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Suzuki S, Sato N, Miyazaki M. Maternal experiences of pregnant women affected by natural disasters: A modified grounded theory approach. Nurs Health Sci 2024; 26:e13135. [PMID: 38866383 DOI: 10.1111/nhs.13135] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2023] [Revised: 05/01/2024] [Accepted: 05/20/2024] [Indexed: 06/14/2024]
Abstract
Pregnant women experience medical and psychological difficulties in their daily lives during disasters. Since the care provided to them in disaster situations is unclear, it is necessary to better understand their experiences. This study aims to identify the maternal experiences of pregnant women during natural disasters. This research employed a modified grounded theory approach. Twenty-three pregnant women, living in disaster-affected areas, were interviewed. The research methods were utilized and interpretive analysis was conducted, resulting in a diagram and storyline to describe the process. The characteristics of the maternal experiences fluctuated between "being unable to face pregnancy because of the disaster response" and "facing the fact of being pregnant." To maintain a fluctuation between their affected life and their pregnant life, it was necessary to control the weighting between "securing a safe and secure place," "encountering support based on pregnancy," and "signs from the fetus." Clarifying the maternal experiences of pregnant women living in disaster areas revealed a multilayered structure of categories and relationships. This study suggests that understanding the structure of fluctuations and control is critical for the nursing practice.
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Affiliation(s)
- Satoko Suzuki
- Human Development, JICA Ogata Sadako Research Institute for Peace and Development, Tokyo, Japan
| | - Naho Sato
- Graduate School of Nursing, Chiba University, Chiba, Japan
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Barkin JL, Philipsborn RP, Curry CL, Upadhyay S, Geller PA, Pardon M, Dimmock J, Bridges CC, Sikes CA, Kondracki AJ, Buoli M. Climate Change is an Emerging Threat to Perinatal Mental Health. J Am Psychiatr Nurses Assoc 2024; 30:683-689. [PMID: 36482670 PMCID: PMC11141104 DOI: 10.1177/10783903221139831] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
OBJECTIVE In this discussion, we build the case for why climate change is an emerging threat to perinatal mental health. METHOD A search of current literature on perinatal and maternal mental health and extreme weather events was conducted in PubMed/MEDLINE and Web of Science databases. Only articles focusing on maternal mental health were included in this narrative review. RESULTS The perinatal period represents a potentially challenging timeframe for women for several reasons. Necessary role adjustments (reprioritization), changes in one's ability to access pre-birth levels (and types) of social support, fluctuating hormones, changes in body shape, and possible complications during pregnancy, childbirth, or postpartum are just a few of the factors that can impact perinatal mental health. Trauma is also a risk factor for negative mood symptoms and can be experienced as the result of many different types of events, including exposure to extreme weather/natural disasters. CONCLUSION While the concepts of "eco-anxiety," "climate despair," and "climate anxiety" have garnered attention in the mainstream media, there is little to no discussion of how the climate crisis impacts maternal mental health. This is an important omission as the mother's mental health impacts the family unit as a whole.
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Affiliation(s)
- Jennifer L. Barkin
- Jennifer L. Barkin, PhD, Mercer University School of Medicine, Macon, GA, USA
| | | | - Carolann L. Curry
- Carolann L. Curry, MLIS, Mercer University School of Medicine, Macon, GA, USA
| | - Saswati Upadhyay
- Saswati Upadhyay, MBBS, MPH, The University of Texas Health Science Center at Houston, Houston, TX, USA
| | - Pamela A. Geller
- Pamela A. Geller, PhD, Drexel University, Philadelphia, PA, USA
- Pamela A. Geller, PhD, Children’s Hospital of Philadelphia, Philadelphia, PA, USA
| | - Madelyn Pardon
- Madelyn Pardon, PhD, James Cook University, Townsville, Queensland, Australia
| | - James Dimmock
- James Dimmock, Telethon Kids Institute, Western Australia, Australia
- James Dimmock, James Cook University, Townsville, Queensland, Australia
| | - Christy C. Bridges
- Christy C. Bridges, PhD, Mercer University School of Medicine, Macon, GA, USA
| | - Christina A. Sikes
- Christina A. Sikes, RN, BSN, North Central Health District, Macon, GA, USA
| | - Anthony J. Kondracki
- Anthony J. Kondracki, MD, PhD, Mercer University School of Medicine Savannah, Savannah, GA, USA
| | - Massimiliano Buoli
- Massimiliano Buoli, MD, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Milan, Italy
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Pardon MK, Dimmock J, Chande R, Kondracki A, Reddick B, Davis A, Athan A, Buoli M, Barkin JL. Mental health impacts of climate change and extreme weather events on mothers. Eur J Psychotraumatol 2024; 15:2296818. [PMID: 38224060 PMCID: PMC10791077 DOI: 10.1080/20008066.2023.2296818] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/04/2023] [Accepted: 12/06/2023] [Indexed: 01/16/2024] Open
Abstract
