Pregnant women in conflict and war zones continually exhibit negative health symptoms in both themselves and their children. These negative symptoms range from physical conditions to mental disorders. As a direct result of the adverse effects of war, the health outcomes of pregnant women in war zones are heavily affects. The factors affecting the maternal and fetal health in these zones can be associated with the effects of war on the environment, the emotional effects of war, and a lack of easily available healthcare in these affected countries.
War and conflict, as well as their aftermath, have a negative impact on pregnant women because of the environmental hazards and physical damage they cause. A cross sectional study in Gaza focused on the relationship between a mother’s exposure to military conflicts and metal contaminants in mothers and newborn babies. The results of this study found that heavy metals such as aluminum, iron, and lead were introduced into the environment of Gaza during military conflicts in 2009 and 2014, and that these heavy metals were found in the mother’s hair, and could be passed from mother to fetus through the placenta (Manduca, Diab, Qouta, Albarqouni & Punamaki, 2017). Women in other war-torn countries, such as Vietnam, suffer with lasting consequences as well. During the Vietnam War in the mid-20th century, a chemical defoliant known by the name “Agent Orange” was sprayed heavily across Vietnam. The effects on health of this chemical were not found until later on, and to this day, citizens of Vietnam are suffering the consequences. In A Luoi Valley in central Vietnam people are plagued by the effects of Agent Orange. It wasn’t until the 1990’s that the people of Vietnam began to see connections between birth defects or negative birth outcomes and exposure to Agent Orange (Uesugi, 2015). In both the Vietnam study and the Gaza study, women, fetuses, and infants clearly exhibit the adverse effects of the environment being affected by war (Uesugi, 2015; Manduca, Diab, Qouta, Albarqouni & Punamaki, 2017).
Although it may seem obvious that war and conflict have detrimental effects on the mental and emotional stability of pregnant women, it is still oftentimes ignored. When pregnant mothers are under stress, the fetus is as well. In a study performed in Timor-Leste, researchers were able to draw the conclusions that pregnant women who have experienced some sort of major trauma and are living in post-conflict zones or impoverished countries are more likely to develop Adult Separation Anxiety than women who do not face these conditions. According to this same study, intervention is necessary for the safety and well-being of the mothers struggling with ASA, and for their children as well (Silove et al., 2016). In a related study in Timor-Leste, researchers found that 9% of the women they interviewed had post-traumatic stress disorder, while 22%, according to the Edinburgh Postnatal Depression Scale, had depression, which indicated that the symptoms associated with PTSD are directly related to the symptoms associated with depression (Silove et al., 2015). Following World War II, 18 women were admitted to a Gladesville Hospital in Sydney, Australia for psychosis and mania after giving birth. While this particular study focuses on the treatment of these women during their stay in the hospital, the evidence also shows that war can have severe effects of citizens, especially those who are pregnant or recently postpartum (Jefferies, Duff, & Nicholls, 2017). By recognizing the fact that decreased mental health directly contributes to physical well-being, and is the direct result of traumatic events related to conflict and war, public health professionals can work with hospitals and governments to provide psychiatric treatment and make efforts to remove women from the areas that are causing them stress (Jefferies, Duff, & Nicholls, 2017; Silove et al., 2015).
In many areas around the world that are affected by war, safe and easily available healthcare is oftentimes not a main priority. Because of this, many pregnant women are unable to receive basic healthcare as well as life-saving postpartum treatments they may need. In a study done in South Sudan, evidence showed that despite the Sudanese government providing free healthcare for mothers and children, the people of South Sudan were still not getting the care they need (Mugo, Dibley, Damundu & Alam, 2018). This study also found that 81% of births in South Sudan take place in the home, rather than a medical facility (Mugo, Dibley, Damundu & Alam, 2018). Researchers attributed this underutilization to a lack of space in hospitals and a lack of qualified medical professionals, as well as difficulty or danger travelling to these medical facilities. By recognizing the flaws in healthcare systems in warzones, public health workers can introduce government policies pertaining to healthcare that provide basic care for patients. Work to ensure safe transportation to medical facilities and advocating for properly trained healthcare professionals could impact and, based on the evidence in the South Sudan study, potentially decrease the number of birth related deaths in women and infants.
Both women and their children are heavily affected by conflict ridden environments. These effects are evident in both physical and mental ways, and seem
to be direct results of war, the aftermath of war, and a lack of a secure healthcare system in war-torn countries. It is important to acknowledge healthcare discrepancies in warzones and conflict areas because there are citizens at risk every day. Pregnant women are some of the people at greatest risk, and because of this they suffer around the world from a lack of proper healthcare and inadequate living conditions due to wars and conflict. Bringing these issues up and drawing attention to them is just the start of working towards a solution for them. Many of the issues addressed in this paper are also related to systematic problems in these suffering areas. The government can provide the healthcare as secondary and tertiary prevention; however, there is no form of primary prevention occurring. The political, public health, and healthcare systems in these countries must work towards forms of primary prevention, such as ensuring safe environment for these women to maintain their health and the health of their children. Fixing these systematic discrepancies would contribute greatly to the well-being of the citizens, and future of these conflict areas.