Constantly working in the field of preventive health care, UNFPA, the United Nations Population Fund Armenia Office has published a booklet “Women’s Health Care in Emergency Situations.” The publication aims to protect women by providing the necessary information. The booklet is authored by Vruyr Grigoryan, the director of the Republican Institute of Reproductive Health, Perinatology, Obstetrics and Gynecology and Angela Mkrtchyan, obstetrician-gynecologist.

It is available on the UNFPA website and is distributed in medical facilities. It is also included in aid packages for forcibly displaced people from Artsakh in cooperation with UNICEF.

Luseh: the miracle of doctors

We met 43-year-old Armine Avetisyan at the entrance of the Republican Maternity Hospital. The woman smiled, warmly greeted the already familiar faces of the medical staff and swiftly made her way inside. Her first child, Luse, was waiting for her in the intensive care unit of the Republican Institute of Reproductive Health, Perinatology, Obstetrics and Gynecology.

“Today my daughter turned two months old. She was born at just 29 weeks, weighing a mere 950 grams. Now she weighs 1550 grams, another 300 grams, and we will go home,” the woman added with a smile.

“I can describe my Luse’s birth as nothing else but the miracle of doctors.”

Armine Avetisyan

Photo: Mediamax

Armine’s first pregnancy at the age of 42 was, unfortunately, unsuccessful. At the age of 43, the woman learned about her second pregnancy and immediately turned to the specialists of the medical center in her hometown of Sevan.

“Words can hardly express my immense gratitude to all the doctors I met. Thanks to doctors Khalafyan and Malkhasyan in Sevan, my pregnancy was preserved for 6 months. After that, I was sent to Yerevan Republican Medical Center. My pregnancy was very difficult. I had multiple fibroids that kept my blood pressure high. But here, too, I met wonderful specialists: Vruyr Grigoryan, Nune Papikyan, who appeared to be not only good doctors but extraordinary individuals. Their tireless dedication and support, including sleepless nights, ensured the safe arrival of my child. This is truly priceless,” said Armine.

In her condition, the doctors decided to perform a caesarean section. As a result of a complex operation, both the child and the mother were successfully saved.

Photo: UNFPA Armenia

“Now, I tell everyone who asks about my daughter: we are together thanks to the doctors. Women should definitely monitor their health, consult doctors on time, voice their concerns and listen to the advice they receive. I can’t tell you what I went through during pregnancy and how happy I am now. When we met in the corridor, it was as if I could not see anything. All I could think about was Luse,” the woman laughed.

Protect the woman by providing her with the information she needs

According to Vruyr Grigoryan, Director of the Republican Institute of Reproductive Health, Perinatology, Obstetrics, and Gynecology, there has been a remarkable shift in public perception regarding pregnancy planning. People have shown a notably heightened sense of responsibility in this regard.

“Certainly, this change did not happen overnight. It is the result of consistent work of the Ministry of Health and partners. Today, people have access to the most important message: prioritizing one’s health, even when not actively planning for pregnancy, is paramount. This is the key to a healthy future pregnancy.”

Vruyr Grigoryan, who also serves as a consultant to the Ministry of Health in the field of obstetrics and gynecology, emphasized the significance of state programs in reproductive health, for example, cervical cancer prevention and infertility eradication programs.

Vruyr Grigoryan

Photo: Mediamax

“In the first case, women can undergo free examinations at their local polyclinics. It is accessible for all. Similarly, when addressing infertility, many interventions can be financially burdensome for individuals, but the state endeavors to alleviate this burden by providing financial support.”

The director of the institute noted that while women can readily consult specialists in normal circumstances, maintaining health becomes more difficult during emergency situations.

Photo: UNFPA Armenia

“This is the reason why we recently published the booklet “Women’s Health Care in Emergency Situations” together with the United Nations Population Fund Armenia Office. Its primary objective is to help women monitor their own health particularly in circumstances such as natural disasters, wars and other emergency situations during which access to doctor may be impossible,” said Vruyr Grigoryan.

He emphasized that such information holds not only medical significance but also psychological importance.

Photo: UNFPA Armenia

“Unfortunately, our country is facing a highly stressful situation and we do not know what will happen tomorrow. Imagine that a woman planned a child, got pregnant, underwent all the necessary prenatal tests, did everything right, but found herself in a situation where her doctor is unavailable. This is incredibly stressful for her. She may panic about the future course of her pregnancy, missing the necessary examinations. Our task is to calm this woman and provide her with information about the situation and the appropriate steps to take. We had a similar experience during the coronavirus pandemic, when pregnant women had to miss their regular check-ups. At that time, first of all, we localized international guidelines, explaining to women that planned examinations could be skipped or postponed without posing any real danger. The same is with this booklet. We want women to feel protected, knowing that they can manage their own health issues.”

Anzhela Mkrtchyan

Photo: Mediamax

Angela Mkrtchyan, co-author of the booklet, obstetrician-gynecologist at the Republican Maternity Hospital, underscored that pregnant women are particularly sensitive to anxiety and stress.

Photo: UNFPA Armenia

“Often, alongside offering professional advice, we also play the role of psychologists, guiding women on when to worry and when not to. This booklet is written in the simplest language possible, covering everything from pregnancy planning to childbirth. We advise women to prepare a bag in advance containing all necessary items for both themselves and their child. A mother should be prepared to safeguard her child in emergency situations until help arrives. I believe this information is valuable not only for pregnant women but for everyone. With knowledge of these essential steps, you may save the lives of both a mother and child in your vicinity.”

An environment where every pregnancy is desirable and every birth is safe

“The UNFPA has been working in the field of reproductive health since 1999. Throughout this time, numerous programs have been executed, and informational materials have been developed for both the general population and medical professionals,” said Narine Beglaryan, Head of Reproductive Health Programs at UNFPA Armenia Office.

The UNFPA cooperates closely with state institutions, supporting the development of strategies and laws in the field.

Narine Beglaryan

Photo: Mediamax

Narine Beglaryan emphasized that alongside efforts focused on safeguarding women’s health in emergency situations, UNFPA Armenia Office also prioritizes enhancing the capabilities of medical professionals.

“In 2023, we trained over 200 healthcare professionals as part of the minimum initial services package in reproductive health. This package represents an internationally recognized standard, comprising essential measures to be implemented at the onset of emergency situations to mitigate maternal mortality, morbidity, and disability. In 2023, we acquired reproductive health kits, which were distributed to regional medical facilities.”

Considering that research conducted by the UNFPA revealed a notably high rate of caesarean sections in Armenia (approximately 38%), the organization supported the development of a national program and action plan within the Ministry of Health aimed at reducing this indicator.

Photo: UNFPA Armenia

“It’s crucial to engage with pregnant women directly. Our research indicates that fears often drive women to opt for caesarean sections. In 2023, we developed a course module for pregnant women led by prenatal psychologists. Additionally, we organized webinars for obstetrician-gynecologists, recognizing that these specialists play a pivotal role in a woman’s pregnancy journey. They are the ones with whom a woman interacts during every regular visit, and every word spoken can have a significant psychological impact on the pregnant woman,” explained Narine Beglaryan.

“Overall, our overarching plans and objectives are directed towards having a country and an environment where every pregnancy is desirable and every birth is safe. Every individual - young, old, woman or child should be able to realize their potential. This will contribute to the development of both the individual and the state.”

Yana Shakhramanyan

Photo: Agape Grigoryan and Emin Aristakesyan