Safety and speed: modern ambulances - an important step for the health of mothers and newborns

Antenatal and post-partum medical care is crucial for ensuring a positive pregnancy experience and the postnatal well-being of mothers and newborns. Expectant mothers should attend regular check-ups and medical examinations at healthcare institutions throughout their pregnancy. Depending on each case, pregnancy monitoring should be conducted not only by family doctors but also by obstetricians and gynecologists. When needed, safe transportation must be ensured from Level I and II Perinatal Centers (district-level) to Level III perinatal care at the Perinatal Center of the Mother and Child Institute.

This is particularly important for pregnant women with chronic conditions that pose risks to pregnancy and childbirth, such as cardiovascular diseases, hypertension, diabetes, or kidney failure - conditions that can complicate pregnancy and require specialized, comprehensive medical monitoring to minimize risks for both mother and child. Equally important is care for women carrying multiple pregnancies (twins or triplets) or those whose pregnancy shows signs of intrauterine growth restriction, placenta praevia, or other obstetric risks. These situations demand careful medical supervision throughout pregnancy, including specific examinations to detect and manage potential complications.

Maria’s story: the journey to childbirth with the right support

Maria from Căușeni was 35 weeks pregnant when, during a routine check-up at the district hospital, doctors noticed a persistent increase in her blood pressure. This wasn’t entirely new for her - she had experienced blood pressure issues even before pregnancy. However, in this context, signs began to appear suggesting possible intrauterine growth delay in her baby.

Specialists advised her not to waste time and to undergo additional examinations at the Mother and Child Institute in Chișinău. In the past, such a trip would have been a source of stress, as safe transportation was not always available - especially for women in the final trimester of pregnancy. But now, thanks to the new ambulance provided by UNFPA to the Căușeni District Hospital, the transfer was fast, smooth, and accompanied by an obstetrician-gynecologist who monitored Maria throughout the journey.

During the journey, the doctor continuously monitored her blood pressure, overall condition, and the progression of the pregnancy. This gave Maria a sense of confidence and security. Upon arrival in Chișinău, examinations confirmed that the baby required close supervision and that delivery would be safest under the care of a team of neonatologists. Maria was admitted, and a few days later she underwent a planned cesarean section. The baby was born slightly premature but breathed independently and was in stable condition.

Today, Maria recalls the journey with gratitude: “If it weren’t for this ambulance and the doctor who accompanied me, I probably would have delayed until the last moment - I was afraid of the trip, of my blood pressure, of everything. But this way, I knew I was in good hands”, she shares.

Maria’s story is just one of many that highlight the importance of access to specialized transportation and qualified medical care, especially for women in rural areas. The safety and health of expectant mothers and their babies should not depend on distance.

To ensure that these pregnant women have access to advanced perinatal care appropriate to the complexity of their cases, it is essential to provide safe transportation from Level I and II Perinatal Centers to the Level III Perinatal Center at the Mother and Child Institute.

“We assess the condition of both the mother and the baby and, if necessary, transfer them to Level III perinatal care. These are usually cases of premature birth, maternal conditions unrelated to pregnancy, or when certain pathologies are detected in the baby”, says Valentina Burciu, head of the Căușeni Perinatal Center.

Ensuring the safe transport of pregnant women and mothers with newborns between perinatal centers of different care levels requires the availability of specialized, well-equipped transport staffed with qualified medical personnel.

In 2024, the United Nations Population Fund (UNFPA), with the support of the European Union, provided the National Health System with nine modern Type A ambulances. These were donated to Level I and II Perinatal Centers at district hospitals, as well as to the Level III Perinatal Center at the Mother and Child Institute in Chișinău. These specialized vehicles are intended for the planned transport of pregnant women and, when necessary, mothers with newborns to the Level III Perinatal Center at the Mother and Child Institute.

The ambulances are equipped with the necessary medical devices to ensure the safe and comfortable transport of pregnant women, as well as mothers with newborns, when needed, to higher-level perinatal care centers. These vehicles are now in service at district hospitals in Edineț, Soroca, Orhei, Ungheni, Căușeni, and Ceadîr-Lunga, as well as at Bălți Clinical Hospital, Chișinău Municipal Clinical Hospital No. 1 “Gheorghe Paladi,” and the Mother and Child Institute.

“Until this donation, patients were transported using older ambulances. We are very happy to have this new ambulance. It is equipped with oxygen, a monitor, two chairs for medical staff, and a patient bed”, says Alexandru Bojonca, Deputy Medical Director of Căușeni District Hospital.

The use of a modern, specialized medical transport vehicle ensures prompt and safe transfer, when needed, of pregnant women and mothers with newborns. This strengthens the referral system within the Perinatology Centers Network, reducing the risk of complications for both mothers and their babies.

“We have had cases where a woman in the final months of pregnancy needed to attend a consultation and give birth at a Level III perinatal care center, but due to financial constraints, she couldn’t afford the trip. With the ambulance, we were able to make the transfer safely. The donated ambulance greatly helps us carry out these transfers more quickly and securely”, says Valentina Burciu, Head of the Căușeni Perinatal Center.

In addition, UNFPA, with financial support from the U.S. Government, has supported the Ministry of Health’s efforts to strengthen the pre-hospital emergency medical service with 20 Type B ambulances for response teams that also handle obstetric emergencies, as well as three Type C ambulances needed for the transport of critically ill newborns. These vehicles are equipped with resuscitation equipment to maintain vital parameters (breathing and heart rate) during transport to higher-level neonatal care. Now, even the most vulnerable newborns, those born prematurely or facing severe complications, have a greater chance of survival.

In collaboration with other international partners, UNFPA continues to support the Ministry of Health in strengthening the National Perinatology Service to ensure that every pregnant woman, mother, and newborn in Moldova, whether in the capital or a small rural village can access high-quality perinatal medical care. Caring for mothers and newborns is not only a priority but also an investment in the future.