Background: The perinatal period is a time of increased vulnerability for perinatal mood and anxiety disorders (PMADs). Emotional trauma is a risk factor for PMAD development and is common among survivors of extreme weather events (EWEs), which are becoming more frequent and intense as the climate crisis progresses. EWE-related stress and anxiety have not been extensively studied in the perinatal population. However, the limited available data suggest a negative impact of EWE exposure on perinatal mental health, warranting further investigation and investment.Objective: To address this knowledge gap, we interviewed new Australian mothers to understand how EWEs affect the mental health of the perinatal population.Method: Australian mothers (18 years of age or older) with a baby under 12 months of age were recruited to participate in a single virtual focus group session (seven group sessions were run in total) and complete an anonymous survey. Participants were asked questions regarding their concerns about extreme weather and its impact, as well as their general maternal functioning. Maternal functioning, depression, and climate distress were measured via the survey.Results: The study sample comprised 31 Australian mothers (Mage = 31.74, SD = 4.86), predominantly located in Queensland. Findings from the focus groups suggested six key themes; however, of focus to this study are three themes related to maternal mental health: health and well-being, helplessness and avoidant coping, and resilience and adaptation. Predominant subthemes focused on trauma resulting from EWE exposure, economic and heat concerns, social isolation, hopelessness about the future, and feelings of resilience.Conclusions: The evidence linking adverse perinatal mental health outcomes with climate change and EWEs highlights the urgent need for interventions in this context to protect perinatal mental health and well-being. By acknowledging the traumatic impact of these experiences on mothers, this study supports advocacy for policies that specifically address this issue.
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Affiliation(s)
- M. K. Pardon
- Department of Psychology, James Cook University, Townsville, Australia
| | - J. Dimmock
- Department of Psychology, James Cook University, Townsville, Australia
| | - R. Chande
- Department of Psychology, Mercer University, Macon, GA, USA
| | - A. Kondracki
- Department of Community Medicine, Mercer University School of Medicine, Savannah, GA, USA
| | - B. Reddick
- Department of Community Medicine, Mercer University School of Medicine, Savannah, GA, USA
| | - A. Davis
- Clinical Mental Health Counseling Program, Southwestern College , Santa Fe, NM, USA
| | - A. Athan
- Teachers College, Columbia University, New York, NY, USA
| | - M. Buoli
- Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy
- Department of Neurosciences and Mental Health, Fondazione IRCCS Ca'Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - J. L. Barkin
- Department of Community Medicine, Mercer University School of Medicine, Macon, GA, USA
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Barman P, Sarif N, Saha A. Association between natural hazards and postnatal care among the neonates in India: a step towards full coverage using geospatial approach. BMC Emerg Med 2023; 23:76. [PMID: 37460972 PMCID: PMC10351138 DOI: 10.1186/s12873-023-00844-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2022] [Accepted: 06/07/2023] [Indexed: 07/20/2023] Open
Abstract
BACKGROUND Postnatal care is crucial to prevent the child mortality. Despite the improvement in the PNC coverage for the neonates, it is still far away from the universal health coverage. Along with, some specific regions mostly are natural hazard prone areas of India show very under coverage of PNC for the neonates. Considering the substantial spatial variation of PNC coverage and natural hazard prevalence, present study aimed to examine spatial variation of PNC coverage and its association with natural hazard at the district level. METHODS The cross-sectional exploratory study utilized National Family Health Survey, 2019-21, which included 1,76,843 children using multistage stratified sampling method to examine postnatal care within 42 days for neonates born within five years prior to the survey. Additionally, the study utilized Vulnerability Atlas of India,2019 maps to categorize regions into hazardous (flood, earthquake, and landslide) and non-hazardous areas. Spatial univariate and bivariate analyses, logistic and geographically weighted regressions were conducted using ArcGIS Pro, GeoDa, and Stata 16.0 software to identify associations between PNC coverage, hazard exposure, and spatial variation. RESULTS The univariate spatial analysis showed some specific regions such as north, east, and north-east region of India had a high concentration of natural hazard and low access of PNC coverage. Bivariate analysis also showed that PNC coverage was low in flood (75.9%), earthquake (68.3%), and landslide (80.6%) effected areas. Compared to the national PNC coverage (81.1%), all these natural hazards effected areas showed low coverage. Further, logic regression showed that these hazard prone areas were less (OR:0.85 for flood, 0.77 for earthquake, and 0.77 for landslide) likely to get PNC coverage than their counterparts. LISA cluster maps significantly showed low PNC and high disaster concentration in these disaster-prone areas. Geographic weighted regression results also showed similar result. CONCLUSIONS The present study elucidates notable heterogeneity in the coverage of postnatal care (PNC) services, with lower concentrations observed in disaster-prone areas. In order to enhance the accessibility and quality of PNC services in these areas, targeted interventions such as the deployment of mobile health services and fortification of health systems are recommended.
