Medical examination of girls at school. Routine medical examination at school

It sounds strange, but if previously the first examination took place at school with a gynecologist at the age of 14, today girls get to the chair at the age of 10-12 years. Why? It's all about the early sexual development of children. And the point is not in sexual knowledge, but in the natural restructuring of the body. Here the production of female sex hormones is determined, which leads to an increase in the mammary glands, the beginning of vegetation in armpit and on the pubis, as well as the beginning of menstruation. The lack of a timely gynecological examination leads to neglect of the developed disease - often girls suffer from the formation of cysts on the ovary, which is explained by the uncontrolled production of hormones.

How and at what age are they examined?

As already presented above, the first visit to a gynecologist at school can occur at the age of 10 years. Of course, here girls are not brought to embarrassing circumstances - a standard examination on a gynecological chair is not carried out. The doctor only checks the growing mammary glands, in which lumps (mastopathy) can form, as well as the genitals - determines the pubic hair. Visible puberty The next visit to the gynecologist is assessed and determined. Also, if possible, it is specified probable attack menstruation.

Inspection at school on a chair in early age is carried out only for girls who have already experienced menstruation. The examination involves a visual examination of the condition of the uterus; if there are complaints, it is possible to check the condition of the internal genital organs through anus.

At the age of 14, as a rule, all girls begin menstruation. Here it is already necessary to “track” the cycle - on average it varies from 25 to 35 days. At first time menstrual cycle may be irregular, which is not uncommon at the age of 14 if menstruation began only six months or a year ago. But often the cause of such failures is the presence of diseases of the internal genital organs. The same cysts on the ovaries can be follicular and lead to delayed menstruation - the release of an egg. With absence timely treatment this leads to ovarian dysfunction, and, consequently, problems with conception at an older age.

Therefore, examination by a gynecologist at the age of 14 is comprehensive. If a girl leads sex life, the gynecologist inserts a magnifying mirror into the vagina, examining the condition of the uterus. In the absence of sexual intercourse, an examination is carried out through the anus. This method also, instead of the usual ultrasound, helps determine the condition of the ovaries - the size and presence of cysts on the organ.

How to overcome fear?

Many girls aged 10-14 years old in the gynecological chair experience discomfort - shame and discomfort provoke a feeling of fear. What can I say - even adult women experience discomfort during examination, because the genitals are very intimate and secret, which you don’t want to show even to a specialist. How to overcome fear?

Gynecologists themselves advise girls:

• Do not watch such videos on the Internet and do not study other manuals - this only increases the feeling of fear, because the video contains material “through the eyes” of a specialist. A girl won’t see anything like this, so there is no need to study the entire procedure for patients 10-14 years old in a gynecological chair;
• when examined in a gynecological chair, relax - discomfort, unpleasant sensations or even pain are provoked precisely by tense muscles;
• trust a specialist - a girl must completely trust the work of the gynecologist and his actions, this is the only way to avoid feelings of fear and shame;
• do not shower 3-4 hours before the intended examination - washing the genitals may incorrectly “provide” the available data. Simply put, flushing removes secretions that may indicate possible inflammatory process;
• do not shave yourself - the hair on a girl’s pubis indicates her puberty and hormonal picture in general, so it is not advisable to shave off the hair before the examination.

An examination by a gynecologist at school can be carried out by either a woman or a man. Of course, being at the age of 10-14 years in a gynecologist’s chair is very uncomfortable in principle, let alone being examined by a male gynecologist. But, if you trust experienced women (experience from the point of view of regular gynecological examinations), then men are more careful in their actions than women. The fact is explained by nature - a man cannot know exactly when a girl will feel pain during examination. Therefore, he tries in advance to prevent such sensations during his actions. The woman is on own experience knows that even with her somewhat careless actions, she will not harm the patient. But due to individual characteristics and in case of elementary stress to the patient safe actions may cause discomfort.

An examination by a gynecologist at school is necessary for the timely detection of diseases and hormonal disorders. If problems are detected, the girl is given a referral to undergo comprehensive inspection at the gynecologist in the antenatal clinic.

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IN last years gynecological examinations girls began to be carried out already in kindergartens. Many parents are surprised by the need to examine their child by such a specialist. Legal issues often arise. We will try to clarify the position of the law.

