Rules for visiting in the maternity hospital: what relatives of a newborn need to know. What should a woman in labor be given to the maternity hospital during her visit and upon discharge? Is it possible to visit the maternity hospital?

Expectant mothers are looking forward to the X day when their baby is born. And it’s clear why - because you really want to see the one who lived and affectionately kicked in your tummy for nine months. - a great joy, not only for his parents, but also for other relatives who will certainly want to see the baby while still in the maternity hospital. However, this is not so simple. Most maternity hospitals in Ukraine have fairly strict requirements for visitors.

To begin with, it is worth saying that visiting mother and baby is possible only at certain times. As a rule, the maternity hospital opens for visitors at 7 a.m. and closes at 7 p.m. In some cases, exceptions are possible - for example, if a pregnant woman and her husband paid for a shared ward, in which parents and the baby can all be together at any time of the day. That is, the baby’s dad can spend the night in this room with his wife, new mother, and recently born child. True, for this, the baby’s father must be dressed in a change of clothes and shoes. A T-shirt, pants and slippers are best for this. In addition, the new daddy must have the results of fluorography in his hands, as well as a certificate from a pediatrician, which will indicate that the man is healthy and can be in the maternity hospital.

However, all these rules apply not only to the father of a newly born baby. Absolutely all visitors to the maternity hospital, without exception, must take off their outerwear and change into replacement shoes before they enter the department where the mother and her child are lying. Once in the room, relatives should change into clean home clothes, or simply put on a sterile medical gown. Before approaching the baby, much less picking him up, dad and other visitors need to wash their hands. Therefore, the expectant mother should make sure in advance that she has soap and towels in her room.

Some maternity hospitals also have other rules for visitors. For example, it is believed that there should be no more than three adults in a room in the neonatal department. In addition, in many maternity hospitals, children under the age of 14 are not allowed to visit mother and child, as they may be carriers of some kind of infection, which is so dangerous for the baby in the first days after its birth. In general, relatives of a new mother and a newborn baby should not run to the maternity hospital at any opportunity. It is better to pay a visit after discharge, when mother and baby have rested and gained strength.

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, which 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, the painkiller is delivered continuously through the 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.

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 for free, 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 Svetlana Manysheva, head of the department of medical care for mothers and children of the health care committee of the Minsk City Executive Committee. - It’s good that the last word on the issue of visiting mothers and children with 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 dads 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...

Perhaps, of all the myths associated with pregnancy or childbirth, the most harmful are precisely these “scary” stories about the maternity hospital. They have a negative attitude towards expectant mothers towards medical staff, often causing distrust in the actions of doctors and in the stay in the maternity hospital itself. Let's talk about the most common myths on this topic.

Myth No. 1. The living conditions in the maternity hospital are terrible.

In fact, stories about rooms for ten people, a non-working shower and one toilet for the entire floor have only historical value. Over the past decades, not only the level of medical services, but also the level of medical comfort has changed significantly. Most modern maternity hospitals meet European standards of medical comfort: small rooms for two to three people with a shower and toilet, the possibility of sharing with children, cozy lounges with TV and video equipment, individual box rooms for childbirth. In addition, future parents have the opportunity to enter into contracts for childbirth management, which provide especially comfortable conditions for mother and baby in the maternity hospital.

Myth No. 2. There are endless queues for medical procedures in the maternity hospital.

This is also not true. Modern maternity hospitals are well equipped with medical equipment, which virtually eliminates queues in front of the offices. For example, there is an ultrasound diagnostic device in every department of a modern maternity hospital (including the emergency room), a cardiotocograph (a device that records uterine contractions and the fetal heartbeat) - one for each woman in labor in the maternity ward, and several devices in the department of pathology of pregnant women. In many maternity hospitals, medical procedures such as medical examination, CTG (fetal heartbeat) recording, blood pressure measurement, administration of medications and treatment of sutures after childbirth are performed directly in the ward.

Myth No. 3. You can’t take personal items into the maternity hospital.

A woman admitted for childbirth is given a nightgown and gown or disposable blue sterile shirts made of non-woven material in the emergency department. You can bring your robe and washable slippers from home. In addition, you can take sterile anti-varicose stockings, a mobile phone, hygienic lipstick, face spray, wet wipes, toilet paper, and a bottle of water for mouth rinsing. Some maternity hospitals allow you to take a fitball (gymnastic ball) and an audio player during childbirth.

