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Addressing the psychosocial needs of pregnant women affected by war: program approaches and program gaps.

Article Excerpt
Abstract

Today's female refugee and internally displaced population faces the increasing risk of adverse birth outcomes associated with stress related to conflict, flight, and displacement. Programs addressing the specific psychosocial needs of pregnant women in situations of war are scarce, and there is little consensus regarding best practices. Initiatives have recently emerged, including psychosocial groups, safe motherhood training, and social support systems, all which aint to alleviate the psychosocial stress experienced by this cohort. However, there remain existing program gaps, such as the absence of specific quality research, the use of a deficits-based vernacular concentrated on vulnerabilities, no focus on postpartum care, and little development of gender-based violence prevention initiatives addressing pregnancies resulting from rape. It is clear that more needs to be done to provide and support comprehensive quality psychosocial services for this population.

Resume

De nos jours les femmes refugiees et les populations deplacees a l'in terieur des frontieres font face a un risque croissant d'accouchements a problemes resultant du stress lie aux conflits, a la fuite, et au deplacement. Les programmes pour satisfaire les besoins psychosociaux specifiques de femmes enceintes dans les situations de guerre sont rares, et il y a peu de consensus en matiere de meilleures pratiques. Des initiatives sont apparues recemment, y compris l'emergence de groupes psychosociaux, de la formation pour une maternites sans risque, et des systemes de support sociaux, qui visent tous a alleger le stress psychosocial eprouve par toutes celles concernees. Cependant ces programmes comportem encore des lacunes, telles que l'absence de recherche specifique de bonne qualite, l'utilisation d'un vernaculaire fonde sur les deficiences et se concentram sur les vulnerabilites, le manque de consideration pour les soins suivant l'ccouchment, et peu de developpement dans les initiatives concernant la prevention de la violence liee au sexe et traitant des grossesses resultant du viol. II est clair que davantage doit etre fait pour fournir et soutenir des services psychosociaux complets et de qualite pour cette population.

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Traditionally, relief efforts during complex emergencies have focused on the provision of food, water, shelter, and health care, with the overarching goal of reducing morbidity and mortality. Gender-specific needs of women are often compromised during wartime, especially the mental health needs of pregnant women. This article focuses on the current program approaches and gaps that exist in addressing pregnant women's mental health needs during times of war and suggests hopeful theoretical methods for the development and improvement of future programs.

Individuals affected by war experience fluctuations in violence, displacement to unfamiliar surroundings, disruption of family and community structures, and lack of access to basic needs. Although many war-affected individuals may experience physical and emotional stress associated with conflict, flight, and displacement, pregnant women may suffer from this stress differently, as they find themselves struggling to meet their families' survival needs while attempting to meet their own physical needs. For the trauma of war is not related just to the exposure to violence, but also to the hardships associated with increased poverty, loss of place, and disintegration of social structures.

Of the estimated 9.2 million refugees and 25 million internally displaced people in the world today, 80 per cent are women or children. (1) Among refugee populations, approximately 25 per cent are women of reproductive age, with one in five of these women likely to become pregnant at any time...

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