What do they do when entering the maternity hospital? Path through the maternity hospital: from admission to discharge
Since 2006, women giving birth have the right to choose their own maternity ward. Today, it doesn’t matter where you live or where you have your permanent residence address. An antenatal clinic, where you need to register, and a perinatal maternity hospital can be located in any city and region.
Which maternity hospital to choose
In order to choose which maternity hospital You can give birth, you need to visit nearby institutions. Find out on what days visits to the department are allowed to familiarize yourself with the internal regulations, equipment and conditions of stay. As a rule, maternity hospitals organize open days for this.
When choosing a maternity ward, it is important to pay attention to the following factors:
- How close is the branch to your place of residence?
- Comfort level. Availability and sanitary condition of the bathroom. Equipment of the wards. Place for food.
- Availability and condition of medical equipment.
- Equipment of maternity rooms for free childbirth. Availability of balls, bathtub, chair and other items.
- Possibility of round-the-clock stay with the newborn.
Having established contact with the doctor, agree on the birth in the chosen department. Find out the possibility of calling at any convenient time and ask for a contact number.
Expert opinion on choosing a maternity hospital for expectant mothers
Answered by Ksenia Georgievna Khorosheva, perinatal psychologist.
Ksenia Georgievna Khorosheva, perinatal psychologist
“Choosing a maternity hospital for a woman expecting a child is probably one of the most important events during pregnancy. It is believed that it is better to start choosing a maternity hospital towards the end of the second trimester of pregnancy. Then there will be enough time to get acquainted with the various clinics and the services they provide.
What influences a woman’s choice of a maternity hospital?
Health status. Sometimes it happens that, due to the nature of pregnancy, only highly specialized specialists can approach a woman. Then the circle of choice narrows significantly. And it is based on the presence of the necessary specialists in the maternity hospital.
Recommendations from friends. When a woman is convinced that everything is in order with her pregnancy, she usually begins interviewing everyone she knows with children about doctors and maternity hospitals. Reads specialized forums. So that, thanks to these reviews, you can find a really good doctor. By the way, most often women go to see a doctor, and the choice of maternity hospital itself is secondary. But there are important points here too.
Distance of the clinic from home. Typical for megacities. Since a maternity hospital on the other side of the city can mean endless traffic jams and the risk of not being able to get to the hospital on time.
If we are talking about paid maternity hospitals. The value of the contract is important here. It happens that even within the same maternity hospital, the cost of childbirth varies. Depends on the qualifications and experience of the doctor. Everyone who has the opportunity to pay for childbirth tries to do so. Since there is an idea in my head that everything free is bad, but if you pay, then there will be special treatment. And this is probably one of the common stereotypes of women about maternity hospitals.
Availability of additional services. This point is especially typical for women who are expecting their first child. They want everything to go absolutely perfectly. And this is the next stereotype regarding maternity hospitals. Since women sometimes think that if the birth does not go perfectly (epidural anesthesia is used, an emergency caesarean section is performed, the child will be supplemented with food or water, etc.), then this will inevitably lead to negative consequences. In fact, without special medical indications and the consent of the expectant mother or her relatives, no one has the right to do anything.
It is also important for some women in the maternity hospital:
- possibility of vertical birth;
- availability of a bathroom, fitball, etc.;
- the possibility of collecting stem cells from umbilical cord blood. And donating them to specialized organizations involved in storing this very blood.
Schedule of maternity hospitals closing for cleaning. This paragraph applies to free clinics. At least once a year, for two weeks, each maternity hospital is closed for routine disinfection. Therefore, if a woman’s preliminary due date falls on the closure of the maternity hospital, then the woman will not consider such a maternity hospital.”
When to choose a maternity hospital and the necessary documents
Certificate issuance is scheduled from 28 to 30 weeks. Once the mother has received the necessary documentation, she may think about choosing a clinic.
Interesting fact! If a pregnant woman stops attending an antenatal clinic, no one has the right to remove her from the register and refuse to issue a certificate.
What documents are needed at the maternity hospital for childbirth:
- Original passport and copy.
- Original insurance certificate SNILS.
- Compulsory medical insurance policy valid throughout Russia.
- Exchange card. It displays the observation history and analyzes. Based on this information, doctors decide which department the woman in labor should be sent to.
What documents are needed for the maternity hospital? Photo: jeell.ru
SNILS to the maternity hospital. Photo: image.newsru.com
If a pregnant woman has not been registered at the antenatal clinic and does not have a birth certificate, she will be provided with medical care at her place of residence or registration. The ambulance team will deliver the woman in labor to the department, based on which maternity hospital her area belongs to.
Interesting fact! You can register for pregnancy anywhere in Russia. To do this, you need to fill out an application addressed to the head physician of the clinic where you decided to be observed, and get approval.
Choose a free or paid maternity hospital
Taking into account her own capabilities and wishes, a woman has the right to choose paid services or the use of a birth certificate. The document is presented at the antenatal clinic where the pregnant woman is being observed.
Interesting facts! The state program provides medical care, which is paid from the budget of the Social Insurance Fund.
Paid maternity hospital
It is important to understand that a private clinic will not accept the certificate. Its effect applies only to government agencies. If you decide to choose a paid institution, you need to keep in mind that paying for medical services will not relieve you of the complexity of obtaining permission. Paid clinics can provide more thorough care and comfortable conditions for mother and baby. In a private maternity ward, a separate room is provided and relatives are allowed to visit the mother in labor.
How to conclude a contract correctly
The advantage of paid clinics is the ability to choose the personnel who will deliver the baby. The team of a paid institution necessarily consists of a doctor, a midwife, a neonatologist and an anesthesiologist on duty. As a rule, a contract with an obstetrician-gynecologist is concluded at 36 weeks. You can choose a midwife in advance.
Childbirth under compulsory medical insurance policy
Using a birth certificate, a woman has the right to give birth in any public clinic. To do this, you need to choose an institution in advance, as well as get to know the staff and conditions for women in labor and the child. The on-duty team attends the birth. Then the woman and child are sent to the general ward.