For this we look Order of the Ministry of Health of the Russian Federation dated December 21, 2012 No. 1346n “On the procedure for minors to undergo medical examinations, including upon admission to educational institutions and during the period of study in them”.

He will help us answer the most important questions.

Is it obligatory preventive examination gynecologist in kindergarten and school?

At a certain age, a visit to an obstetrician-gynecologist is expected and prescribed in the Order of the Ministry of Health. However, parents should remember that the federal law“On the basics of protecting the health of citizens Russian Federation"(No. 323-FZ of November 21, 2011) and other legislative documents provide for the right to refuse medical intervention.

Read more below in the answer to the question “Does a parent have the right to refuse a medical examination of a child by an obstetrician-gynecologist?”

At what age is a girl examined by a gynecologist?

The Order contains lists of specialists required to visit different cases life.

During preventive examinations carried out upon reaching a certain age, an obstetrician-gynecologist examines the child at 3 years, 7 years, 12 years, 14 years and then annually.

During preliminary examinations, that is, before entering any educational institutions (including kindergartens), a visit to an obstetrician-gynecologist is always expected.

Does a parent have the right to refuse a medical examination of a child by an obstetrician-gynecologist?

The Order clearly states that a necessary precondition for conducting a medical examination is the consent of the parent (legal representative) of the minor (Part I, Article 2). Consent is documented.

In addition, parents have other ways to protect themselves from unwanted medical intervention.

The basic rights and obligations of doctors and patients are regulated by federal law dated November 21, 2011 No. 323-FZ “On the fundamentals of protecting the health of citizens of the Russian Federation.” Article 20 states:

“A citizen, one of the parents or other legal representative of the person specified in part 2 of this article (note: a minor under the age of 15 years) has the right to refuse medical intervention or demand its termination, except for the cases provided for in part 9 of this article ."

Cases where medical intervention cannot be refused include diseases dangerous to society and emergency situations posing a danger to human life.

Refusal of any medical examination cannot lead to a refusal to visit or enroll the child in educational institution, since it is not provided for by the Law “On Education”.

Can a preventive examination in a kindergarten or school be carried out without parents?

According to Part II of Art. 15 Rules, children preschool age and schoolchildren under 15 years of age are examined in the presence of parents or other legal representatives.

Are they obligated kindergarten and the school notify parents in advance about the upcoming medical examination of children?

Notification must be made no later than 5 days before the medical examination. Parents should know full list specialists who will check the children, what research will be carried out, as well as the date, time and place of the examination (Part II, Article 14, Part III, Article 32, Part IV, Article 47).

Other important aspects question of examining a child by a gynecologist

It is fundamentally important that the child is examined precisely children's specialist, since pediatric gynecology has its own examination methods and instruments. It is illegal to refer a minor under 16 years of age to an adult obstetrician-gynecologist.

After the consultation, the doctor should leave medical card child, record the examination performed and its results and write a diagnosis.

Presence of parents gynecological examination The child’s care is important not only from the point of view of morality and psychology, but also from the point of view of hygiene and safety. No one except parents will monitor whether the doctor washes his hands and changes gloves after examining each child.

Medical examinations at school were carried out both during our childhood and now. The children are examined by a gynecologist and a urologist. Let's figure out whether you should be afraid of these examinations.

I remember well the confusion my classmates and I experienced when, in the eighth grade, we were told that we needed to visit the gynecologist’s office. What added to the fear was that the doctor was a man. For many of us, this was the first appointment with such a specialist. How are things now, what has changed after a couple of decades? After all, children are now much more educated in matters of sex, and society as a whole has become much more tolerant in many respects.

How often are medical examinations performed?

I'll start with the fact that rare child Now it will be possible to avoid a visit to a gynecologist or urologist until such a late age. An examination is required even upon admission to kindergarten! You will need to visit these doctors again. Graphs for their “verdict” are provided in the medical record. However, such intervention requires the written consent of the minor’s parents. Some mothers and fathers, not considering it necessary to visit a gynecologist and urologist at such an early age, decide to write a refusal to be examined by these specialists.

