Improving maternity care across borders: 'We were proud of what we had learned' – Dr. Alenka Zavrtanik Čelan

Through the EGTC-GO! Physiological Pregnancy project, Dr. Zavrtanik Čelan and her team have established unprecedented collaboration with Italian healthcare professionals, enhancing maternal care on both sides of the border. In this interview, she shares insights into the challenges, achievements, and lasting impact of this initiative on patient care and cross-border cooperation.

How has the Physiological Pregnancy project improved cross-border healthcare services in your hospital, and what impact have you seen on patient care?

Working on the cross-border EGTC-GO! Physiological Pregnancy project in a hospital environment was challenging because, until this initiative, we had no significant professional contact with gynaecologists and midwives from the Italian side of the border. The project involved doctors and midwives from the border municipalities of Nova Gorica, Šempeter pri Gorici, and Gorizia.

On both sides of the border, healthcare for pregnant women and women in labour is well organised, with excellent perinatal outcomes (low perinatal mortality and morbidity). Since pregnancy and childbirth are physiological events, we decided to approach pregnant and postpartum women in a way that respects their specific needs without unnecessary medical interventions and medicalisation. We compared the approaches to pregnancy and childbirth on both sides of the border with good examples from other EU countries and implemented some best practices in our daily work. EGTC-GO! supported our efforts by investing in facilities for pregnant women on the Italian side and renovating the maternity department on the Slovenian side to improve the birthing experience.

Following the project, we have had positive experiences as doctors, midwives, and women in labour. Women can now experience physiological childbirth in our hospital's beautiful and intimate environment. Our maternity department has gained recognition in the local community, and midwives have been essential in empowering pregnant and postpartum women.

What are the biggest challenges in collaborating with hospitals and healthcare professionals across the Italy-Slovenia border, and how has this project helped overcome them?

The biggest challenge in cross-border collaboration was the language barrier. Despite the daily connections between people living in the participating municipalities, the two languages are very different. During the project, interpreters, ensuring smooth communication were provided

Another obstacle was the difference in healthcare systems and service organisations, particularly concerning hospital childbirth and payment for services. To address this, an agreement was reached between the two cross-border regions, allowing women from the Italian side of the border to give birth in the nearest maternity hospital on the Slovenian side under specific conditions.

Can you share a specific example of a patient or case where cross-border cooperation made a real difference?

One of the project's most significant outcomes has been the enhanced role of midwives. They now more frequently provide individualised care to women in labour, respecting their wishes. Many midwives meet expectant mothers before labour begins, helping to resolve concerns and familiarising them with the maternity ward and its staff.

Women in labour can now use new equipment in delivery rooms to give birth according to their preferences, avoiding unnecessary medicalisation while ensuring safety. During pregnancy, they also have access to dedicated infrastructure that supports their psychological and physical preparation for childbirth.

What aspects of the project should be sustained or expanded in the future to ensure long-term benefits for cross-border healthcare?

In the future, we would like to see continued investment in the maternity ward infrastructure. Through the project, we have established professional relationships with our Italian colleagues and anticipate future collaboration. One joint professional event is already planned for April this year.

Local policymakers should create conditions for greater integration between the healthcare systems of both regions. This would enable cross-border employment of healthcare professionals and ensure pregnant women can access healthcare services seamlessly across the border.

How has the role of EGTC-GO! as the sole partner and the use of the ITI (Integrated Territorial Investments) instrument contributed to the success and sustainability of this project?

The role of EGTC-GO! was crucial to the success of our project. The ITI financial instrument allowed EGTC-GO! direct insight into the actual needs of the project without unnecessary administrative burdens. Our colleagues from EGTC-GO! were consistently present, providing support and encouragement throughout the project.

What if Interreg Italy-Slovenia funds did not exist?

Both cross-border regions are located at the far ends of Slovenia and Italy and are somewhat disadvantaged in terms of financial and political attention. They are remote from centres of financial power and decision-making, and their needs are often not prioritised.

I believe that without Interreg Italy-Slovenia funds, which are regionally oriented, our project and its benefits for the population of both regions would not have been possible.

What are your conclusions and hopes for the future?

We approached the EGTC-GO! Physiological Pregnancy project with no prior experience and no high expectations. By the end of the project, we were proud of what we had learned, how our work had evolved, and what we had built.

We hope to participate in another cross-border project in the future. With the experiences gained from the Physiological Pregnancy project and the European Capital of Culture Nova Gorica-Gorizia 2025 initiative, we will approach future projects with greater confidence.