Subjective effect of September 11, 2001 among pregnant women: is cumulative history of interpersonal violence important?

Exploring the Linkages between Substance Use, Natural Disasters, Pandemics, and Intimate Partner Violence against Women: A Rapid Review in the Context of COVID-19

Rates of intimate partner violence (IPV) and substance use have risen during the COVID-19 pandemic, with potentially enduring effects on women’s health. A rapid review was conducted on IPV and women’s substance use in the context of the COVID-19 pandemic. The rapid review explored two separate research questions with a view to integrate the literature related to: (1) containment, social isolation, pandemics, disasters, lockdowns, and IPV; and (2) the relationships between substance use and IPV. Two different searches for each question were conducted between May and October 2020 and n = 47 articles were included. Women experience multiple physical and mental health consequences related to IPV that can be exacerbated by public health crises such as pandemics and disasters. Perpetrators may use these events as a tactic to threaten, isolate, or use coercive control. Similar tactics are reported in the complex relationship between IPV and substance use, where substance use can accompany IPV and/or be used as a coping mechanism for survivors. The findings highlight long standing women’s health concerns made further visible during the COVID-19 pandemic. Additional research is needed to identify actions required to reduce gender inequities and harms associated with IPV and substance use, and to adequately tailor and prepare effective responses in the context of future public health crises.

Disasters and perinatal health:a systematic review

BACKGROUND

The empirical literature on the effects of disaster on pregnancy and the postpartum period is limited. The objective of this review was to examine the existing evidence on the effect of disasters on perinatal health.

METHODS

A systematic review was conducted by searching electronic databases (MEDLINE, EMBASE, Cinahl, PsycInfo), including literature on disasters and pregnancy outcomes (e.g., preterm birth, low birth weight, congenital anomalies), mental health, and child development. A total of 110 articles were identified, but many published reports were anecdotes or recommendations rather than systematic studies. The final review included 49 peer-reviewed studies that met inclusion criteria.

RESULTS

Studies addressing the World Trade Center disaster of September 11 and other terrorist attacks, environmental/chemical disasters, and natural disasters such as hurricanes and earthquakes were identified. Disasters of various types may reduce fetal growth in some women, although there does not appear to be an effect on gestational age at birth. Severity of exposure is the major predictor of mental health issues among pregnant and postpartum women. After a disaster, mental health of the mother may more strongly influence on child development than any direct effect of disaster-related prenatal stress.

CONCLUSIONS

There is evidence that disaster impacts maternal mental health and some perinatal health outcomes, particular among highly exposed women. Future research should focus on understudied outcomes such as spontaneous abortion. Relief workers and clinicians should concentrate on the most exposed women, particularly with respect to mental health.

TARGET AUDIENCE

Obstetricians & Gynecologists.

LEARNING OBJECTIVES

After completion of this educational activity, the obstetrician/gynecologist should be better able to compare and contrast the effects of different types of disasters (hurricanes, earthquakes, chemical spills) on pregnant and postpartum women in order to prepare for patient care in the aftermath of such disasters; differentiate the birth outcomes likely to be affected by disaster, in order to identify patients likely to be at high risk; and assess the extent to which pregnant and postpartum women are a uniquely vulnerable population after disaster, to assist in organizing care under such circumstances.