An increase in various problems can be observed in pregnant women affected by the earthquake, which has been effective recently and is shown as one of the greatest disasters of the century. It has been observed that natural disasters experienced in the past have had negative effects on mothers and babies during and after pregnancy; It has been noted that physical and mental problems continue even after years. In this respect, it is important to carefully monitor and inform our pregnant women.
Negative Effects of Earthquake on Pregnancy and Postpartum: Natural disasters increase the stress level of the whole society and pregnant women. After the disaster, the following effects and perinatal complications may be encountered regarding women’s health.
Increase in maternal mortality
Increase in perinatal mortality
· Premature birth: It has been observed that preterm birth rates increase significantly after major disasters. Even years later, preterm birth is more common.
Fetal growth restriction, low birth weight
· Infections: Unhealthy housing conditions and unhealthy drinking and utility water increase the risk of epidemic diseases such as respiratory tract infections and gastroenteritis. After major disasters, collective shelter needs are met in tent/container camps or in public buildings or social facilities. In crowded places, pregnant, puerperal and newborns may be more exposed to infectious diseases.
Maternal anemia, lung diseases
Pregnant women with chronic diseases such as chronic hypertension, pregestational diabetes, etc.
Inadequate pregnancy follow-up
· Hygiene issues
Nutritional problems
Unplanned pregnancies
Spontaneous abortions, unsafe abortions
Breastfeeding problems
· Psychological stress: While pregnancy and childbirth are stress factors in their own right, factors such as exposure to disaster, injury/death of relatives, family disintegration, moving to a new place can aggravate this situation and Post Traumatic Stress Disorder may develop.
Smoking – alcohol use
Preventive Measures and Treatment
· Although providing healthy and more isolated accommodation conditions is necessary for all individuals in terms of preventing communicable diseases, pregnant women and puerperant women should access these services as a priority.
· Although providing access to healthy drinking and utility water and appropriate food is necessary for all individuals, pregnant women and postpartum women should be among the priority groups in the provision of these services. Caloric balance and adequacy of meals are very important for pregnant health, fetus and newborn development.
Reducing exposure to environmental toxins and air pollution: Exposure to environmental toxins such as polycyclic aromatic hydrocarbons, asbestos, etc. can cause problems such as spontaneous abortion, fetal growth restriction, preterm birth and low birth weight. In environments where conditions are unfavorable, toxins and microorganisms in the inhaled air can be reduced by wearing a mask.
· Prenatal follow-up services for pregnant women should be continued. Pregnant women and their families should be informed about possible complications. Careful follow-up should be made in terms of preterm birth, which significantly increases after natural disasters.
· Pregnant women with chronic diseases should be followed up in well-equipped centers. These patients should have access to the drugs they use.
· Pregnancy and post-pregnancy vaccination programs should be applied completely. In accordance with the Antenatal Care Management Guidelines of the Ministry of Health of the Republic of Turkey, tetanus, influenza and COVID vaccines should be given to pregnant women and puerperant women when necessary. There is no harm in administering these vaccines during pregnancy and puerperium.
· During pregnancy, especially folic acid, iron and vitamin D support should be provided in line with the Turkish Ministry of Health’s Prenatal Care Management Guide.
· Breastfeeding should be encouraged. During disaster periods, breast milk is the most important nutritional source for newborn babies and beyond. Mothers whose milk is weaned due to stress should be encouraged to breastfeed and they should be told that their milk will come back.
· Continuation of postpartum care services for puerperant women should be provided.
· Family planning services should be provided to protect women of childbearing age from unplanned pregnancies.
Psychological support and treatment to reduce psychological stress: Emotional, mental and behavioral problems such as post-traumatic depression and anxiety problems, fear, anger, indifference, self-blame, forgetfulness or denial can be seen during pregnancy and especially in the postpartum period. In order to overcome this process, a clinical psychologist or psychiatry specialist should be consulted.
Earthquakes adversely affect the ecosystem of the entire geography and region they affect, the health of all living creatures in neighboring provinces and even countries, especially pregnant women, newborns, children, those with chronic diseases and the elderly population. Earthquakes and other natural disasters such as these cause economic, social and social problems as well as long-lasting problems that affect public health.
Turkish Maternal Fetal Medicine and Perinatology Association
