The Impact of Natural Disasters on Maternal Health: Hurricanes Irma and María in Puerto Rico

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.

Are maternal wards in government hospitals disaster prepared?: Systematic review

“…The backgrounds of the articles discuss historical disasters and pandemic occurrences and accordingly the causative lack of disaster preparedness resulting in increased maternal and neonatal deaths during these events. The resources also discuss the increased surge of pregnant and postpartum patients and health complications, seeing that this population is especially vulnerable to disasters [3].…”

Development and application of a large‐scale disaster preparedness system in the perinatal field

“…Pregnant women and newborns are vulnerable in times of disaster, and recent large‐scale disasters in various locations worldwide have had a major impact on these patient groups 4–9 . Several studies have reported higher rates of preterm births and low‐birth‐weight infants during large‐scale disasters 10–12 .…”

“…Pregnant women and newborns are vulnerable in times of disaster, and recent large-scale disasters in various locations worldwide have had a major impact on these patient groups. [4][5][6][7][8][9] Several studies have reported higher rates of preterm births and low-birth-weight infants during large-scale disasters. [10][11][12] In areas affected by the Great East Japan Earthquake, future need of a new acute perinatal care management system was identified, focused on the special needs of affected pregnant and nursing mothers.…”

Impact of COVID-19 on Neuropsychiatric Disorders

“…The economic recession resulting from the COVID-19 pandemic has adversely affected many people’s mental health and created new barriers for people already suffering from mental illness [ 81 ]. This is not only limited to COVID-19 pandemic, as such negative impacts on mental health and neuropsychiatric conditions have been seen in other global or regional shocks including wars [ 82 , 83 , 84 ], natural disasters [ 85 , 86 ], or other disease outbreaks, e.g., with Ebola [ 87 , 88 ], Zika virus [ 89 ], Middle East respiratory syndrome coronavirus (MERS) [ 90 , 91 ], and severe acute respiratory syndrome coronavirus (SARS-CoV) [ 90 ]. Social isolation due to lockdown or quarantine may have been particularly detrimental to individuals with neuropsychiatric and neurodevelopmental disorders, as social interaction and exercise may be used to regulate several symptoms of these disorders [ 46 , 92 ].…”