Interesting fact! If the certificate is lost, it can be restored directly in the maternity ward. The clinic is interested in receiving budget funds, so specialists will help you in this matter.
The state maternity hospital will provide advice on the possibility of paid services:
- separate room;
- selection of a team and other aspects that imply improved comfort.
Everyone has the right to decide which maternity hospital is better for themselves.
Types of maternity hospitals
The following types of maternity institutions are distinguished:
- A department with a predominance of births without pathologies and an obstetrician on duty around the clock. Accepts up to 1000 women in labor per year.
- An institution with a resuscitation ward and intensive care.
- Regional or federal institution with a pathology department.
Maternity hospital No. 3 (Tyumen). Photo: http://roddom3-tmn.ru
How long does it take to give a referral to the maternity hospital?
Which maternity hospital to go to is recommended by a gynecologist who monitors how the pregnancy progresses. Taking into account the individual characteristics of pregnancy, the doctor will write a referral to the maternity ward that suits the indications. The document is usually issued at 40 weeks. If pacing is observed, the pregnant woman is sent to the inpatient department for observation until the onset of labor.
During which contractions should you go to the maternity hospital?
The onset of labor is accompanied by contractions. Irregular aching cramps with aching pain in the lower abdomen may appear. As a rule, they disappear when changing body position or after a short interval of time. In this case, there is no need to go to the department for hospitalization. Pregnant women are concerned about the interval of contractions at which to go to the maternity hospital, and for what symptoms to go to the maternity hospital:
- if a woman experiences bleeding;
- discharge of amniotic fluid;
- regular contractions with an interval of 8-10 minutes.
In these cases, it is necessary to urgently call an ambulance or go to the maternity ward yourself.
Premature birth
Childbirth is considered premature if it occurs between 22 and 36 weeks. They are induced artificially if there are medical indications for this. Spontaneous premature birth occurs naturally. In this case, urgent hospitalization is indicated. Which maternity hospital is located nearby and equipped with resuscitation equipment will be a priority in the event of an emergency premature birth. In this case, we are not talking about comfort, but rather about the opportunity to save the life of mother and child.
Which maternity hospital will they be taken to during an emergency birth?
An ambulance will take you to a pre-selected institution only if there is a corresponding mark on the exchange card confirming the agreement with the clinic. If there is no such mark, the team will take the woman in labor to the nearest department. Before choosing a maternity hospital, find out which maternity hospitals will be closed during the period of interest to you for preventive maintenance, as well as which maternity hospital is on duty for the period of preventive maintenance of other institutions.
What week should I go to the maternity hospital?
If labor does not occur spontaneously and prematurely, the gynecologist will advise you on what week to go to the maternity hospital. As a rule, this occurs at 40 weeks, as close as possible to the expected date of birth.
The question of which maternity hospital is best to do this is of interest to women who are candidates for surgery. The date of the planned operation is selected taking into account the condition of the pregnant woman and other medical indicators. The gynecologist at the antenatal clinic will recommend institutions with a suitable profile and equipment. Each institution has distinctive features of work and procedures for preparing for surgery. Ask if you can invite assistants to care for your baby after surgery.
List of necessary things for the maternity hospital
Expectant mothers pack a separate bag for the maternity hospital, containing necessary things for themselves and the baby.
Things for the baby in the maternity hospital
Often, the antenatal clinic and the maternity ward itself provide a list of necessary items for the maternity hospital for mother and baby. The baby will need hygiene products, as well as clothes and a baby envelope for discharge. It is better to bring a blanket when leaving the maternity hospital in winter. Each mother decides independently what clothes to take to the maternity hospital for her newborn. It is important to remember that things should be made from natural fabrics. The seams should be on the outside, and the item itself should not hinder movement. Usually this is a vest, cap or overalls. If desired, you can wear mittens and socks. Which hat to take to the maternity hospital for your baby needs to be decided depending on the season and the air temperature in the department. In any case, it’s good if you have a cap made of soft cotton fabric and a comfortable knitted cap in stock for discharge.
A salesperson in a specialized department can tell you what size to take for a newborn to the maternity hospital. Size 36 is designed for a height of 56 cm and is suitable for a child in the first month of life. In addition to clothes, the baby will need:
- Diapers.
- Baby cream.
- Powder.
- Wet wipes for children.
- Towel.
- Cloth and disposable diapers. You can decide what size diapers to choose for the maternity hospital yourself or on the advice of obstetricians.
Many people are interested in which diapers are best to take to the maternity hospital. There is no clear answer. Manufacturers offer a line of products for babies from the first days of life. Among the variety of diapers there are premium products. There are diapers with recesses in the navel area for clothespins. The choice is up to the parents.
List of things for a woman in labor in the maternity hospital
Expectant mothers have many questions regarding packing for the maternity hospital, what to take with them to the maternity hospital:
- What kind of robe can you take to the maternity hospital?
- What kind of pads are suitable for the maternity hospital?
- Which disposable panties are best for the maternity hospital?
For mom, it is better to choose things made from natural fabrics with a loose fit. This could be a loose T-shirt or a nightgown. It would be good if its style included the possibility of breastfeeding.
It is better to take a spacious cotton robe. You can choose a style with either a zipper or a belt. It would be good if the robe had pockets for personal items.
What to do after being discharged from the hospital
Often husbands (fathers) upon discharge from the maternity hospital decorate the child’s room with balloons, posters, and present flowers to their wife, whatever she likes. Parents have new worries when the baby is brought home from the maternity hospital. New mothers have a question about what day after the maternity hospital they can go for a walk. There is no clear answer here. It all depends on the weather conditions and climatic features, as well as the health status of the mother and baby after discharge. In any case, on a clear sunny day, a walk in the fresh air will not be superfluous.
