The impact of military actions on the psycho-emotional state of pregnant displaced women
DOI:
https://doi.org/10.15574/HW.2025.4(179).6472Keywords:
pregnancy, martial law, internally displaced persons, psychoemotional distress, SRQ-20, Lviv regionAbstract
Pregnancy is a critical period in a woman’s life, and the risks to physical and mental health increase substantially under conditions of armed conflict. Pregnant women who are forced to leave their homes because of hostilities experience heightened stress, which may be accompanied by sleep disturbances, anxiety, somatic complaints, and reduced overall well-being, and may increase vulnerability to anxiety and depressive disorders as well as post-traumatic manifestations.
Aim - To study the clinical and epidemiological characteristics of pregnancy during the armed conflict in Ukraine, with a focus on the psycho-emotional state, war exposure and their connection with somatic complaints and the course of pregnancy..
Materials and methods. A prospective cohort study was conducted in the Lviv region. A total of 1,000 pregnant women were examined: group 1 - internally displaced women from areas of active hostilities (n=333), group 2 - internally displaced women from other regions of Ukraine (n=333), and group 3 - permanent residents of the Lviv region (n=334). Data were collected using a standardized questionnaire covering sociodemographic characteristics, living conditions, and war-related exposures. Psychoemotional status was assessed using the SRQ-20 (20 items, yes/no responses). Group differences in proportions were tested using the chi-square test or Fisher’s exact test; effect sizes with 95% confidence intervals were estimated; statistical significance was set at p<0.05.
Results. A pronounced gradient of emotional distress was identified. In group 1, women more frequently reported anxiety/nervousness (58.3%), difficulty falling asleep/insomnia (51.6%), tension/worry (75.7%), low self-esteem (55.1%), and somatic complaints including headaches (46.9%), fatigue/exhaustion (49.7%), poor appetite (75.8%), and poor digestion (78.8%), whereas in group 3 these indicators were low (mostly 0.9-3.9%). Group 2 showed intermediate levels but remained substantially higher than the group 3. War-related exposures (material losses, housing damage, exposure to shelling/occupied territories, and violence) were more common in the displaced groups.
Conclusions. War and forced displacement are associated with sharply increased psychoemotional distress and somatized complaints in pregnant women, most notably among those displaced from areas of active hostilities. The findings support the need for comprehensive medical, psychological, and social support programs, including routine distress screening.
The author declares that there is no conflict of interest.
References
Acharai L, Khalis M, Bouaddi O, Krisht G, Elomrani S, Yahyane A et al. (2023). Sexual and reproductive health and gender-based violence among female migrants in Morocco: a cross sectional survey. BMC Womens Health. 23(1): 174. https://doi.org/10.1186/s12905-023-02307-1; PMid:37041501 PMCid:PMC10091612
Ahn JA, Chae D. (2019). The influences of socio-individual determinants and health information seeking on health-promoting behaviors among migrant women: A cross-sectional study. Jpn J Nurs Sci. 16(4): 481-490. https://doi.org/10.1111/jjns.12259; PMid:31161723
Aibangbee M, Micheal S, Mapedzahama V, Liamputtong P, Pithavadian R, Hossain Z et al. (2023). Migrant and Refugee Youth's Sexual and Reproductive Health and Rights: A Scoping Review to Inform Policies and Programs. Int J Public Health. 68: 1605801. https://doi.org/10.3389/ijph.2023.1605801; PMid:37342678 PMCid:PMC10278890
Al-Adhami M, Berglund E, Wångdahl J, Salari R. (2022). A cross-sectional study of health and well-being among newly settled refugee migrants in Sweden-The role of health literacy, social support and self-efficacy. PLoS One. 17(12): e0279397. https://doi.org/10.1371/journal.pone.0279397; PMid:36534679 PMCid:PMC9762600
Al-Adhami M, Hjelm K, Wångdahl J, Larsson EC. (2021). "This course is like a compass to us" - a qualitative study on newly settled migrants' perceptions of civic and health orientation in Sweden. BMC Public Health. 21(1): 1606. https://doi.org/10.1186/s12889-021-11654-3; PMid:34465333 PMCid:PMC8408945
Al-Adhami M, Wångdahl J, Salari R, Åkerman E. (2023). "Putting words to their feelings" - civic communicators' perceptions and experiences of an in-depth course on mental health for newly settled refugee migrants in Sweden. BMC Health Serv Res. 23(1): 510. https://doi.org/10.1186/s12913-023-09524-2; PMid:37208683 PMCid:PMC10198591
Amroussia N, Holmström C, Ouis P. (2022). Migrants in Swedish sexual and reproductive health and rights related policies: a critical discourse analysis. Int J Equity Health. 21(1): 125. https://doi.org/10.1186/s12939-022-01727-z; PMid:36064412 PMCid:PMC9446749
