Good Practices in Perinatal Mental Health for Women during Wars and Migrations: A Narrative Synthesis from the COST Action Riseup-PPD in the Context of the War in Ukraine

Abstract

Since February 24 th , 2022, the beginning of Russia's aggression against Ukraine, over 5 million refugees from Ukraine have crossed the European Union border, mainly women and children. In addition, over 35,000 people crossed the Polish border, over 972,000 the Romanian border, 654,000 the Hungarian border, 473,000 the Moldavian border, and 446,000 the Slovakian border (Verner, n.d.). Most arrivals are women and children from all parts of Ukraine. However, the exact number of pregnant and postpartum women war refugees is unknown. According to the United Nations Population Fund, an estimated 265,000 Ukrainian women were pregnant when Clínica y Salud (2022) 33(3) 127-135

The impact of the war in Ukraine on the perinatal period: Perinatal mental health for refugee women (pmh-rw) protocol

“…The current war in Ukraine affects every other European country in some ways. Since the war outbreak, the neighboring countries have absorbed and registered a high number of refugees on a daily basis ( Chrzan-Dętkoś et al, 2022 ; Kumar et al, 2022 ; Lloyd and Sirkeci, 2022 ). Although the number of war refugees varies in European countries, every country faces similar challenges in providing adequate support and possible medical and psychological interventions for women during this vulnerable period; these challenges include language barriers, provision of culturally sensitive services and trauma-informed care, and equitable access to health and mental health services in each European country.…”

“…It is estimated that 1 in 5 women will develop a perinatal mental disorder, which implies that the onset and recurrence of mental health disorders during this period is very high ( Andersen et al, 2012 ; Soto-Balbuena et al, 2018 , 2021 ; Fawcett et al, 2019 ; Legazpi et al, 2022a , b ). Depression, posttraumatic stress disorder (PTSD), and anxiety are shown on the literature as the most recurrent diagnoses ( Chrzan-Dętkoś et al, 2022 ). The consequences of war and migration can be particularly damaging for mothers and babies.…”

“…For instance, the negative effects often stem from being exposed to a toxic environment with pollutants, radiation, exhaust fumes, or even water or food that has been contaminated in a war zone ( Arnetz et al, 2013 ). Additionally, emerging research has found that women who fled from the Ukraine war experience significant changes in their status, including a loss of a previous lifestyle, daily contact with friends and relatives, financial losses, changes in perinatal health care associated with limited access to health care, and difficulties in finding a health professional (doctor or midwife) that meets all the medical needs ( Chrzan-Dętkoś et al, 2022 ). Additionally, these women report having limited social support (lack of friends, relatives) and live in isolation as a result of being an immigrant (external refugee); research has found that lack of social support (perceived or actual) is a significant risk factor for developing several mental illnesses during the perinatal period ( Marcos-Nájera et al, 2020 , 2021 ).…”

“…As Chrzan-Dętkoś et al (2022) has pointed out, more research should focus on different topics (e.g., risk and protective factors for the perinatal mental health status). The first necessary step should be to develop a comprehensive definition of psychological distress in this target group.…”

Psycho-rehabilitation adaptation of pregnant women and mothers in the postpartum period who experienced traumatic events during the war

“…This is the situation for Ukrainian women who are currently suffering as a direct result of the conflict in their country. As a consequence of this, Riseup-PDD has come together once more to provide their support to the aforementioned narrative review and to further the cause of promoting highly recommendable in perinatal psychological health [7].…”