You can take clean home clothes to the antenatal department: a robe, pajamas or nightgown, underwear, a bandage; if walking is planned - comfortable clothes and shoes for the street. In addition, you are allowed to take necessary care and personal hygiene items: toothbrush and paste, comb, hair dryer, towel, shower products, cosmetics. In the department of pathology of pregnant women, the sanitary regime is not as strict as in the maternity ward, and there is a lot of free time from medical procedures, so you can take a laptop, books, magazines, embroidery, knitting or board games with you.

For the postpartum department, you can take nursing and sleeping bras, bra pads, a breast pump, cream against cracked nipples, intimate pads for postpartum women and a postpartum bandage. Walking in the postpartum ward is not provided due to decreased immunity in the first days after birth, so outerwear will only be needed for discharge. A young mother certainly has less free time than a pregnant mother - you can leave your laptop and handicrafts at home. The requirements for other things do not differ from the requirements of the department of pathology of pregnant women. For a newborn, you can bring disposable diapers and wet wipes, and if the maternity hospital allows you to use “your own” clothes, things will also come in handy: bodysuits, overalls, hats and socks. Bed linen for mother and baby is provided by the maternity hospital.

Myth No. 4. In the maternity hospital you can only eat hospital food.

This is completely false: in any modern maternity hospital they accept food parcels. At the same time, the maternity hospital employees do not control the content of “grocery orders”! Although, of course, there is a list of products that are not recommended for consumption during breastfeeding, as well as medical restrictions in the diet for some complications of pregnancy.

Myth No. 5. Visitors are not allowed into the maternity hospital departments.

This is not so: visitors are allowed to see the expectant mother, and in some maternity hospitals, in the absence of health contraindications, pregnant women are allowed daily walks with their relatives. Almost all modern maternity hospitals allow partner births - which means that even in the most “strict” department of the maternity hospital, the patient can ensure the presence of a loved one. In order to be present at the birth, your partner may need to undergo tests and provide a certificate of completion of courses for future parents.

After the birth, visitors are allowed to visit the mother and baby, but there are restrictions on the number of guests and the time of their stay in the maternity hospital. The restrictions are due to the protective regime necessary for the mother and newborn to recover after childbirth. In the first days after birth, mother and baby are most vulnerable to infections and get tired quickly; they need to rest and gain strength. Based on this, the maternity hospital administration controls the duration and number of visits to its patients. Another reason for limiting visits may be quarantine associated with an epidemic of acute respiratory viral infection or influenza. Finally, the possibility of visits depends on the living conditions of the maternity hospital: if there are many patients in the ward, visits from relatives may cause discontent among neighbors in the ward (for religious, national reasons, superstition or fear of infection).

Myth No. 6. If you end up in the pathology department, you won’t be released before giving birth.

This myth has no basis in reality. In order to hospitalize a pregnant woman in the pathology department, the doctor must make a fairly serious diagnosis (not all complications of pregnancy require hospital treatment). For example, severe gestosis (late toxicosis), placental insufficiency or threat of premature birth. For the treatment of each pathology of pregnancy under the terms of compulsory medical insurance (compulsory health insurance), the law defines a fixed time in the day, longer than which the patient cannot stay in the hospital. So, even if we assume that for some reason the doctor specifically wants to keep the expectant mother in the maternity hospital until the birth, he will not be able to fulfill this intention! When treated under VHI (contract form), the patient pays for every additional day of hospital stay, so the timing of discharge is as clearly regulated as with compulsory medical insurance, and extension of hospitalization is possible only with the personal consent of the pregnant woman.

Myth No. 7. If you go to the maternity hospital in advance, contractions will be artificially induced

Special measures to induce labor (“induce” contractions) are taken only in the case of post-term pregnancy. Moreover, post-maturity is not just a pregnancy lasting more than 40 weeks, as is commonly believed at the level of the same myths. Let us remind you that pregnancy is considered full-term (and the baby is ready for birth) from 38 to 42 weeks. 40 weeks is the most likely, but not exact, date of birth. The term “postmaturity” refers to the failure of the auxiliary organs of pregnancy - the placenta and fetal membranes, their “aging” and deterioration of functions. Aging of the placenta and membranes gradually leads to oxygen starvation of the fetus, decreased nutrition and metabolism. The baby’s intrauterine “habitat” also undergoes changes - the amount of water decreases and it becomes viscous. The membranes become thicker and lose their elasticity, causing the walls of the uterus to put pressure on the fetus. These changes worsen the prognosis for childbirth and pose a danger to the health of the fetus.