Anderson FM, Hatch SL, Ryan EG, Trevillion K, Howard LM. (2019). Impact of Insecure Immigration Status and Ethnicity on Antenatal Mental Health Among Migrant Women. J Clin Psychiatry. 80(5): 18m12563. https://doi.org/10.4088/JCP.18m12563; PMid:31365196
Ankomah A, Byaruhanga J, Woolley E, Boamah S, Akombi-Inyang B. (2022). Double burden of malnutrition among migrants and refugees in developed countries: A mixed-methods systematic review. PLoS One. 17(8): e0273382. https://doi.org/10.1371/journal.pone.0273382; PMid:35981085 PMCid:PMC9387835
Aryal S, Shrestha D, Pant SB. (2019). Reproductive Health Issues and Depression in Wives of Labor Migrant Workers. J Nepal Health Res Counc. 17(3): 308-314. https://doi.org/10.33314/jnhrc.v17i3.1817; PMid:31735923
Babatunde-Sowole OO, DiGiacomo M, Power T, Davidson PM, Jackson D. (2020). Resilience of African migrant women: Implications for mental health practice. Int J Ment Health Nurs. 29(1): 92-101. https://doi.org/10.1111/inm.12663; PMid:31917517
Bahamondes L, Laporte M, Margatho D, de Amorim HSF, Brasil C, Charles CM et al. (2020). Maternal health among Venezuelan women migrants at the border of Brazil. BMC Public Health. 20(1): 1771. https://doi.org/10.1186/s12889-020-09912-x; PMid:33228642 PMCid:PMC7682772
Bentley A, Riutort-Mayol G. (2023). The association between intimate partner violence type and mental health in migrant women living in Spain: findings from a cross-sectional study. Front Public Health. 11: 1307841. https://doi.org/10.3389/fpubh.2023.1307841; PMid:38145064 PMCid:PMC10740158
Chaudhry A, Hebert-Beirne J, Hanneke R, Alessi EJ, Mitchell U, Molina Y et al. (2024). The Health Needs of Sexual and Gender Minority Migrant Women in the United States: A Scoping Review. LGBT Health. 11(1): 1-19. Epub 2023 Aug 4. https://doi.org/10.1089/lgbt.2022.0392; PMid:37540144
Chavez-Baray SM, Martinez O, Chaparro P, Moya EM. (2022). The Use of Photovoice Methodology to Assess Health Needs and Identify Opportunities Among Migrant Transgender Women in the U.S.-Mexico Border. Front Public Health. 10: 865944. https://doi.org/10.3389/fpubh.2022.865944; PMid:35664104 PMCid:PMC9160798
Doma H, Tran T, Rioseco P, Fisher J. (2022). Understanding the relationship between social support and mental health of humanitarian migrants resettled in Australia. BMC Public Health. 22(1): 1739. https://doi.org/10.1186/s12889-022-14082-z; PMid:36100895 PMCid:PMC9472377
El Arab RA, Somerville J, Abuadas FH, Rubinat-Arnaldo E, Sagbakken M. (2023). Health and well-being of refugees, asylum seekers, undocumented migrants, and internally displaced persons under COVID-19: a scoping review. Front Public Health. 11: 1145002. https://doi.org/10.3389/fpubh.2023.1145002; PMid:37181725 PMCid:PMC10169615
Gieles NC, Tankink JB, van Midde M, Düker J, van der Lans P, Wessels CM et al. (2019) Maternal and perinatal outcomes of asylum seekers and undocumented migrants in Europe: a systematic review. Eur J Public Health. 29(4): 714-723. https://doi.org/10.1093/eurpub/ckz042; PMid:31098629 PMCid:PMC6734941
Goble G, Formica M, Lane SD, Sous M, Stroup C, Rubinstein RA et al. (2023). Refugee Births and the Migrant Health Effect in Syracuse NY. Matern Child Health J. 27(9): 1599-1606. Epub 2023 Jun 7. https://doi.org/10.1007/s10995-023-03694-5; PMid:37284922 PMCid:PMC10244839
Gray C, Crawford G, Maycock B, Lobo R. (2021). Socioecological Factors Influencing Sexual Health Experiences and Health Outcomes of Migrant Asian Women Living in 'Western' High-Income Countries: A Systematic Review. Int J Environ Res Public Health. 18(5): 2469. https://doi.org/10.3390/ijerph18052469; PMid:33802277 PMCid:PMC7967613
Hamel-Smith Grassby M, Wiedmeyer ML, Lavergne MR, Goldenberg SM. (2021). Qualitative evaluation of a mandatory health insurance 'wait period' in a publicly funded health system: understanding health inequities for newcomer im/migrant women. BMJ Open. 11(8): e047597. https://doi.org/10.1136/bmjopen-2020-047597; PMid:34353797 PMCid:PMC8344307
Koudstaal K, Verdonk P, Bartels E. (2020). "At this age, a Moroccan woman's life's work is over" - older Moroccan-Dutch migrant women's perceptions of health and lifestyle, with a focus on Ramadan experiences: qualitative research integrating education and consultation. Int J Equity Health. 19(1): 34. https://doi.org/10.1186/s12939-020-1141-9; PMid:32171312 PMCid:PMC7071612
Ngongalah L, Rapley T, Rankin J, Heslehurst N. (2023). Cultural Influences on African Migrant Pregnant and Postnatal Women's Dietary Behaviours and Nutrition Support Needs in the UK. Nutrients. 15(19): 4135. https://doi.org/10.3390/nu15194135; PMid:37836419 PMCid:PMC10574463
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