Neonatologists recommend taking the first bath after the maternity hospital on the same day. Before you start swimming, you should take into account the advice of specialists or experienced parents regarding the temperature of the water, a comfortable position to support the baby and other technical issues.
Conclusion
Regardless of which maternity hospital you decide to give birth in, the main thing is that you feel comfortable during childbirth and in the postpartum period. Despite stereotypes, you can give birth for free in a public clinic in good conditions. The medical team of a paid clinic usually inspires more trust, but this does not mean that less qualified care will be provided in a budget institution.
Pregnancy and preparation for the appearance of a “little miracle”, by definition, is one of the most pleasant periods in a woman’s life. However, the closer the day of birth, the more worries and worries expectant mothers have. The question of where the baby will be born becomes relevant. To this will be added preparations for the maternity hospital and worries about “how will I be there alone.” Together with MedAboutMe, we figure out how to safely survive your stay in the maternity hospital and remain satisfied at the same time.
Right to rights
In what status do people usually enter a medical facility? More like a supplicant than a client. This is a fact. Especially if it's an emergency. They look at the doctor with pleading in their eyes when someone close to them feels bad. They are embarrassed to disturb a nurse or orderly, so as not to hear in response another portion of “friendly instructions” about the rules of behavior for the patient, although we are talking about the direct responsibilities of the medical staff. Pregnant and giving birth women are especially vulnerable - they also worry about the child, especially if this happens for the first time.
Why does this happen? As a rule, because not everyone and does not always know about their rights when they get to the maternity hospital.
What to do? Just read the article. 30, which is in the “Fundamentals of Legislation” protecting the health of Russian citizens. If possible, consult with a lawyer in advance about what you can and cannot demand in the maternity hospital. Believe me, you will learn a lot of interesting things.
Firstly, the medical staff and service personnel must treat a woman admitted to the maternity hospital with respect. Any woman who gave birth (well, perhaps, except for those who were assigned to special conditions at paid clinics) was faced with inhumane treatment of herself. The most “harmless” of the set is “What are you yelling about? I knew what I was getting into!” There are many psychological traumas after such “friendly” words. It is difficult to prove rudeness.
What to do? Don't get upset. You can go to court. In addition, the mother (or relatives) has the right to write a complaint about boorish behavior or the words of the doctor to her immediate superiors, citing the law on the protection of rights. It will definitely work. Medical staff must know that they are responsible not only for their actions, but also for their words.
Secondly, women are not always informed that partner childbirth is a free service, according to the law. Paid partner births are organized in private medical institutions.
What to do? Inform in advance that you want to exercise this right and prepare for it. Remember that you must pay for medications for the woman in labor and your partner yourself.
Thirdly, a woman has the right to refuse any medical intervention. This can be demanded both in relation to the woman herself and in relation to the child. Reason: the same Law (Article 33).
What to do?
notify the doctor; listen carefully to his explanations about possible consequences; sign a record of this in the appropriate medical document. Specialist commentary Sergei Golovin, lawyer
The first thing you need to understand is that only you can determine where to give birth and how, whether the father will be present or not. If they demand money for the presence of the father, you must complain - this is illegal, unless there is no technical possibility.
Only you can make the final decision:
whether to save or not; refuse a doctor if he is rude or behaves unprofessionally; whether to take prescribed medications; whether to take the prescribed tests.
Upon admission to a medical institution, you may be asked to sign a statement where you immediately agree to any interventions and medical procedures.
Remember - this is illegal. You may not always be able to understand what is happening, so my advice is to give a notarized power of attorney to a person who can protect you and, if necessary, refuse or allow certain procedures to be performed by doctors.
You or your authorized representative have the right to receive complete information about the progress of treatment and the course of pregnancy in an understandable form.
The doctor should answer all the questions that concern you. This also applies to prescriptions, medications - what they are for, side effects, how they can affect the child, the doctor must know and explain all this.
Using a birth certificate, a woman can register with any municipal or state antenatal clinic if she wishes, if she does not want to go to the one at whose address she is registered. In case of refusal, according to the law, criminal liability arises. If this happens, contact the head physician; if this does not help, write to the police or prosecutor's office. If you do not have a birth certificate, you must be admitted to the maternity hospital.
After the birth of the baby, the mother has the right to attach him to the breast. In the future, she may refuse supplemental feeding and breastfeed on demand.
You are responsible for the child, so it is your right to refuse medications that may be administered to the child. Mom has the right to know what these drugs are, their effects and other information.
You have the right to refuse vaccinations if you think that this is not necessary or if you do not like the instructions for the drug. If you do not want to be seen by a doctor or health visitor, you can refuse this. If you think that the baby is sick, but the doctor says that everything is fine, ask for tests and ask the opinion of another doctor.
Also, according to labor law, you have the right to:
for leave and maternity benefits; you cannot be fired; You cannot be refused employment because of your position; cannot be required to work overtime or night work; send on a business trip; are obliged to reduce production standards while maintaining earnings. I’ll come quickly, I’ll give birth quickly
Depending on the type of birth a woman has, her behavior in the maternity hospital is determined.
Experienced mothers know everything and even more, so they can give professional advice to “firstborns.” Don't be alarmed - this word is sometimes also used to describe women giving birth for the first time. And your status will soon change - you will become a mother.
Those who have a difference of 5-6 years between the first and second visit to the maternity hospital will notice changes. If you're lucky, they'll be for the better.
And yet, every woman on the eve of childbirth will face the following question: how to survive there?
It's not that scary. We need to prepare for what awaits there. Mentally and physically. However, for those mothers who already have a child, the option “I already know everything, so I’ll quickly come, give birth and go home” will not work.
Expert commentaryMichelle Oden, obstetrician-gynecologist, researcher, author of the book “Revived Childbirth”
The circumstances of a person’s birth influence the following qualities: sociability, aggressiveness, friendliness, and the ability to love. Over 50 years of work, I had the opportunity to attend 15 thousand births.
