Registering your pregnancy in Uzbekistan: what happens at the polyclinic

A positive test is usually followed by a practical question: where do I go now? In Uzbekistan, routine pregnancy care runs through the prenatal office of your district polyclinic (ayollar maslahatxonasi, or women's consultation). Registering there early gives you a doctor or midwife who knows your history, free screening scans and tests, and the paperwork you will later need for maternity leave and the maternity hospital. Here is what to expect, step by step.

When and where to register

• Aim to register by 10 weeks; you can go as soon as a home test is positive, without waiting for an ultrasound.
• Go to the prenatal office of the polyclinic that serves your home address and bring your passport. If you live far from your registered address, ask the polyclinic near you about attaching to it for the pregnancy.
• A normal pregnancy involves about 4–7 planned visits: usually every four weeks until 28 weeks, every two weeks from 28 weeks and weekly from 36 weeks. High blood pressure, diabetes or twins mean more visits.
• Private clinics are a choice, not a requirement. The state polyclinic programme is the baseline: it provides the free screenings, the sick-leave certificate and the exchange card. Many women see a private doctor as well and share the results with their polyclinic.

The first visit

The first appointment is the longest. The doctor or midwife takes a detailed history (previous pregnancies, chronic conditions, medicines, allergies, illnesses in the family), measures your blood pressure, weight and BMI, examines your breasts, does a gynaecological examination and works out your dates from your last period. The ultrasound at 11–13 weeks will confirm the due date later.

Under the national "Normal pregnancy" protocol you will be sent for a set of tests:

• blood group and Rh factor;
• HIV, hepatitis B and C, syphilis;
• complete blood count, biochemistry, coagulation;
• fasting glucose or HbA1c;
• thyroid hormone (TSH) and rubella antibodies;
• urinalysis and urine culture;
• vaginal smear and cervical cytology.

You will also be referred to a therapist (general physician), a dentist and an eye doctor. Two supplements are recommended from the start: folic acid 1 mg daily until 12 weeks, and potassium iodide 200 µg daily throughout pregnancy and breastfeeding, because Uzbekistan is an iodine-deficient region.

Screenings and tests through the pregnancy

The national screening programme offers three free ultrasound screenings at the polyclinic:

• 11 weeks to 13 weeks 6 days — the first screening scan with nuchal translucency measurement and blood tests (PAPP-A, free beta-hCG). It also confirms your dates and checks for twins. The window is strict, so ask for the appointment early.
• 16–20 weeks — the detailed anatomy scan. Women placed in a risk group are referred in the same window to the regional Mother and Child Screening centre for second-stage tests.
• 28–32 weeks — the third scan: growth, placenta and amniotic fluid, plus a Doppler study in high-risk pregnancies.

Between the scans, expect a glucose tolerance test at 24–28 weeks to screen for gestational diabetes, Rh antibody tests at 18–20 and 28 weeks if you are Rh-negative, and a seasonal flu vaccine offered in autumn. From 33 weeks a CTG (cardiotocography) recording of your baby's heartbeat is done about every two weeks. At 35–37 weeks a swab for group B streptococcus is taken, and the HIV, hepatitis and syphilis tests are repeated before 36 weeks so that the maternity hospital has fresh results.

Maternity leave and the exchange card

At 30 weeks the polyclinic issues your sick-leave certificate for maternity leave: 126 calendar days (70 before and 56 after the birth), or 140 days for twins or complicated births. Give it to your employer; if you are a student or self-employed, ask your doctor which paperwork applies to you.

Around the same time you receive the exchange card (obmen kartasi) — a summary of your whole pregnancy with all the results. Keep it with you from 30 weeks onwards, together with your passport, and bring it to the maternity hospital. Without it the hospital may have to repeat tests or admit you to an observation ward.

Your district maternity hospital is the default, but you may ask about others. Useful questions: can a partner or relative be present during labour, what pain relief is available, and are skin-to-skin contact and rooming-in standard. Private maternity hospitals exist and are paid; the quality of care depends on the team, not the price.

Your rights and what to ask

You have the right to understand each test and to agree to or decline it, to privacy during examinations, to respectful treatment, and to ask for another doctor if the relationship is not working. Bring a written list of questions to each visit, for example:

• Which screenings do I need, and when exactly?
• Which results are back, and what do they mean for me?
• Which symptoms should make me call you, and which mean I should go straight to the maternity hospital?
• Which of the medicines I already take are safe to continue?

In an emergency — heavy bleeding, severe pain, fluid leaking before 37 weeks, a severe headache with blurred vision, or your baby moving much less than usual — call 103 (ambulance) or go straight to the maternity hospital. Do not wait for your next appointment.

This article is general information, not medical advice. Talk to your doctor about your own situation.