To accurately diagnose postmaturity, ultrasound, Doppler (monitoring placental blood flow), CTG (monitoring the fetal heartbeat) and amnioscopy (transvaginal optical examination of the amniotic sac and fluid) are used. If the pregnancy lasts more than 40 weeks, but there are no signs of post-term, only monitor the condition of the mother and baby without taking any additional interventions.

Myth No. 8. If you go to the maternity hospital on the eve of giving birth, they will administer medications to dilate the cervix.

In fact, this is not so: doctors simply observe the condition of the mother and baby preparing for childbirth, but do not interfere with this natural process. Special measures to prepare the cervix are taken only in the case of biological immaturity of the birth canal. This term refers to the discrepancy between the condition of the cervix and vaginal walls and the duration of pregnancy. Normally, before childbirth, the cervix gradually shortens and begins to open slightly, the tissues of the vagina and cervix become soft and elastic. Changes in the birth canal usually occur between 37 and 39 weeks of pregnancy. If, during a full-term pregnancy and a mature fetus (this data is confirmed by ultrasound), the cervix remains tight and long, as in the middle of pregnancy, and the cervical canal remains closed, it is necessary to prescribe medication for the preparation of the birth canal. None of the drugs that are used for these purposes have labor-inducing properties, that is, they do not directly lead to the onset of contractions. Drug preparation of tissues of the birth canal is never carried out without indications, and, of course, is not a mandatory element of planned prenatal hospitalization.

Myth No. 9. To ensure that labor does not last long, labor is always stimulated in the maternity hospital.

Labor stimulation refers to measures to enhance labor, that is, contractions. The only indication for stimulating contractions is weakness of labor forces - a complication of labor in which the force of contractions is not enough to open the cervix and move the fetus along the birth canal. The strength of contractions can be judged using cardiotocography, as well as by the dynamics of labor: increasing contractions, increasing opening in the cervix and advancement of the fetus. The duration of labor is individual and is not a direct indicator of weak labor. In addition, measures to intensify contractions are never applied in advance, in the form of prevention of protracted labor - because as a result, another, no less dangerous complication can develop - rapid labor.

Myth No. 10. A woman is alone in the maternity unit, and it may happen that she has no one to turn to for help.

In fact, the maternity hospital staff constantly monitors all women in labor. The prenatal midwife is in the room constantly or enters the room every 15–20 minutes, depending on the “general” or “box” structure of the maternity ward. Her task includes monitoring the general condition of the woman in labor, monitoring the frequency and strength of contractions, calling a doctor and performing medical prescriptions (injections, measuring blood pressure). The doctor should appear in the room every 40–60 minutes, listen to the fetal heartbeat using a stethoscope, portable ultrasound sensor or CTG readings, assess the strength and dynamics of contractions, the location of the fetal head, and, if necessary, perform a vaginal examination. During pushing, birth of the fetus and discharge of the placenta, the doctor and midwife are constantly with the woman in labor. If complications arise at any stage of labor, the doctor remains with the patient, monitoring her condition. At the same time, the remaining patients in the maternity unit are not left without medical supervision: the duty team consists of several doctors and midwives.

Many modern maternity wards are equipped with an effective means of communication - a staff call button!

Myth No. 11. The baby can be confused in the maternity hospital

This myth is probably the most persistent of all those listed. It is impossible to confuse the child: even if during contractions the woman is in the general prenatal ward, the process of giving birth to the baby takes place in an individual delivery room. Immediately after birth, the baby is examined, weighed, height is measured, and individual identification bracelets are placed on the arms. The bracelets contain the mother’s last name, first name, patronymic and medical card number, gender, weight and height of the child, date and time of birth. These bracelets are not removed from the newborn until discharge from the maternity hospital under any circumstances, regardless of whether the mother and baby are staying together or separately in the postpartum department.

In order not to be afraid of the maternity hospital, to navigate the requirements of the staff and to trust the actions of doctors, it is worth learning more about the structure and operation of this medical institution in advance. You can find information in magazines and courses for expectant parents, on the website and at the maternity hospital’s insurance company. You can also call the helpline or drive up to the emergency department of the maternity hospital and talk with the staff. Finally, you can go on a tour of the maternity hospital - this opportunity is available in many modern maternity hospitals. But you shouldn’t believe myths - that’s why they are myths!