The main advice for a woman who is about to give birth is that she needs a special atmosphere and environment. Everyone knows this, but few people care about it and not everyone understands it.
Thanks to research, we have begun to better understand the true reasons that make childbirth difficult. This is cause for concern.
A woman giving birth needs to produce a whole cocktail of hormones produced in the brain. Not the whole brain participates in this during childbirth, but only its oldest part. Using modern scientific language, it can be explained that if during childbirth some events begin to activate the cerebral cortex, which is more developed in humans than in animals, then this slows down the process of childbirth. Any stimulation of thought processes can interfere with the progress of labor.
What are these factors that prevent the intellect from resting?
Firstly, the language. Especially rational. A woman giving birth enters a certain state that allows her to relax. All her sensations are directed inward. Any questions at this time disturb the woman.
Secondly, bright light. During childbirth, a woman does not need vivid visual impressions. On the contrary, dim lighting helps her.
Thirdly, the feeling that the whole world is watching you. It gets in the way. Studies have been conducted in the West that have confirmed that it is calmer for a woman when there are not a lot of people around during childbirth, except for the midwife.
Fourthly, the release of adrenaline (and during childbirth this is fear) also negatively affects a woman. Any impressions that frighten the woman in labor slow down the process. A woman needs security. The midwife must play the role of an advocate.
In the traditional sense, feeling protected during childbirth means that there is someone nearby whom the woman trusts and feels protected. The midwife in this situation is the prototype of the mother who will protect.
And one more important question. For thousands of years people have tried to describe love, but no one was interested in how the ability to love develops.
I have an answer to this question - love begins at the moment of childbirth. If you interfere with the natural course of childbirth (pain relief, for example), this ability to love may not be formed.
Lifehacks for the maternity hospital
Any woman who appears in a building where they help the birth of new citizens of the country will benefit from the experience from previous “races,” which is now called a “life hack.”
1. Experienced mothers know: you need to get ready for the maternity hospital in advance (about a month in advance) and you need to do it yourself in order, as they say, to “remember everything.”
2. Upon admission (unless labor has already begun), certain procedures are required, some of which the woman can do at home in advance, in order to:
firstly, reduce the reception time; secondly, exclude manipulations with someone else's shaving machine and scissors.
3. Throw out of your head “horror movies” about incessant unbearable fights. Consult a doctor, midwife or more experienced mother in advance and get down to business. Instead of mental suffering about “Oh, I can’t stand this unbearable pain!”, screams from the heart and endless calls to the medical staff, walk, breathe, count contractions. Before the time (before pushing begins), do not pull the nurses and doctors.
Personal experience
Svetlana Zolotareva, perinatal and analytical psychologist
When should mommy “move forward” to the maternity hospital?
If your water breaks at home, start counting the water-free period. You can't wait more than 12 hours.
About contractions.
Subjectively, contractions occurring once every 5 minutes are really sensitive. If you are counting on anesthesia in advance, then it is at this moment that the doctor will ask: “Shall we take pain relief?” The decision whether to take pain relief or not depends on how this process goes for you. This largely depends on your motivation, since many women now want to minimize the intervention of doctors. Someone is waiting in advance for the anesthesiologist. You make the decision. Everyone's pain threshold is different and you will have your own experience.
What awaits you in the maternity hospital?
I want to warn you. In any maternity hospital, three procedures await you in the emergency department:
asking questions that seem unnecessary to women - you can write everything off from the exchange card - but this survey is necessary for verification; shaving the perineum (to avoid anything, take a razor with you or do it at home); magic enema (our domestic women are unusually shy and the feeling of shame covers all labor, so take a shower after the enema and before “sending” to the maternity ward).
If you have contact lenses.
It is better to take glasses for childbirth. If you don’t want to, be sure to take a spare container with a spare pair of lenses. Glasses, in my opinion, are more convenient. This is temporary while you are in the maternity hospital.
4. You’ll be lucky if they take you to the ward “after that” on a gurney. Usually, with the air of a philosopher, you have to accept the fact that you will have to get to it yourself, trying not to drop the diaper lining and things. You'll be lucky again when the pediatric nurse follows the child and grabs your things.
5. Many people know that a woman who has given birth is “attacked by zhor.” However, you may be late for the next lunch or dinner due to your busy childbirth, so stock up on something conveniently edible in advance: everything that you can eat quickly and without unnecessary preparations. The hospital catering unit should not be completely written off. Sometimes there is quite edible food there.
6. A warning that it is strictly forbidden to take linen into the maternity hospital - both bed linen and underwear. Everything is explained by the requirement to maintain sterility. Do not take into account the lack of three times (according to the rules) wet cleaning in the room, but rather do not be too lazy to stock up on sterile pads and sterile disposable panties.
7. The maternity hospital provides diapers. True, they have holes and are rough for a delicate body, but mommy needs to provide an option that the laundry is not open on weekends and holidays. Stock up strategically in advance. Disposable diapers are also useful, but you need to wrap the baby in something. Many maternity hospitals allow you to take baby clothes - bodysuits and rompers.
8. Bring earplugs. Mom must sleep sometime. If your own baby is calm, your neighbor’s may start screaming. If this “trouble” has passed, then any woman will wake up from the sound of buckets rattling late in the evening or early in the morning, doors swinging open at dawn with the simultaneous switching on of lights and screams notifying that the temperature is being measured.
9. Rumors about sterility in the maternity ward should not confuse either expectant or established mothers when they head to the shower or toilet. Suggested disposable toilet seat covers are not commonly observed. Not everyone will be able to handle the weight, especially the Caesar babies. A roll of regular transparent bags will help a lot. Some mothers use cling film.
10. A woman who has just given birth can, of course, ask a “stupid” question to the doctor, but experienced mothers know: doctors do not like this outrage. Especially during the rounds. It is worth asking your roommates or nurse any questions you may have in advance. If the question still remains relevant or the baby’s condition raises real concerns, you need to ask the doctor again - preferably after a round.