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Affiliation(s)
- Papai Barman
- Department of Family & Generations, International Institute for Population Sciences, Mumbai, 400088, India.
| | - Nawaj Sarif
- Department of Migration and Urban Studies, International Institute for Population Sciences, 400088, Mumbai, India
| | - Amiya Saha
- Department of Family & Generations, International Institute for Population Sciences, Mumbai, 400088, India
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Jeffers NK, Wilson D, Tappis H, Bertrand D, Veenema T, Glass N. Experiences of pregnant women exposed to Hurricanes Irma and Maria in the US Virgin Islands: a qualitative study. BMC Pregnancy Childbirth 2022; 22:947. [PMID: 36528572 PMCID: PMC9759877 DOI: 10.1186/s12884-022-05232-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2021] [Accepted: 11/22/2022] [Indexed: 12/23/2022] Open
Abstract
INTRODUCTION Hurricanes Irma and Maria made landfall in the US Virgin Islands (USVI) in 2017. To date, there is no published literature available on the experiences of pregnant women in the USVI exposed to these hurricanes. Understanding how hurricanes affect pregnant women is key to developing and executing targeted hurricane preparedness and response policies. The purpose of this study was to explore the experiences of pregnancy and birth among women in the USVI exposed to Hurricanes Irma and Maria. METHODS We employed a qualitative descriptive methodology to guide sampling, data collection, and analysis. Semi-structured interviews of 30-60 min in length were conducted with a purposive sample of women (N = 18) in the USVI who were pregnant during or became pregnant within two months after the hurricanes. Interviews were transcribed verbatim and data managed in MAXQDA. Team members developed a codebook, applied codes for content, and reconciled discrepancies. We thematically categorized text according to a socioecological conceptual framework of risk and resilience for maternal-neonatal health following hurricane exposure. RESULTS Women's experiences were organized into two main categories (risk and resilience). We identified the following themes related to risk at 3 socioecological levels including: (1) individual: changes in food access (We had to go without) and stress (I was supposed to be relaxing); (2) household/community: diminished psychosocial support (Everyone was dealing with their own things) and the presence of physical/environmental hazards (I was really scared); and (3) maternity system: compromised care capacity (The hospital was condemned). The themes related to resilience included: (1) individual: personal coping strategies (Being calm); (2) household/community: mutual psychosocial and tangible support (We shared our resources); and (3) the maternity system: continuity of high-quality care (On top of their game). CONCLUSIONS A socioecological approach provides a useful framework to understand how risk and resilience influence the experience of maternal hurricane exposure. As the frequency of the most intense hurricanes is expected to increase, clinicians, governments, and health systems should work collaboratively to implement hurricane preparedness and response plans that address pregnant women's unique needs and promote optimal maternal-infant health.
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Affiliation(s)
- Noelene K. Jeffers
- grid.21107.350000 0001 2171 9311Johns Hopkins Bloomberg School of Public Health, Baltimore, MD USA
| | - Deborah Wilson
- grid.21107.350000 0001 2171 9311Johns Hopkins University School of Nursing, Baltimore, MD USA
| | - Hannah Tappis
- grid.21107.350000 0001 2171 9311Johns Hopkins Bloomberg School of Public Health, Baltimore, MD USA ,grid.21107.350000 0001 2171 9311Jhpiego, MD Baltimore, USA
| | - Desiree Bertrand
- grid.410427.40000 0001 2284 9329Augusta University College of Nursing, GA Augusta, USA
| | - Tener Veenema
- grid.21107.350000 0001 2171 9311Johns Hopkins Bloomberg School of Public Health, Baltimore, MD USA
| | - Nancy Glass
- grid.21107.350000 0001 2171 9311Johns Hopkins University School of Nursing, Baltimore, MD USA
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The Impact of Natural Disasters on Maternal Health: Hurricanes Irma and María in Puerto Rico. CHILDREN (BASEL, SWITZERLAND) 2022; 9:children9070940. [PMID: 35883924 PMCID: PMC9315789 DOI: 10.3390/children9070940] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 11/17/2021] [Revised: 06/07/2022] [Accepted: 06/09/2022] [Indexed: 11/16/2022]
Abstract
The PROTECT research Center funded by the NIH's National Institute of Environmental Health Sciences (NIEHS) Superfund Research Program was launched in 2010 to explore the impact of exposure to pollutants on the high rate of premature births in Puerto Rico. In September 2017, Hurricanes Irma and María devastated the archipelago, which caused: collapse of the electrical system, collapse of the communication system, limited access to clean water, food, gas, and health services, destruction of public (e.g., hospitals) and private property (e.g., houses) and more than 4500 deaths. Pregnant and postpartum individuals are especially vulnerable to natural disasters. They face difficulty obtaining adequate pre- and post-natal care, are exposed to increased risk of miscarriage, premature delivery, and giving