that day. The expectant mother will find out who it will be only during childbirth.
No doctor will ever guarantee that the birth of a baby will go without a hitch. So it is better to immediately choose an operating obstetrician-gynecologist. Otherwise, in an emergency, the surgeon on duty will perform a caesarean section.
Please pay attention to the duration of the contract, the size, timing and procedure for paying for services or making insurance premiums.
The agreement must stipulate possible types of pain relief during childbirth. When a woman wants to give birth without resorting to anesthesia, she should not only stipulate this option in the contract, but also determine the procedure for recalculation.
It is important to clarify whether drugs that enhance or slow down labor will be used, and to provide for the possibility of voluntary refusal to use these drugs. It is also better to document the chosen delivery technique in the contract.
The expectant mother has the right to independently form a team of specialists who must be present during childbirth (obstetrician-gynecologist, midwife, anesthesiologist, resuscitator, neonatologist). In addition, one of the clauses of the childbirth contract may be the requirement to provide an experienced nurse to care for the newborn if the mother wants to rest after giving birth.
It is also better to specify in advance the responsibilities of the maternity hospital staff if the mother or baby needs emergency resuscitation or diagnostic care. Otherwise, you will be required to pay separately for this type of service or you will have to hospitalize the mother or baby at the place of registration of one of the parents under the compulsory health insurance program, that is, in a free department of a municipal hospital.
It is imperative to record how many days the mother and baby will stay in the maternity hospital. They can be detained beyond the term only on the written conclusion of a doctor. Provide for this option and ask the contract to indicate how much each additional day spent within the walls of the maternity hospital will cost.
State in the agreement that if the mother or baby develops postpartum complications that develop within 7 calendar days after birth, hospitalization is guaranteed.
It would also be a good idea to find out whether medical care is provided after discharge from the hospital (ultrasound, consultations, examinations). If yes, then to what extent and for what period.
And finally, the contract must indicate what responsibility the maternity hospital or insurance company bears to the client, how and in what order they will compensate for inadequate performance of the contract.
How to make a claim
The terms of the contract always provide for the financial liability of the parties. For example, if an expectant mother is not immediately placed in a single room provided for in the contract, the woman has every right to demand that the maternity hospital pay a penalty for each day overdue.
A claim for compensation for material damage can be brought against an insurance company or a medical institution. Maternity hospitals prefer to resolve all disagreements amicably and return the money without bringing the matter to court. But you often have to sort things out with the insurance company in court. But in any case, the claim must be submitted in writing and have it registered.
Regardless of compensation for material losses, you can also demand compensation for moral damage. This is provided for in Article 15 of the Law “On Protection of Consumer Rights”. True, for the sake of fairness it must be said that in Russia the courts assess moral damage in purely symbolic amounts.
Photobank Lori
In fact, medical care in Russia remains free. So if a woman has a compulsory insurance policy (CHI), she has the right to give birth for free. In this case, the birth will be attended by a doctor who is on duty at the moment when the pregnant woman with contractions is delivered by ambulance. Since 2006, women have been issued: for a singleton pregnancy, a document is issued at 30 weeks, and for a multiple pregnancy - 28 weeks. The birth certificate implies the allocation of a nominal 10 thousand rubles by the Social Insurance Fund. This amount is spent on management of 3 thousand rubles, on childbirth - 6 thousand rubles, and monthly care of a newborn in a children's clinic during the first year of life - 1 thousand rubles.
Of course, in our country there are many well-equipped maternity hospitals with qualified staff. However, many women who decide to give birth “for free” still complain about the unfriendly attitude of the medical staff, the lack of any amenities, etc. You can provide for everything down to the smallest detail and leave the maternity hospital with positive emotions if you sign a contract for childbirth.
What's worth paying for?
The contract, of course, is not a guarantee of an “easy” birth. But, thanks to the contract, you can choose the maternity hospital in which you want to give birth, a doctor who will know the history of your pregnancy in advance and, accordingly, will be more prepared for various surprises during childbirth. Also, the contract can discuss a number of fundamental details to ensure that the stay in the maternity hospital brings comfort to the young mother.
The range of services provided by maternity hospitals may vary, but usually includes the following:
Choosing a personal doctor who will observe the woman for the last month before giving birth and deliver the child (in this case, the doctor will be “in the access zone” at any time, and the expectant mother can call him to consult on any questions that arise);
Possibility of partner birth (the husband or one of the close relatives may be present at the birth);
Finally, comfortable postpartum rooms with a bathroom, TV, refrigerator, etc.
With whom to enter into a contract for childbirth?
If the future mother’s choice fell on a state maternity hospital, then it is necessary to conclude a VHI agreement with an insurance company. In this case, the woman in labor is admitted to a paid department, gives birth in a comfortable maternity ward, and after the birth she will be provided with separate meals.