11. Don't forget to take water with you. Lots of water. Childbirth is a strenuous physical exercise. Remember how much water you drank after fitness classes “before.” It is not recommended to drink water from the hospital tap, and tea provided during breakfast or dinner runs out quickly.
12. When collecting a cosmetic bag for the maternity hospital, put chapstick in it. Your lips dry out, during childbirth you often lick them, and even try to bite them. After childbirth, your lips will “thank you” for your forethought.
13. Bring warm clothes: a jacket, a shawl, socks. Drafty corridors are common, and after childbirth, women often feel cold.
14. Phone charger is your everything. The flow of congratulations, chats and messages after a joyful event cannot be handled by any phone. He will have to be “fed.”
15. Be sure to take your husband with you to the maternity hospital - it is irreplaceable and very useful.
Childbirth is a unique process. Any woman needs timely support. She hopes that everything will go well for both her and the baby.
The main thing is confidence, a calm attitude towards what is happening and positivity. Add knowledge to the kit - success is guaranteed.
When going to the maternity hospital, an expectant mother expecting her first baby usually experiences anxiety. The many incomprehensible procedures that await a woman in the maternity hospital, like everything unknown, cause some anxiety. To dispel it, let’s try to figure out what medical personnel will do and why at each stage of childbirth.
Childbirth in a maternity hospital. Where will you be sent?
So, you started having regular contractions or your amniotic fluid began to break, in other words, labor began. What to do? If at this time you are in a hospital in the pregnancy pathology department, then you need to immediately inform the nurse on duty, and she, in turn, will call a doctor. The obstetrician-gynecologist on duty will examine and decide whether labor has really begun, and if so, he will transfer you to the maternity ward, but before that they will do a cleansing enema (an enema is not given in the case of bleeding from the genital tract, with, full or close to it opening of the cervix, etc.).
In the case when labor begins outside the hospital, you need to seek help at the maternity hospital.
When hospitalized in a maternity hospital, a woman passes through a reception block, which includes: a reception area (lobby), a filter, examination rooms (separately for healthy and sick patients) and rooms for sanitary treatment.
A pregnant woman or woman in labor, upon entering the reception area, takes off her outer clothing and goes into the filter, where the doctor on duty decides which department she should be sent to. To do this, he collects a detailed history (asks about health, about the course of this pregnancy) in order to clarify the diagnosis, trying to find out the presence of infectious and other diseases, gets acquainted with the data, conducts an external examination (detects the presence of pustules on the skin and various kinds of rashes, examines the pharynx) , midwife measures temperature.
Patients who have an exchange card and no signs of infection are hospitalized in the physiological department. Pregnant women and women in labor who pose a threat of infection to healthy women (without an exchange card, who have certain infectious diseases - acute respiratory infections, pustular skin diseases, etc.) are sent to an observational department specially designed for these purposes. Thanks to this, the possibility of infection of healthy women is excluded.
A woman may be admitted to the pathology department when the onset of labor is not confirmed using objective research methods. In doubtful cases, the woman is hospitalized in the maternity ward. If labor does not develop during observation, then a few hours later the pregnant woman may also be transferred to the pathology department.
In the examination room
Once it has been established which department the pregnant woman or woman in labor is being sent to, she is transferred to the appropriate examination room. Here the doctor, together with the midwife, conducts a general and special examination: weighs the patient, measures the size of the pelvis, abdominal circumference, the height of the uterine fundus above the womb, the position and presentation of the fetus (cephalic or pelvic), listens to its heartbeat, examines the woman for the presence of edema, and measures arterial blood pressure. pressure. In addition, the doctor on duty performs a vaginal examination to clarify the obstetric situation, after which he determines whether labor is occurring, and if so, what its nature is. All examination data is entered into the birth history, which is created here. As a result of the examination, the doctor makes a diagnosis, prescribes the necessary tests and prescriptions.
After the examination, sanitary treatment is carried out: shaving of the external genitalia, enema, shower. The scope of examinations and sanitization in the examination room depends on the general condition of the woman, the presence of labor and the period of labor. Upon completion of sanitary treatment, the woman is given a sterile shirt and gown. If labor has already begun (in this case, the woman is called a woman in labor), the patient is transferred to the prenatal ward of the birth block, where she spends the entire first stage of labor until pushing, or to a separate birth box (if the maternity hospital is equipped with one). A pregnant woman still awaiting childbirth is sent to the pregnancy pathology department.
Why do you need CTG during childbirth?
Cardiotocography provides considerable assistance in assessing the condition of the fetus and the nature of labor. A cardiac monitor is a device that records the fetal heartbeat and also makes it possible to monitor the frequency and strength of contractions. A sensor is attached to a woman’s stomach, which allows the fetal heartbeat to be recorded on a paper tape. During the study, the woman is usually asked to lie on her side, because when standing or walking, the sensor constantly moves away from the place where it is possible to record the fetal heartbeat. The use of cardiac monitoring allows for timely detection of fetal hypoxia (oxygen deficiency) and labor anomalies, assessment of the effectiveness of their treatment, prediction of the outcome of childbirth and selection of the optimal method of delivery.
In the birth block
The birth block consists of prenatal wards (one or more), delivery wards (delivery rooms), an intensive observation ward (for observation and treatment of pregnant women and women in labor with the most severe forms of pregnancy complications), a manipulation room for newborns, an operating unit and a number of ancillary rooms.
In the prenatal ward (or maternity ward), details of the course of pregnancy, past pregnancies, childbirth are clarified, an additional examination of the woman in labor is carried out (physique, constitution, abdominal shape, etc. are assessed) and a detailed obstetric examination. Be sure to take a test for blood type, Rh factor, AIDS, syphilis, hepatitis, and conduct a urine and blood test. The condition of the woman in labor is carefully monitored by the doctor and midwife: they inquire about her well-being (degree of pain, fatigue, dizziness, headache, visual disturbances, etc.), regularly listen to the fetal heartbeat, monitor labor activity (duration of contractions, interval between them, strength and pain), periodically (every 4 hours, and more often if necessary) measure the blood pressure and pulse of the woman in labor. Body temperature is measured 2-3 times a day.