birth to low birth weight babies during and after disasters and are also more likely to suffer physical and mental health problems compared to the general population during and after disasters. A face-to-face questionnaire was administered to PROTECT participants who were pregnant during hurricanes Irma or Maria or who became pregnant shortly after in order to identify hurricane-related sources of stress and other adverse effects. This paper is based on the answers to the open-ended question at the end of the questionnaire where participants were asked to share their experiences during and after the hurricanes. Among the 375 participants who completed the survey, 76 answers to the open-ended question were considered due to data saturation. The answers to the open-ended question were transcribed into a document in order to facilitate the coding process. The transcribed text was analyzed first to identify emerging categories and then coded to identify common themes as well as divergence among participants. The following themes were identified: pregnancy and birth challenges, lack of access to basic services, housing conditions, stressful working conditions, concerns about health, concerns about their children, and positive or protective aspects. The results indicate how the disruption in access to basic services has a unique impact on the physical and mental health of pregnant and post-partum women in an emergency situation. These findings point to the potential benefit of developing specific protocols designed for emergency preparedness aimed at this population, which can inform healthcare providers and community organizations in case of future events.
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Sahoo KC, Negi S, Patel K, Mishra BK, Palo SK, Pati S. Challenges in Maternal and Child Health Services Delivery and Access during Pandemics or Public Health Disasters in Low-and Middle-Income Countries: A Systematic Review. Healthcare (Basel) 2021; 9:828. [PMID: 34209238 PMCID: PMC8306470 DOI: 10.3390/healthcare9070828] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2021] [Revised: 06/02/2021] [Accepted: 06/12/2021] [Indexed: 01/02/2023] Open
Abstract
Maternal and child health (MCH) has been a global priority for many decades and is an essential public health service. Ensuring seamless delivery is vital for desirable MCH outcomes. This systematic review outlined the challenges in accessing and continuing MCH services during public health emergencies-pandemics and disasters. A comprehensive search approach was built based on keywords and MeSH terms relevant to 'MCH services' and 'pandemics/disasters'. The online repositories Medline, CINAHL, Psyc INFO, and Epistemonikos were searched for studies. We included twenty studies-seven were on the Ebola outbreak, two on the Zika virus, five related to COVID-19, five on disasters, and one related to conflict situations. The findings indicate the potential impact of emergencies on MCH services. Low utilization and access to services have been described as common challenges. The unavailability of personal safety equipment and fear of infection were primary factors that affected service delivery. The available evidence, though limited, indicates the significant effect of disasters and pandemics on MCH. However, more primary in-depth studies are needed to understand better the overall impact of emergencies, especially the COVID-19 pandemic, on MCH. Our synthesis offers valuable insights to policymakers on ensuring the uninterrupted provision of MCH services during an emergency.
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Affiliation(s)
| | | | | | | | | | - Sanghamitra Pati
- Regional Medical Research Centre, Indian Council of Medical Research, Bhubaneswar 751023, India; (K.C.S.); (S.N.); (K.P.); (B.K.M.); (S.K.P.)
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Data Collection Tools for Maternal and Child Health in Humanitarian Emergencies: An Updated Systematic Review. Disaster Med Public Health Prep 2019; 14:601-619. [PMID: 31818343 DOI: 10.1017/dmp.2019.103] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
The worst rates of preventable mortality and morbidity among women and children occur in humanitarian settings. Reliable, easy-to-use, standardized, and efficient tools for data collection are needed to enable different organizations to plan and act in the most effective way. In 2015, the World Health Organization (WHO) commissioned a review of tools for data collection on the health of women and children in humanitarian emergencies. An update of this review was conducted to investigate whether the recommendations made were taken forward and to identify newly developed tools. Fifty-three studies and 5 new tools were identified. Only 1 study used 1 of the tools identified in our search. Little has been done in terms of the previous recommendations. Authors may not be aware of the availability of such tools and of the importance of documenting their data using the same methods as other researchers. Currently used tools may not be suitable for use in humanitarian settings or may not include the domains of the authors' interests. The development of standardized instruments should be done with all key workers in the area and could be coordinated by the WHO.
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