I am definitely in favor of paid management and childbirth! Pros: attention to you, polite staff, the opportunity to call your doctor 24 hours a day, a separate good room, six meals a day. Meeting your baby turns into a celebration!
Before concluding an agreement, you need to find out whether this insurance company really has a contractual relationship with the maternity hospital in which you plan to give birth - ask them for documentary evidence of cooperation. In addition, the company must have a valid license to provide health insurance services.
As a rule, you can conclude a contract for childbirth in the paid department of the maternity hospital - representatives of insurance companies are usually based there. However, this can also be done at the insurers' office. Some insurance companies, understanding the specific characteristics of this category of clients - a pregnant woman may not feel well - are ready to visit the expectant mother at home. After concluding the contract, the insurance company provides the maternity hospital with a letter of guarantee, in accordance with which the service will be provided to you.
If you prefer to give birth in a commercial clinic, then the contract must be concluded directly with it. It is important that she has the right to provide services to pregnant women and newborns.
When signing a contract, pay attention to the person authorized to sign it with you. This must be either the director of the organization or his authorized representative. But in this case, the document must include the license plate of the power of attorney, on the basis of which the contract for childbirth is concluded by another representative of the insurance company. A copy of the power of attorney must be attached to the agreement. Otherwise, the contract may be declared invalid.
To conclude a contract, only two documents are required: a passport and an exchange card, which is issued at the antenatal clinic for a period of 20 weeks. If you want, he will have to take blood tests for HIV, hepatitis, syphilis, and undergo fluorography.
Important Details
In order for the “paid” birth to be as comfortable and enjoyable as possible, it is recommended to include the following points in the content of the contract:
Money paid for childbirth will not guarantee that one day everything will not go awry and then you will not have to deal with the consequences. They guarantee that they will come in to see you again, hold your hand, and, probably, the conditions of your stay may be a little better than those of the free ones.
1. Record the first and last name of the doctor to whom you entrust the management of the last month of pregnancy and, in fact, the birth. If you miss this point, then the contract will most likely state that the birth will be conducted by a doctor of the highest category who was on duty that day. In this case, it is unlikely that you will see the doctor you planned to see.
2. Document possible types of pain relief during childbirth. This will be especially important if there is a need for a cesarean section and suturing due to postpartum tears or episiotomy.
3. If you want to give birth on your own, without resorting to anesthesia, but doubt your abilities, it is better to include in the contract the option of voluntarily refusing anesthesia. It is recommended to resolve the issue of recalculation in advance.
4. It is important to clarify whether medications will be used to enhance or slow down labor. Consider the possibility of voluntarily stopping these medications. It is also better to document the chosen birth control technique in the contract; stipulate the mandatory use of disposable instruments.
5. You have the right to independently form a team of specialists who will be present in the delivery room (obstetrician-gynecologist, anesthesiologist, resuscitator, neonatologist, midwife). Of course, you need to hope for the best, but it is also advisable to provide options for getting out of unpleasant situations. Stipulate in the contract the responsibilities of the maternity hospital specialists if you or the baby needs emergency resuscitation or diagnostic care. If these points are not specified in the contract, most likely, emergency medical services will have to be paid separately.
6. As a rule, today in all Russian maternity hospitals, paid and free, the child is with his mother after birth. If the state of health of both does not cause concern, of course. The birth contract can stipulate the presence of experienced medical staff to care for the newborn - if the mother wants to rest a little after giving birth.
7. If the delivery ends, the contract must indicate how many days the mother and baby will stay in the maternity hospital. She can be detained beyond the agreed period only on the written opinion of a doctor. At the same time, it is important to discuss in advance how much each overdue day in the ward will cost.
8. Check whether the estimated date of birth coincides with the closure of the maternity hospital for cleaning. In this case, you will have to choose another maternity hospital: the contract will not open the doors of the maternity hospital.
9. Find out if the maternity hospital offers lactation consultants. If available, the young mother is recommended to add this service to the contract;
10. It would be a good idea to find out whether medical care is provided after discharge from the hospital (consultations, ultrasound, examinations). If yes, then to what extent and for what period.
11. State in the contract that the insurance company guarantees hospitalization in the event of postpartum complications in the mother or child that develop within seven calendar days after birth.
12. The contract must indicate what responsibility the maternity hospital or insurance company bears to you, how and in what order they will compensate for inadequate performance of the contract.
If you enter into a contract with a non-state clinic, then often the final bill for childbirth is written twice as much as was calculated in the contract. This is due to the fact that many additional procedures for mother and child were not described in the contract. Therefore, it is better to familiarize yourself with the price list of a private clinic in advance and analyze whether you can afford it.
By the way, a tax deduction for paid medical care during childbirth can only be obtained if the contract for the provision of paid medical services was concluded directly with the maternity hospital, since, in accordance with the Tax Code of the Russian Federation, a tax deduction concluded with an insurance company does not give the right to receive tax deduction.