In the process of monitoring the birth process, the need for vaginal examination arises. During this study, the doctor uses his fingers to determine the degree of opening of the cervix and the dynamics of the fetus’s movement along the birth canal. Sometimes in the maternity ward, during a vaginal examination, a woman is asked to lie down on a gynecological chair, but more often the examination is carried out while the woman in labor is lying on the bed.
A vaginal examination during childbirth is mandatory: upon admission to the maternity hospital, immediately after the rupture of amniotic fluid, and also every 4 hours during labor. In addition, there may be a need for additional vaginal examinations, for example, in case of pain relief, deviation from the normal course of labor or the appearance of bloody discharge from the birth canal (one should not be afraid of frequent vaginal examinations - it is much more important to ensure complete orientation in assessing the correct course of labor). In each of these cases, the indications for the procedure and the manipulation itself are recorded in the birth history. In the same way, the birth history records all studies and actions carried out with the woman in labor during childbirth (injections, measurement of blood pressure, pulse, fetal heartbeat, etc.).
During childbirth, it is important to monitor the functioning of the bladder and intestines. Overfilling of the bladder and rectum prevents the normal course of labor. To prevent the bladder from overflowing, the woman in labor is asked to urinate every 2-3 hours. In the absence of independent urination, they resort to catheterization - the insertion of a thin plastic tube into the urethra through which urine flows.
In the prenatal ward (or individual maternity ward), the woman in labor spends the entire first stage of labor under the constant supervision of medical personnel. Many maternity hospitals allow the presence of the husband at the birth. With the beginning of the pushing period, or the period of expulsion, the woman in labor is transferred to the delivery room. Here they change her shirt, scarf (or disposable cap), shoe covers and place her on Rakhmanov’s bed - a special obstetric chair. This bed is equipped with footrests, special handles that need to be pulled towards you during pushing, adjustment of the position of the head end of the bed and some other devices. If childbirth takes place in an individual box, then the woman is transferred from a regular bed to Rakhmanov’s bed, or if the bed on which the woman was lying during labor is functional, it is transformed into Rakhmanov’s bed.
During an uncomplicated pregnancy, normal births are performed by a midwife (under the supervision of a doctor), and all pathological births, including fetal births, are performed by a doctor. Operations such as caesarean section, application of obstetric forceps, vacuum extraction of the fetus, examination of the uterine cavity, suturing of soft tissue ruptures of the birth canal, etc., are performed only by a doctor.
After the baby is born
Once the baby is born, the midwife who delivers the baby cuts the umbilical cord with scissors. A neonatologist, who is always present at the birth, sucks out mucus from the newborn's upper respiratory tract using a sterile balloon or catheter connected to an electric suction and examines the child. The newborn must be shown to the mother. If the baby and mother feel well, the baby is placed on his stomach and applied to the breast. It is very important to put your newborn to the breast immediately after birth: the first drops of colostrum contain the vitamins, antibodies and nutrients the baby needs.
For a woman, after the birth of a child, labor does not end yet: the no less important third stage of labor begins - it ends with the birth of the placenta, which is why it is called the placenta. The placenta includes the placenta, membranes and umbilical cord. In the afterbirth period, under the influence of afterbirth contractions, the placenta and membranes separate from the walls of the uterus. The birth of the placenta occurs approximately 10-30 minutes after the birth of the fetus. The expulsion of the placenta is carried out under the influence of pushing. The duration of the afterbirth period is approximately 5-30 minutes, after its completion the birth process is completed; During this period, a woman is called a postpartum woman. After the birth of the placenta, ice is placed on the woman’s stomach to help the uterus contract better. The ice pack remains on the stomach for 20-30 minutes.
After the birth of the placenta, the doctor examines the birth canal of the mother in the mirror, and, if there are ruptures of soft tissues or instrumental dissection of the tissues was performed during childbirth, restores their integrity - suturing it up. If there are small tears in the cervix, they are sutured without anesthesia, since there are no pain receptors in the cervix. Tears in the walls of the vagina and perineum are always restored with pain relief.
After this stage is over, the young mother is transferred to a gurney and taken out into the corridor, or she remains in an individual maternity ward.
For the first two hours after birth, the postpartum woman should remain in the maternity ward under the close supervision of the doctor on duty due to the possibility of various complications that may arise in the early postpartum period. The newborn is examined and treated, then swaddled, a warm sterile vest is put on him, wrapped in a sterile diaper and blanket and left for 2 hours on a special heated table, after which the healthy newborn is transferred together with the healthy mother (parturient) to the postpartum ward.
How is pain relief performed?
At a certain stage of labor, pain relief may be necessary. The most commonly used medications for pain relief during labor include:
- nitrous oxide (gas supplied through a mask);
- antispasmodics (baralgin and similar drugs);
- promedol is a narcotic substance that is administered intravenously or intramuscularly;
- - a method in which an anesthetic substance is injected into the space in front of the dura mater surrounding the spinal cord.
Madina Esaulova,
Obstetrician-gynecologist, maternity hospital at IKB No. 1, Moscow
When labor begins or amniotic fluid breaks, a list of what to take with you to the birth should be prepared in advance. These are the following documents:
- exchange card (the main document of a pregnant woman)
- passport, compulsory medical insurance policy
- birth certificate (provided that it was issued to you by the housing complex),
- medical documentation not included in the exchange card (ultrasound data, consultations with other specialists, extracts, etc.).
You can take with you to the maternity hospital when hospitalized in the maternity ward:
- washable slippers
- mobile phone with charger
- compression hosiery (if indicated).
All medical care in the maternity hospital is provided free of charge in accordance with the medical and economic standards (MES) of Moscow. There is no need to come to the maternity hospital in advance of the start of labor if there is no indication.
