How to register as a pregnant woman Printable versionLast update: 22.02.2023
You are to become a mother!
We are happy to assist you during this best and most responsible period, i.e. period of pregnancy and giving birth.
Pregnancy is an amazing period in a woman's life. This is a time of celebrating the new life growing inside you. Along with the previously unfamiliar joy, a new sense of responsibility is emerging in you.
Maternity in the Republic of Kazakhstan is protected and encouraged by the state.
Pursuant to Article 77 of the Code of the Republic of Kazakhstan as of July 7, 2020 "On the Health of People and Healthcare System" (hereinafter: Code), citizens of the Republic of Kazakhstan have the right to:
1) receive a statutory free medical assistance;
2) freely select a doctor and medical organization.
Pursuant to Article 81 of the Code of rights and duties of pregnant women and mothers in the field of health protection, pregnant women should:
1) within the period up to twelve weeks of pregnancy, get registered as pregnant at the place of registration for medical care under the statutory free medical assistance and (or) in the system of compulsory social health insurance;
2) follow a doctor's recommendations during pregnancy, during childbirth and after childbirth.
Thus, a pregnant woman should consult an obstetrician-gynecologist at a place of actual residence.
Pursuant to the Order of the Minister of Health of the Republic of Kazakhstan "On amendments and additions to the Order of the Minister of Health of the Republic of Kazakhstan as of August 26, 2021 No. KR DSM-92 "On approval of the standard for organization of obstetric and gynecological care in the Republic of Kazakhstan" (hereinafter: Standard), an obstetrician-gynecologist should perform the following after receiving an informed consent of a pregnant woman or her legal representative:
- collect a comprehensive anamnesis, find out whether a pregnant woman and relatives have socially significant diseases in accordance with the requirements of the Order of the Minister of Health of the Republic of Kazakhstan as of September 23, 2020 No. KR DSM -108/2020 "On approval of the list of socially significant diseases" (registered in the Register of State Registration of laws and regulations under No. 21263) and somatic diseases, multifetal pregnancies, birth of children with congenital malformations and hereditary diseases;
- consider diseases (somatic and gynecological), operations, transfusions of blood and its components during childhood and adulthood;
- collect an epidemiological anamnesis;
- when collecting anamnesis, identify pregnant women with "risk" factors for congenital and hereditary pathology to provide them a referral to a doctor majoring in "Medical Genetics" (without ultrasound screening and maternal serum markers analysis) based on the following indications:
- the age of a pregnant woman is 37 years and above,
- anamnesis has a case of pregnancy termination due to genetic indications and (or) birth of a child with congenital malformations or chromosomal pathology,
- anamnesis has a case of giving birth to a child (or presence of relatives) with a monogenic hereditary disease,
- there are hereditary chromosomal or gene mutations,
- anamnesis has a case of stillbirth, recurrent miscarriage, death of one or more children with an unclear and not established diagnosis linked to gender;
- study the reproductive function features;
- clarify the health status of a spouse (partner), blood type and Rh status;
- study the working environment where the spouses (partners) work;
- clarify whether there are any bad habits, such as: consumption of tobacco products, psychoactive substances (alcohol, narcotic drugs, psychotropic substances, their analogues, other intoxicating substances) or passive smoking;
- check anthropometry: measure the height, body weight, find out a body mass index, conduct a general physical examination of the respiratory system, circulation, digestion, urinary system, mammary glands, examine legs to check for varicose veins; perform gynecological examination of the cervix in mirrors and bimanual vaginal examination;
- after the examination, determine the pregnancy period, perform early registration of pregnant women up to 10 weeks on the day of addressing to a medical organization and detecting pregnancy for timely examination;
- prescribe the initial set of mandatory laboratory tests to a pregnant woman: a general blood count, a general urine test, blood type and Rh factor, serological examination for syphilis (blood sampling for Wasserman's reaction), examination for HIV infection with preliminary pre-test consultation and obtaining informed consent for testing, examination for specific antigens and antibodies of hepatitis: hepatitis B and C, blood glucose determination, blood testing for maternal serum markers in the period from 11 weeks 0 days to 13 weeks 6 days of pregnancy from the first day of the last menstruation, if there are indications for sexually transmitted infections, bacteriological examination of the average portion of urine (urine culture tank), bacterioscopy of a vaginal smear for purity, smear for oncocytology, if there are any clinical indications, than microbiological examination of the female genital organs for aerobic and facultative anaerobic microorganisms with determination of sensitivity to antibiotics. Send a spouse or sexual partner (partners) of a pregnant woman to be examined for HIV infection, according to the order of the Minister of Health of the Republic of Kazakhstan as of November 27, 2020 No. KR DSM-211/2020 "On approval of the Rules for mandatory confidential medical examination for HIV infection" (registered in the Register of State Registration of laws and regulations under No. 21692);
