In short: When choosing a maternity hospital, pay attention to the level (1, 2 or 3) and equipment, the possibility of partner and contract births, the presence of ICU of newborns, location and transport accessibility. Most level 2 maternity hospitals provide full care for uncomplicated childbirth. In case of pregnancy complications, a level 3 maternity hospital (perinatal center) is indicated.
Levels of maternity hospitals in Russia
In Russia, obstetric hospitals are divided into three levels depending on their capabilities and equipment. This is determined by the order of the Ministry of Health and directly affects which patients are indicated for a particular maternity hospital.
Level 1 – maternity wards in district hospitals. Designed for uncomplicated childbirth with full-term pregnancy. There is no neonatal intensive care unit and neonatal pathology department. In case of complications, emergency transportation to a more equipped hospital.
Level 2 – specialized obstetric hospitals. There is a neonatal intensive care unit. Childbirth is performed in a number of complications and at a gestational age of 32-33 weeks. Most urban maternity hospitals in Russia are of 2 levels.
Level 3 – perinatal centers. Maximum equipment, the ability to nurse very premature babies (from 22 weeks), treatment of severe pathologies of the mother and fetus. They are referred here for complicated pregnancies: preeclampsia, multiple pregnancies, fetal malformations, the need for a high-risk cesarean section .
What to look for when choosing a maternity hospital
Correspondence of the level of the maternity hospital to your situation. In case of an uncomplicated pregnancy, a level 2 maternity hospital is the best choice. In case of complications, be sure to discuss with your doctor whether you need level 3. Not always the best-equipped maternity hospital is the best choice for a particular situation: perinatal centers have a heavy workload, and planned uncomplicated childbirth is not always accepted there.
Presence of neonatal ICU and maternal ICU. If you have any doubts about the course of pregnancy or the prognosis for childbirth, make sure that the maternity hospital has an intensive care unit for newborns. This is critical in emergency situations.
Partner birth. If you want your husband or partner to be present at the birth, check whether the maternity hospital allows it. Most city maternity hospitals allow partner births, but conditions may vary (separate delivery room, partner requirements, surcharge). The partner must have fluorography and a certificate of the absence of infections.
Contract childbirth. A contract with a specific doctor or midwife ensures that this specialist will lead your birth (provided that there is no emergency with another person on duty). The cost of the contract varies from 30,000 to 200,000 rubles and more, depending on the city and maternity hospital. Specify what exactly is included in the price.
Maternity hospital policy on breastfeeding and cohabitation. The joint stay of mother and child and early attachment to the breast are important for establishing lactation. WHO recommends skin-to-skin contact immediately after birth.
Transport accessibility. When contractions begin, there is no time to think. Make sure the hospital is within reasonable reach of your home – especially given the possible traffic jams. A good practice is to make a "test trip" along the route in advance.
How to collect information about the maternity hospital
Reviews of women who gave birth there. Read on specialized forums, in pregnancy support groups. Pay attention to reviews written recently (over the past 1-2 years) - the situation in maternity hospitals may change. Single negative reviews are not always indicative; the big picture is important.
Attending an open day. Many maternity hospitals hold open days, where you can inspect delivery rooms, postpartum wards, and ask questions to the staff. This is a good opportunity to make an impression "live".
Recommendations of the doctor of the antenatal clinic. Your obstetrician-gynecologist knows the local maternity hospitals and the peculiarities of your pregnancy well. His recommendation is an important guideline.
Official data. Perinatal mortality rates and the frequency of cesarean sections in the maternity hospital are objective indicators of the quality of care, although they should be interpreted taking into account the "complexity" of the cases taken.
Rights when choosing a maternity hospital
According to the legislation of the Russian Federation, you have the right to choose any state maternity hospital within the subject of the federation under the compulsory medical insurance policy. A referral from the antenatal clinic is advisory in nature - you are not obliged to give birth in the recommended maternity hospital. Read about the documents required for admission in the article Birth certificate and documents for the maternity hospital.
Special situations when choosing a maternity hospital
Multiple pregnancy. A maternity hospital of 2-3 levels with the possibility of nursing premature babies is recommended (multiple pregnancies increase the risk of premature birth).
Planned cesarean section. Make sure that the maternity hospital has experience in elective cesarean for your specific situation. For more information, see the article Planned cesarean section.
Breech presentation of the fetus. Clarify the maternity hospital's policy regarding the management of breech birth – in some maternity hospitals, such women are referred for planned cesarean sections, in others, vaginal delivery in breech presentation is practiced by experienced specialists.
When to see a doctor
Discuss the choice of maternity hospital with your doctor:
If you have pregnancy complications (preeclampsia, diabetes, placenta previa), you need specialist advice on the level of the required hospital.
If the fetus has developmental abnormalities , a specialized perinatal center may be needed.
If you have not decided on your choice by the 35th-36th week , it's time to make a decision.
If you have pregnancy complications (preeclampsia, diabetes, placenta previa), you need specialist advice on the level of the required hospital.
If the fetus has developmental abnormalities , a specialized perinatal center may be needed.
If you have not decided on your choice by the 35th-36th week , it's time to make a decision.
Frequently Asked Questions
Is it necessary to conclude a contract with a maternity hospital?
No. Under the compulsory medical insurance policy, childbirth in a state maternity hospital is free. The contract is a paid option that gives additional guarantees: a specific doctor, a separate ward, an expanded scope of services. Non-contractual childbirth under compulsory medical insurance is standard, full-fledged medical care.
Is it possible to change the maternity hospital in the late stages?
Yes. You can change your choice of maternity hospital at any time before admission. If you have already entered into a paid contract, termination is possible under the terms of the contract. If the pregnancy situation has changed and the doctor recommends another maternity hospital, be sure to listen.
Conclusion
Choosing a maternity hospital is a personal and important decision. Take into account the level of equipment, the relevance of your situation, transport accessibility, the policy of the maternity hospital and the doctor's recommendations. Study the possibilities of the chosen maternity hospital in advance, attend an open day and prepare all the necessary documents. A competent choice of a maternity hospital is part of comprehensive preparation for childbirth.
Bibliography
- Order of the Ministry of Health of Russia dated 20.10.2020 No 1130n "On Approval of the Procedure for the Provision of Medical Care in the Field of Obstetrics and Gynecology". https://www.garant.ru/products/ipo/prime/doc/74831372/
- Federal Law of 21.11.2011 No 323-FZ "On the Fundamentals of Public Health Protection in the Russian Federation". https://www.consultant.ru/document/cons_doc_LAW_121895/
- WHO. Standards for improving quality of maternal and newborn care in health facilities. WHO, 2016. https://www.who.int/publications/i/item/9789241511216
- Ministry of Health of the Russian Federation. Clinical recommendations: Normal pregnancy. Ministry of Health of the Russian Federation, 2023. https://cr.minzdrav.gov.ru/
This material is for informational purposes only and does not constitute medical advice and is not a substitute for medical advice. If a child's sleep is accompanied by alarming symptoms, a pronounced deterioration in health, problems with breathing, feeding or weight gain, it is necessary to consult a qualified medical specialist as soon as possible, and not rely only on information from the Internet.
