Pregnancy monitoring, including consultations with a physician and midwife, laboratory and diagnostic investigations during certain weeks of pregnancy are funded from the state budget. Pregnancy monitoring is carried out by specialists who have a contract with the National Health Service to care for pregnant women.
Investigations according to the pregnancy monitoring plan are paid for above the state funding established for the healthcare facility – following the "money follows the pregnant woman" principle. This means that a pregnant woman is free to choose the healthcare facility where she receives a state-funded healthcare service.
When requesting a state-funded healthcare service, it is important to inform the healthcare provider that the service you need is related to pregnancy monitoring.
Pregnancy Monitoring
To get state-funded pregnancy monitoring, you need to see a gynaecologist, midwife or general practitioner who has contractual relations with the state (a contract with the National Health Service). The aforesaid healthcare providers determine which specialist is competent to provide further care for the pregnant woman after assessing the medical needs during the individual pregnancy.
List of Medical Facilities
The information on medical facilities providing state-funded consultations of gynaecologists are available on the website rindapiearsta.lv (select "Gynaecological consultation" in the "Service" search engine). You can find out which healthcare facilities provide state-funded healthcare services and where you can get it faster on the website rindapiearsta.lv. Waiting times vary from one healthcare facility to another. If you have to wait to get a state-funded healthcare service at one healthcare facility, you have the right to go to another healthcare facility where there is no or shorter waiting list. Information on the waiting time is collected once a month by healthcare facilities, so waiting list reports are informative and may not reflect information as of the current date. For the most up-to-date information on waiting lists, please contact the reception of the specific healthcare facility.
For more information on medical institutions and list of physicians providing state-funded healthcare services to pregnant women and women in postpartum period, please contact the National Health Service Customer Service Centre at nvd@nvd.gov.lv or call the information line 80001234. Telephone number for international calls +37167045005.
When the patient consults a gynaecologist, co-payment is not required if the physician confirmed the pregnancy. Consultations provided by physician and necessary investigations for pregnancy monitoring are free of charge (also in the postpartum period up to 70 days). However, when receiving state-funded healthcare services that are not related to pregnancy, maternity care and the postpartum period, patient co-payments are required.
Services covered by the state budget during certain weeks of pregnancy for pregnant women:
- consultations with a gynaecologist (general practitioner or midwife if the pregnancy is monitored by one of these specialists);
- laboratory tests (e. g., complete blood count, urine test);
- foetal ultrasound;
- identifying body mass index;
- checking the foetal heartbeat;
- other services.
Taking into account the pregnant woman's health state and medical indications, the physician may assess the need for additional consultations and investigations. In this case, a physician who has contractual relations with the state has the right to issue a referral for a state-funded healthcare service.
If the pregnant woman chooses a physician who has no contractual relations with the state, all pregnancy monitoring services – consultations, laboratory tests, diagnostic investigations (e. g., ultrasonography) – will be paid services, subject to payment according to the facility's price list.
Ultrasound
- The first ultrasound is performed at weeks 11 to 13 of pregnancy, the second ultrasound is performed at weeks 20 to 21 of pregnancy. By this time, the baby has grown enough to see potential issues in the best way. The third ultrasound is performed at weeks 34 to 36 of pregnancy for pregnant women at risk. For example, if the baby has growth retardation, if the pregnant woman has high blood pressure during pregnancy, and in other cases.
- Ultrasound between weeks 11 and 13 is performed to assess and measure the baby's breech fold. During this time, the pregnant woman also has blood tests and the data are assessed using a special software to identify the risk of genetic diseases in babies. If the findings show a high risk of abnormalities (1:50), the pregnant woman is advised to undergo amniocentesis (amniotic fluid test) or chorionic villus biopsy (tissue sample). If the risk score is between 1:50 and 1:1000, the pregnant woman is advised to undergo more in-depth ultrasound examinations.
The list of gynaecologists who perform ultrasound for pregnant women with normal pregnancies and pregnant women at risk can be found by contacting the National Health Service Customer Service Centre at nvd@nvd.gov.lv or call the information line 80001234. Telephone number for international calls +37167045005.
Special Investigations
- All pregnant women are screened for haemolytic group B streptococcus at weeks 35–37 of pregnancy to reduce the risk of neonatal infections.
- For rhesus-negative pregnant women who have been identified by their physician as requiring immunoglobulin administration, immunoglobulin administration at week 28 week of pregnancy is mandatory. Immunoglobulin administration is fully funded from the state budget. Rhesus-negative pregnant women undergo a blood group rhesus test at week 28 of pregnancy and an anti-erythrocytic antibody screen (to see if the pregnant woman has rhesus antibodies). If it is identified that a rhesus-negative pregnant woman does not have rhesus antibodies, then if the pregnant woman has a rhesus-positive partner or the partner's rhesus affiliation is unknown, the pregnant woman may be administered antibody immunoglobulin. In order to ensure the administration of antibody immunoglobulin to a rhesus-negative pregnant woman, a gynaecologist carrying out state-funded pregnancy monitoring shall assess the pregnant woman's state of health and the need for immunoglobulin administration and, if necessary, give a referral for immunoglobulin administration.
To find the medical facilities providing state-funded outpatient antibody immunoglobulin administration, please contact the National Health Service Customer Service Centre at nvd@nvd.gov.lv or call the information line 80001234. Telephone number for international calls +37167045005.
Childbirth
State-funded childbirth assistance is provided in medical facilities that have contractual relations with the state (a contract with the National Health Service). The state budget also pays for family births – the pregnant woman's husband or other family member can attend the birth free of charge.
To find healthcare facilities providing state-funded childbirth assistance, please contact the National Health Service Customer Service Centre at nvd@nvd.gov.lv or call the information line 80001234. Telephone number for international calls +37167045005.
Do patients have to pay for childbirth?
Maternity obstetric service is paid for from the state budget. If the pregnant woman chooses to receive additional paid services offered by the healthcare facility (for example, increased comfort room or a specific physician providing maternity obstetric care), she must pay according to the healthcare facility's pricelist for paid services.
When going to the delivery facility, a pregnant woman should bring her maternal passport and the original ultrasonography, blood type and rhesus factor tests taken during pregnancy so that the physician has all necessary information.
Are antenatal courses compulsory?
Psychological preparation courses offered by a healthcare facility to a pregnant woman, her husband or another person before childbirth are not covered by the state budget and are not compulsory. Failure to attend these courses cannot be a reason for refusing to provide state-funded family childbirth.
Information on preparing for childbirth – relaxation, breathing techniques, birthing positions and partner support – is provided by the physician monitoring the pregnancy during weeks 29–30 of pregnancy.
Do patients have to pay for a maternity kit?
The rate, according to which the state pays a healthcare facility for providing maternity care, covers the cost of medical supplies to enable the healthcare facility to provide patients with the medicines and supplies they need during childbirth, including a maternity kit.
The healthcare facility may additionally offer paid services, but if patients don’t use them, it cannot be a reason for refusing to provide a state-funded birth. It is the patient's free choice to receive paid services.