Planned hospitalization in the maternity hospital is carried out if there are indications by referral from the antenatal clinic doctor.
Emergency hospitalization is carried out in the presence of emergency indications by an emergency medical team (EMS), or when independently reporting complaints to the emergency room of the obstetrics and gynecology center.
Postpartum items should be brought to you after the birth, when you are transferred to the postpartum ward.
List of things for the postpartum mother and newborn in the postpartum ward and for discharge.
The postpartum department of our maternity hospital provides the most necessary things for the postpartum mother and her child. After childbirth, relatives and friends can give you the following things to the postpartum ward in a bag or in a light small bag made of polymer materials:
- disposable panties – 1 pack
- postpartum pads – 1 pack
- small cotton body towel
- cotton robe and nightgown – 2 pcs.
- soap, toothbrush and toothpaste
- rubber shower slippers
- cup, spoon
- nursing bra
- disposable nipple covers
- cream (for example, “Bepanten”)
- postoperative abdominal bandage (necessary for patients after cesarean section)
List for a child in the postpartum ward:
- diapers – 1 package (from 2 to 5 kg)
- wet wipes
- baby soap or gel
- diaper protective cream
- a set of clothes for every day (2-4 undershirts per day, bodysuit, cap, socks, etc.)
If discharge from the maternity hospital occurs in winter, then the child will additionally need a warm blanket, a vest, and 2 diapers.
If discharge occurs in the summer, then the child, depending on the air temperature outside, will need a vest, a bodysuit, a hat, and a light blanket.
Items for discharge should be brought on the day of discharge from the maternity hospital.
List of documents required in the postpartum department:
- copy of certificate of incapacity for work for maternity leave (maternity leave)
- copy of SNILS
- copy of passport and policy
- for foreign citizens – a translation of the passport into Russian, certified by a notary
- birth certificate (if issued) and exchange card (if issued)
If a pregnant woman is “in labor”, this means that the woman arrived either with contractions or with broken amniotic fluid and will have to give birth in the next few hours. In this case, the sequence of the procedure is as follows:
- conversation with the midwife, with the doctor on duty who fills out the documentation - the birth chart;
- determining the weight of a pregnant woman;
- A pregnant woman changes into maternity hospital clothes or her own clothes.
- A cleansing enema is performed. If a pregnant woman is admitted in the period of pushing, an enema is not performed; she is immediately transferred to the delivery room.
- If necessary, the genital area is treated (shaving), followed by a shower.
- The pregnant woman is sent to the department - physiological or observational.
If bleeding or other life-threatening conditions are detected and requiring immediate delivery, the pregnant woman can be sent to the operating room directly from the emergency room with only minimal or no processing.
In this case, the pregnant woman is sent to the pathology department or home. The procedures that are carried out in this case are as follows:
- If the pregnant woman is not hospitalized, she is given an advisory report with further recommendations.
A pregnant woman may be in the pathology department, her birth may be planned, or contractions may begin at any time. In this case, she expects the following:
- CTG recording - fetal heartbeat.
- Cleansing enema and shower.
Cardiotocography (CTG) If a woman is planning to have a caesarean section, the procedure is the same. A light dinner is allowed the night before; in the morning you can only drink a little clean water.
In the delivery room the woman is assigned to one of the prenatal wards, where she will be monitored and CTG monitoring of the fetal condition will be carried out. The doctor clarifies the woman’s complaints and medical history, studies the birth chart and, if necessary, conducts an examination on the chair.
All the time contractions the woman is in the prenatal ward, she is also allowed to move along the corridor and take a shower (as a method of pain relief).
With the beginning of the pushing period, the woman lies down on a chair in the delivery room, the doctor monitors the condition of the fetus by heart rate (listened to with a stethoscope or CTG monitor).
After the birth of the child, the birth canal is examined for rupture. For another two hours, the woman is under close supervision of medical personnel for timely detection of complications, after which the postpartum woman is transferred to the ward.
If an emergency or planned caesarean section is performed, then immediately after the operation the woman is transferred to the intensive care unit for observation - for at least two hours, most often for 12-24 hours.
What else will happen after childbirth
- after a natural birth, women stay in the postpartum department for 3-5 days, after a cesarean section - up to 10 days;
- treatment of sutures twice a day - perineum (for natural childbirth), postoperative scar (after cesarean section);
- dispensing tablets for concomitant diseases;
- installation of intravenous infusions - after gestosis, cesarean section, after heavy blood loss or other complications;
- if necessary, women are talked to about breastfeeding and taught how to latch on to the baby;
- in case of complicated labor, the woman may be referred for additional examinations or procedures.
Procedures before discharge from the hospital include:
- blood and urine tests, biochemical examination, if necessary, in-depth urine tests;
- inspection of seams and their treatment;
- vaginal examination on a chair;
- examination of the mammary glands;
- Ultrasound examination of the pelvic organs.
The newborn undergoes separate examinations and examinations. If any abnormalities or complications are discovered, the mother and child may be left for some more time in the maternity hospital. In some hospitals, in such cases, transfer to another department is assumed.
As soon as mother and baby are ready for discharge, all documents are drawn up: discharge summary, documents for the child, and others if necessary.
Read more in our article about procedures in the maternity hospital.
A maternity hospital is for many a medical institution full of mysteries, because since Soviet times, pregnant women and women in labor have been accepted from the moment of admission until discharge not to be allowed out even to relatives, but to communicate “through the glass window.” In order to feel calm and be prepared for all manipulations, it is useful to know what procedures are carried out in the maternity hospital at different stages.
Pregnant women enter the maternity hospital for two reasons:
- by referral from a antenatal clinic doctor;
- on your own or in an ambulance with some complaints.