- refer a pregnant woman to prenatal screening in order to identify a risk group for chromosomal pathology and congenital malformations of an intrauterine fetus:
- to ultrasound screening in the first trimester during pregnancy from 11 weeks to 13 weeks 6 days of pregnancy;
- send for MSM analysis with calculation of the individual genetic risk of fetal chromosomal pathology;
- refer pregnant women to functional examinations: electrocardiogram (hereinafter: ECG) and depending on indications to echocardiogram
(hereinafter: referred to as EchoCG), ultrasound examination (hereinafter: ultrasound) of kidneys;
- refer a pregnant woman to a dentist for consultation (emergency and planned dental care for pregnant women is provided free-of-charge under the compulsory social health insurance ) and depending on indications to an otolaryngologist;
- get and study information from the register of pregnant women and women of fertile age and medical information systems about previous pregnancies, childbirth and previously identified somatic diseases;
- ensure personalized maintenance of the register of pregnant women and women of fertile age with inclusion of all the examination data, laboratory test results and consultations;
- an obstetrician-gynecologist enters the received information into a personal card of a pregnant woman in the form No. 077/y (hereinafter: form No. 077/y) approved by Order No. KR DSM–175/2020, in paper and/or electronic format as well as into a prental record of a pregnant woman in the form No. 048/y approved by Order No. KR DSM-175/2020 (hereinafter: form No. 048/y), which is issued to a pregnant woman at the first visit and which she keeps throughout pregnancy for presentation at the place of observation, during consultation by specialists of medical organizations, when calling an ambulance, during patronage by medical workers, when applying for in-patient replacement care, organization of treatment at home (hospital at home), when contacting diagnostics departments of medical organizations providing round-the-clock medical care in stationary conditions;
- tells about antenatal care, recommends therapeutic and preventive measures in the first trimester such as taking 0.4 milligrams of folic acid daily during the first trimester;
- date of the next visit is set in 7-10 days from the date of registration of a pregnant woman;
- on the day of a pregnant woman registration, data about her is provided to a place of her registration in the form of an entry in the register of pregnant women. A pregnant woman is sent to a therapist, a general practitioner and a visiting nurse.
Pursuant to Clause 18 of the Standard, within three working days from the date of registration of a pregnant woman, a district nurse and (or) a male nurse, a midwife and (or) an obstetrician conducts prenatal patronage which is a universal package of services for pregnant women in medical organizations when providing primary health care based on a universally progressive patronage model.
Pursuant to Clause 31 of the standard, patronage of pregnant women and new mothers is carried out by district therapists, pediatricians, family doctors, midwives and nurses.
When making a patronage visit to a pregnant woman, a medical worker:
- enquires whether a pregnant woman has any complaints, measures blood pressure, examines for swellings and signs of anemia;
- assesses mood (whether there is depression), safety of domestic environment and living conditions, room hygiene and personal hygiene, pregnancy risk factors;
- explains about physical and mental changes associated with pregnancy, about harmful effects of stress during pregnancy, smoking and use of narcotic drugs, psychotropic substances and precursors;
- gives advice on balanced nutrition, weight control, physical activity, oral hygiene, personal hygiene;
- informs a pregnant woman and her family about the alarming signs of pregnancy when it is necessary to consult a doctor immediately;
- consults on how to prepare for childbirth, how to prepare a room, care items and clothes for a newborn, basic newborn care, explains the importance of breastfeeding and demonstrates breastfeeding techniques.
When a pregnant woman changes her place of residence, further supervision is carried out by a doctor, a medical assistant or a midwife/obstetrician at the place of actual residence. The note on a pregnant woman's departure is made in the medical documents (form No. 077/y and form No. 048/y). Information about a pregnant woman's relocation is transferred to the local public health authorities of regions, cities of republican significance and the capital and medical organizations at the place of arrival of a pregnant woman by telephone and e-mail with indication of passport data, individual identification number, residence address, contact details of a pregnant woman and her relatives.
Medical organizations at the address where a pregnant woman moved, ensure her temporary registration, carry out registration at any stage of pregnancy and provide medical care to the full extent.