It is interesting that they are also supported by deputies of the Legislative Assembly of St. Petersburg. In an appeal to the Minister of Health of the Russian Federation, they ask to amend the order “On the procedure for undergoing medical examinations for minors” (came into force in September 2013), in particular, to cancel the examination of a gynecologist and urologist before entering a kindergarten or school. In the preliminary discussion and the document itself, deputies refer to the increased workload on clinic doctors, the inappropriateness and even immorality of such interventions.

Moreover, some children experience significant shock from visiting the doctor. Indeed, despite the fact that, as a rule, only an external examination is carried out (sometimes smears are taken), gynecologists or urologists are not always in sufficiently delicate. That is why good children's specialists are highly valued by parents, information about the miracle doctor is passed on by word of mouth. Some kids are already early years become patients of these doctors: we already wrote earlier, and in girls (unions) has become very common.

Schoolchildren undergo annual medical checkup from 5th grade (from 12 years old). It can be carried out both in the school itself ( medical office, a specially designated class), and in the clinic to which the educational institution is assigned.

What and how do gynecologists and urologists look at?

So, if a student, independently or together with his parents, has decided to visit a doctor during a medical examination, then it is advisable to prepare him for how everything will happen. Although, of course, the nature of the inspection differs significantly depending on educational institution, doctor, age and status of the patient. In some cases, everything can end with a simple conversation about the presence of sexual intercourse and any complaints.

But a standard visit for girls looks something like this: palpation mammary glands and abdomen to identify tumors, assess the timeliness of puberty (hair growth, menstruation). Examination of the internal genital organs is carried out only in the clinic. Virgins are examined through the rectum, girls who have sexual experience are examined using mirrors. The doctor can take the necessary swabs.

In boys, the urologist will examine the penis and scrotum, and will also evaluate the timeliness of maturation.

It is better to conduct a conversation with a child in calm atmosphere, you need to try to dispel the inevitable fears before the visit. At the request of the boy or girl, parents can be present during the examination or be outside the office door. The student should also be warned that the doctor’s questions should be answered honestly, since the problems identified on early stages, will allow them to be eliminated in a timely manner. Teenagers are often concerned about whether someone will find out from a gynecologist or urologist that a child is masturbating or being sexually active. The doctor is obliged to maintain medical confidentiality, therefore, without the consent of the young patient, he has no right to disclose information to either parents or teachers.

What should you pay attention to?

If a son or daughter refuses to have a parent present at the examination, a brief briefing must be given.

Firstly, if for some reason a student changes his mind about visiting a doctor, he can refuse in the presence of his parents or without them; no one has the right to force him or blackmail him with anything (non-issuance of a certificate, etc.).

It happens that during the medical examination there are strangers present - classmates waiting in line or getting dressed after the examination, teachers, other staff. This is unacceptable, and if the child is shy, it may be better to go separately to the clinic or medical Center, and then provide the certificate.

Secondly, if the examination takes place in a clinic, in order to conduct the correct form of examination, girls must immediately notify the doctor whether they have had sexual intercourse. You should also ensure that the doctor changes gloves and uses a new set of instruments for each patient. Alternatively, you can purchase your own gynecological kit at the pharmacy, or take a sheet or towel from home for the chair.

Third, discuss necessary preparation. Sometimes children are concerned about whether it is necessary to shave their hair before the examination. This is done only at the request of the teenager; doctors do not have the right to demand this. Girls should take care of bowel movements. AND bladder must also be empty. Before the examination, gently perform genital hygiene with neutral soap; douching is not necessary! During the day before the examination, sexual contact should be avoided.

And finally, the child should know that during the consultation he has the right to ask questions that interest him, for example, about possible methods contraception.

Up to 14 years of age inclusive, parents are legal representatives child as far as medical interventions. But as soon as children get older, they have the right to independently contact a gynecologist or urologist for examination and obtain the necessary advice. And it is very important that this visit does not turn out to be necessary, say, for the reason unwanted pregnancy. And for this, adults need, first of all, to be literate in matters of sex education. It is clear that in older children, but it is still advisable to support trusting relationship in family. And convey to daughters and sons that health in “this” area is very important, and therefore periodic visits to a gynecologist or urologist are a necessity.