If a pregnant woman is “in labor”
This means that the woman arrived either with contractions or with broken amniotic fluid and will have to give birth in the next few hours. In this case, the sequence of procedures that will be performed upon admission to the maternity hospital is as follows:
- conversation with the midwife, and then with the doctor on duty, who fills out the documentation - the birth chart;
- examination by a doctor, listening to the fetal heartbeat;
- measuring the abdominal circumference and the height of the uterine fundus;
- determining the weight of a pregnant woman;
- blood pressure measurement.
- The pregnant woman changes into clothes (robe, slippers, underwear) from the maternity hospital or her own clothes - depending on the institution.
- A cleansing enema is performed. If a pregnant woman is admitted while pushing, an enema is not performed and she is immediately transferred to the delivery room.
- If necessary, the genital area is treated (shaving), then you should take a shower.
- The pregnant woman is sent to the department - physiological or observational, based on the clinical situation.
Expert opinion
Daria Shirochina (obstetrician-gynecologist)
If bleeding or other conditions that are life-threatening and require immediate delivery are detected, the pregnant woman can be sent to the operating room directly from the emergency room with only minimal or no treatment.
If there are signs of labor or other problems
In this case, the pregnant woman is sent to the pathology department or home (for example, if she refuses hospitalization or her condition does not require inpatient care). The procedures that are carried out in this case are as follows:
- Conversation with the midwife and doctor, completing the necessary documentation.
- Examination on a gynecological chair.
- Measuring weight, blood pressure, parameters of a pregnant woman.
- If the pregnant woman is not hospitalized, she is given an advisory report on her condition with further recommendations.
- If necessary, the woman is sent to the pathology department or the delivery room for observation.
Procedures to prepare for the day of birth
If a woman enters the maternity hospital with contractions or broken waters, the algorithm of actions and all procedures before childbirth are described in the previous paragraph.
But a pregnant woman may be in the department of pathology of pregnant women and her birth may be planned, or contractions may begin at any time. In this case, she expects the following:
- Examination by the attending or duty doctor, and, if necessary, by the head of the department.
- CTG recording - fetal heartbeat.
- Cleansing enema and shower.
- Transfer to an observational or physiological maternity ward.
If a woman is planning a caesarean section, the procedure is the same. A light dinner is allowed the night before; in the morning you can only drink a little clean water.
Also, the pregnant woman must collect all her things if she was previously in the pathology department. Some can be taken with you to the delivery room, the other will need to be put in a storage room.
Watch this video about preparatory procedures before childbirth:
In the delivery room
The maternity room includes an examination room (usually several), prenatal wards where women are during contractions, as well as the maternity rooms (halls) themselves - they contain special chairs, a table for treating a newborn, as well as equipment and tools that may be needed during childbirth, everything is sterile, and consumables are disposable (diapers, etc.).
The delivery room also includes an operating room, where, if necessary, a woman can be sent urgently during childbirth.
After admission to the delivery room, the woman is assigned to one of the prenatal wards, where she will be monitored (including video), and CTG monitoring of the fetal condition is performed. The doctor, who is in charge of the delivery room at this time, clarifies the woman’s complaints and medical history, studies the birth chart and, if necessary, conducts an examination in a gynecological chair.
If childbirth proceeds without complications, then the frequency of vaginal examinations is as follows:
- every four hours during labor;
- after the rupture of amniotic fluid;
- if complications are suspected.
The woman is in the prenatal ward throughout the contractions; she is also allowed to move along the corridor and take a shower (as a method of pain relief).
With the beginning of the pushing period, the issue of transfer to the delivery room itself is decided. Here the woman lies down on a chair, the doctor monitors the condition of the fetus by heart rate (listened to with a stethoscope or CTG monitor).
After the birth of the child, the birth canal is examined for rupture. If necessary, the doctor performs suturing and additional manipulations. For another two hours, the woman is under close supervision of medical personnel to ensure timely detection of complications. After which the postpartum woman is transferred to a ward with the baby.
If an emergency or planned caesarean section is performed, then immediately after the operation the woman is transferred to the intensive care unit for observation - for at least two hours, most often for 12-24 hours. After this, she is also transferred to the postpartum ward.
Watch this video on how to care for a suture after a caesarean section:
What else will happen after childbirth
As soon as doctors are confident that the woman’s condition is stable, she is transferred to the postpartum ward. After a natural birth, women stay here for 3-5 days, after a cesarean section - up to 10 days. If necessary, the period may be extended. What procedures a woman will undergo after this depends on how her labor progressed.
If necessary, women are talked to about breastfeeding and taught how to properly latch onto a baby.
In case of complicated labor, a woman may be sent for additional examinations or procedures (for example, physical therapy), which are done directly in the maternity hospital.
Features before discharge from the hospital
Depending on the condition of the postpartum woman, the doctor determines the time of her discharge. The day before you need to undergo a minimum examination and examination. Procedures before leaving the hospital include the following:
- blood and urine analysis, if necessary - a broader study, including biochemical examination, in-depth urine tests;
- inspection of seams and their treatment;
- vaginal examination on a chair - the rate of uterine contraction and the nature of discharge from the genital tract are determined;
- examination of the mammary glands;
The newborn undergoes separate examinations and examinations. If any abnormalities or complications are discovered in the baby, mother and child may be left in the maternity hospital for some more time. In some hospitals, in such cases it is assumed that the patient will be transferred to another department (rehabilitation) or even a children's hospital.
As soon as the mother and baby are ready for discharge, all documents are drawn up - discharge summary, documents for the child, and others, if necessary. The woman should subsequently provide some of them to the pediatrician, and the other to the gynecologist at her place of residence.
Preparation for childbirth is universal and is performed in all maternity hospitals, but each medical institution has its own approaches and nuances. For example, in some places visiting relatives is allowed during the entire stay in the maternity hospital and even during childbirth. In others, this is strictly prohibited and even wearing your own clothes is not allowed. Therefore, when sending to a hospital on a scheduled basis, you should find out such nuances in advance.
Useful video
Watch this video about the features of the postpartum period:
