Natural disasters are not new to Australian rural and regional communities. Over the summer of 2019–20, devastating bushfires affected over 1.2 million hectares of Victorian land, including communities in Gippsland that were isolated from families and services, with thousands displaced. The communities had no chance to recover before another disaster – the COVID-19 pandemic – emerged in early 2020. With most rural health services already under strain at the best of times, this compounds when disaster strikes.
Pregnant and birthing women have been recognised as a vulnerable group in the context of natural disasters including flood, fire and pandemics such as COVID-19. Disparities in income, health literacy, social supports, as well as systemic inequities, mean that groups such as First Nations women, women with disabilities and women with enduring mental health challenges are likely to experience more detrimental effects as a result of disasters.
The rural context adds an extra layer of complexity and potential vulnerability with challenges around distance and transport, technology, limited service options, cultures and the nature of rural occupations. These factors all influence parenting roles and responsibilities.
Bringing together our interests in mental health, health literacy and breastfeeding, and applying a rural lens, we wanted to understand the impacts of natural disasters on perinatal mental health. We realised that research was urgently required exploring the mental health challenges and experiences for women during the perinatal period in times of natural disaster. What can we learn from these women to transform the continuity of care provided? How can we help ensure no women and their families fall through the cracks when proven supports – like maternal healthcare nurse visits – are taken away in times of disaster?
We were particularly interested in the experiences of women who had mental health challenges prior to their pregnancy. We were also interested in how perinatal services like maternal and child health services adapt during times of disaster, and whether they have strategies to proactively support women whose circumstances mean that they may be more disadvantaged in accessing the supports and services they need.
Gathering the perspectives of maternal and child health (MCH) nurses enabled us to gain insights into the experience of new mothers. It also provided increased understanding of service delivery strengths, challenges and gaps during natural disasters and pandemics. Next, we are interested in hearing from women firsthand about what is needed to support them at this time, and how services can adapt and innovate to meet their needs. We are also interested in the experience of fathers during disasters and how emergency services and emergency planners can implement disaster planning that specifically considers the needs of parents and infants.
With challenge comes opportunity. When complete, we hope insights from this study will encourage rural health services to innovate – from their service delivery to disaster policies, to training and resources for staff on the ground during a disaster – to help recover ground for young families.
For information about future stages of this study, please contact Dr Rochelle Hine: [email protected]