Abstract
Background
Despite the existing knowledge about stress, trauma and pregnancy and maternal stress during natural disasters, little is known about what types of trauma pregnant or preconception women experience during these disasters. In May 2016, the worst natural disaster in modern Canadian history required the evacuation of nearly 90,000 residents of the Fort McMurray Wood Buffalo (FMWB) area of northern Alberta. Among the thousands of evacuees were an estimated 1850 women who were pregnant or soon to conceive. In August 2017, Hurricane Harvey devastated areas of the United States including Texas, with 30,000 people forced to flee their homes due to the intense flooding.
Objective
To explore immediate and past traumatic experiences of pregnant or preconception women who experienced one of two natural disasters (a wildfire and a hurricane) as captured in their expressive writing. Research questions were: (1) What trauma did pregnant or preconception women experience during the fire and the hurricane? (2) What past traumatic experiences, apart from the disasters, did the women discuss in their expressive writing?
Methods
A qualitative secondary analysis of expressive writing using thematic content analysis was conducted on the expressive writing of 50 pregnant or preconception women who experienced the 2016 Fort McMurray Wood Buffalo Wildfire (n = 25) and the 2017 Houston Hurricane Harvey (n = 25) Narrative data in the form of expressive writing entries from participants of two primary studies were thematically analyzed. One of the expressive writing questions was used in this analysis: “What is the most traumatic, upsetting experience of your entire life, especially that you have never discussed in great detail with others?” NVivo 12 supported thematic content analysis.
Results
For some women, the disasters elicited immense fear and anxiety that surpassed previous traumatic life events. Others, however, disclosed significant past traumas that continue to impact them, including betrayal by a loved one, abuse, maternal health complications, and illness.
Conclusion
We recommend a strengths-based and trauma-informed care approach in both maternal health and post-disaster relief care.
Significance
What is already known on this subject?
The relationships between stress, trauma and pregnancy and maternal stress and adverse birth and child health outcomes are well established, with stressful events like natural disasters linked to increased prevalence of preterm birth, low birth weight, and developmental delays in children.
What this study adds?
The results of this study indicate that many women who had experienced one of two natural disasters indicated that the natural disaster was not their most traumatic life event. These findings demonstrate that women carry many past traumas into their time of pregnancy, necessitating the application of trauma-informed care approach to prenatal care, particularly for women who experience natural disasters.
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Data Availability
Data is not currently publicly available; however, reasonable requests may be considered.
Abbreviations
- CDC:
-
Centre for Disease Control
- FMWB:
-
Fort McMurray Wood Buffalo
- PTSD:
-
Post-traumatic stress disorder
- TIC:
-
Trauma informed care
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Funding
This study was funded by a grant from the Canadian Institutes of Health Research (No.151029) and support from the Faculty of Medicine and Dentistry, University of Alberta, The Women and Children’s Health Research Institute, and the O’Brien Institute for Public Health.
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The primary studies were conceptualized by DMO, SBP, SK, JKO and JB. Data analysis for the secondary study was carried out by ES, AH, JKO, SBP. All authors contributed to the write up of the findings and critically reviewing the final version for publication.
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The authors of this study have no conflicts of interest to report.
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Ethical approval was obtained for both primary studies through the institution’s Health Research Ethics Board (FMWB: Pro00067510; Hurricane Harvey: Pro00077985).
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Prior to participation in each of the primary studies, participants consented to participate in accordance with local ethics review boards.
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Severson, E., Olson, J.K., Hyde, A. et al. Experiencing Trauma During or Before Pregnancy: Qualitative Secondary Analysis After Two Disasters. Matern Child Health J 27, 944–953 (2023). https://doi.org/10.1007/s10995-023-03625-4
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DOI: https://doi.org/10.1007/s10995-023-03625-4