Hurricane-Related Stressors’ Impact on Postpartum Maternal Mental Health and Care-Seeking in Puerto Rico 公开

Dixon, Meredith (Spring 2020)

Permanent URL: https://etd.library.emory.edu/concern/etds/dz010r14c?locale=zh
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Abstract

Objective: The aim of this study was to examine how experiences during the 2017 hurricanes in Puerto Rico influenced postpartum mental health and care-seeking, as well as whether these associations were modified by hurricane preparation or availability of support in the aftermath of the hurricanes.

Methods: This study utilized data from the Pregnancy Risk Assessment Monitoring System - Zika Postpartum Emergency Response (PRAMS-ZPER) 2.0 telephone follow-up survey, which was aimed at sampling all women who lived in Puerto Rico and delivered live-born babies during November and December 2017.

Results: While women were more likely to have a postpartum visit in the aftermath of hurricanes Maria and Irma, there was also an increase in the prevalence of poor maternal mental health. There were no notable factors associated with having a postpartum checkup. In contrast, many hurricane-related stressors were discovered to have significant associations with postpartum maternal mental health conditions. For example, the prevalence of mothers who reported postpartum feelings of depression or anxiety was 1.93 times as high among women who also reported trouble getting services or aid from the government after the hurricanes compared to those who did not (95% CI: 1.48 – 2.52). Additionally, the prevalence of mothers reporting postpartum feelings of depression or anxiety was also higher among women who reported: being injured or becoming ill, walking through debris or floodwater, living in temporary housing, losing personal belongings, being separated from loved ones, having trouble dealing with insurance or relief agencies, experiencing trouble getting clean drinking water, having trouble getting enough food to eat, feeling unsafe because of lack of order and security, having to move to another municipality, experiencing the destruction of their home, or having to change doctors.

Conclusion: The specific hurricane-related events that were affiliated with worse postpartum mental health outcomes were factors undermining the physical well-being and safety of the mothers. The findings of this work support the idea that basic needs such as food, water, safety, and shelter are associated with mental health outcomes among new mothers in the wake of natural disasters.

Table of Contents

Background .......................................................................................................................1

Methods.............................................................................................................................4

Results...............................................................................................................................6

      Sample Characteristics.................................................................................................6

      Potential Effect Measure Modification.........................................................................6

      Measures of Association...............................................................................................8

Discussion .........................................................................................................................9

      Strengths and Weaknesses...........................................................................................10

      Future Directions.........................................................................................................11

References.........................................................................................................................14

Tables................................................................................................................................18

Figures...............................................................................................................................22

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