“This type of triage is unsuitable for pregnancy situations, which can transform into high-risk pregnancies at any stage, necessitating timely care before becoming life-threatening. It also adds ethical suffering to healthcare professionals who conducted the triage if things go wrong,” stated AMPDS in a communiqué.
Questioning the triage process, the association specified that the lack of investment in the National Health Service (SNS) “severely limits its ability today to respond in fundamental health areas, especially maternal health.”
“How can an SNS 24 triage or its algorithm, or a consultation in primary healthcare, ensure that a fetus is alive if there is a placental abruption or an ectopic pregnancy, or confirm whether stomach pains are due to pre-eclampsia if there is no quick access to tests, ultrasound, and a qualified professional?” they asked.
For the association, the health of pregnant women and fetuses “should be an absolute priority and not a pawn in the cosmetic game that avoids increasing and retaining the number of healthcare professionals in the SNS and improving their careers, keeping obstetric emergencies closed, leading inexorably to the privatization of the SNS.”
“Pregnancy should be seen as unique in its individual characteristics, which depend on particular factors such as the age of the pregnant woman, comorbidities, and obstetric history, bearing in mind that women are having their first child later,” they emphasized.
The association further noted that the new model for gynecology/obstetrics emergencies and delivery blocks “violates the most basic scientific and ethical principles, with potential consequences for the health and safety of the pregnant woman and consequently her unborn child.”
The AMPDS also observed that the Government’s exceptions for pre-triage, such as severe trauma or intense pain, “demonstrate a total lack of understanding of pregnancy risks.”
“A loss of consciousness could mean a stroke (HELLP syndrome), seizures will likely be eclampsia, situations that are very severe with high mortality, and could have been prevented if diagnosed in a timely manner, saving the woman’s and baby’s lives if time were not wasted in phone triages and consultations,” they added.
By February, over 94,000 women had been triaged via SNS Grávida, a branch of the SNS 24 line (808 24 24 24) that began operation on June 1, 2024. Around 9,300 were placed in self-care, and more than 16,000 were referred to primary healthcare.
The SNS Grávida, accessible through the same number as SNS 24 (808 24 24 24), is a measure under the Health Emergency and Transformation Plan, aimed at addressing demands in gynecology/obstetrics emergencies, an area facing significant challenges in the SNS.
In its initial phase, the SNS Grávida pilot project covered Santa Maria, São Francisco Xavier, Amadora-Sintra, Loures, and Cascais hospitals, as well as units in Vila Franca de Xira, Santarém, Abrantes, Caldas da Rainha, and Leiria.
Health Minister Ana Paula Martins announced on Monday that the National Commission on Women’s, Children’s, and Adolescents’ Health will soon announce the results of the pilot project and the program’s expansion nationwide.
