Ukrainian refugees in Moldova guaranteed access to comprehensive sexual and reproductive health services

KYIV, Ukraine – “I caught the last evacuation train out. The next day, the station was bombed.” Katya is still haunted by the very different turn her life could have taken. 

At seven-months pregnant, she had been hiding with her family in a basement for 11 days. When she developed kidney stones and became unwell, she made the painful decision to leave her husband, parents and sister behind. Katya embarked on a gruelling two-day journey alone from eastern Ukraine to neighbouring Moldova. She knew she would likely give birth in Moldova and prayed that she would be safe and her baby healthy. “We rode in a sleeping car, with four people occupying one seat,” she said. “It was not an easy trip.”

Olga was also seven-months pregnant when the sirens started wailing and bombs began falling on her home town, near the city of Odesa. She had no choice but to flee, bringing with her all she could carry – including her four-year-old son, Timofey. But by the time she left, a line of cars stretched back further than she could see. Olga walked the 7.5 miles to the border. “It took us a long time. I had many bags and a tired toddler stumbling along,” she recalled.

Navigating childbirth alone and far from home

Once in Moldova, a family in Balti, the country’s second largest city, hosted Olga and her son. She was struck by the warm welcome they received, from the family who invited them into their home to the neighbours who brought them food.

But, the trauma of the war caused Olga severe stress. Doctors in Moldova monitored her condition during her third trimester later gave birth to a healthy daughter via caesarean section. When she arrived in Moldova, Katya went to a local clinic where she received swift and comprehensive prenatal care. She gave birth to her son at the same maternity hospital as Olga.

Both women were amazed to learn that their full treatment, delivery, and anaesthesia were free of charge. This was thanks to an agreement between UNFPA and the Moldovan national health insurance system. The agreement guarantees that through the end of the year, refugees from Ukraine can access the same free sexual and reproductive health care services as Moldovan citizens. This includes emergency obstetric care for women experiencing life-threatening complications.

Ensuring access to health care and support

The initiative is critical for some 22,000 Ukrainian women refugees of reproductive age in Moldova. 1,500 of these women are currently pregnant. As well as skilled care before, during, and after birth, the women can access cancer screenings, family planning services, treatment for sexually transmitted infections and other essential sexual and reproductive health services.

“We do everything we can for women in Moldova to ensure that they give birth safely, that the child is , healthy and that mothers leave the hospital fit and well,” said Caroline Frumusaki, chief physician at the hospital. Ms. Frumusaki personally oversaw Olga’s prenatal care and the birth of her daughter. She told UNFPA her mission is to make sure that all women, wherever they are from, receive the maternal and child health care they need, when they need it.

UNFPA is working closely with the Government of Moldova and partners to provide that women and girls access to life-saving sexual and reproductive health services and information. We also work to provide mental health care, so refugees can deal with the trauma and stress they will likely experience from having their lives upended by the war.

A bittersweet moment

While Olga is relieved that her daughter is safe, it was not the birth she wanted. “Our New Year’s resolution was to buy a new home. We had planned to celebrate the birth of our baby girl and our son’s fifth birthday with family and friends. But everything has changed, nothing is certain anymore. It’s difficult to make resolutions now,” she said.

It has been just over four months since Russia’s brutal invasion of Ukraine. The Republic of Moldova is hosting some 86,000 Ukrainian refugees. UNFPA has distributed more than 10 tons of reproductive health supplies to hospitals and clinics across the country. This includes the Balti maternity hospital, where Katya and Olga gave birth. The deliveries contain medicine and equipment for emergency obstetric care, treating sexually transmitted infections, and clinical management of rape. The kits will meet the needs of some 450,000 people, including Ukrainian refugees. 

Katya said she is grateful that her son, Matvey, is healthy. But, she said, it’s not what she wanted for the birth of her first child. Alone, far from home and with an uncertain future before them, she said she often feels anxious and lost. “My husband and I dreamed about this day for so long. His father is very excited. I can’t wait for the day when he can hold our baby in his arms.”