The increasing incidence of climate change-induced heat spikes, wildfires, and life-threatening flash floods is engulfing pregnant and postpartum individuals in a wave of ecological anxiety and depression.
“Mom is steering the ship,” Jennifer Barkin, a maternal mental health expert, told The Hill. “You’re already worried about — are your kids eating enough vegetables? Are the kids going to school on time? How are their grades? And now you have this added worry.”
Barkin, a professor of community medicine and of obstetrics and gynecology at Mercer University School of Medicine in Georgia, characterized the influence of climate change on maternal mental health as “a global issue,” while noting that it “hits the disadvantaged of a more dramatic way.” way – and faster.”
The problem appears to be going unnoticed, however.
While the concept of climate despair has attracted some media attention, there has been little coverage of the unique mental health impacts that occur during the perinatal period, Barkin and colleagues found in a December 2022 study. pregnancy up to one year after birth.
This phase of a mother’s life “is a period of increased vulnerability to negative mood symptoms due to various changes in the mother and her environment,” the authors noted in the study, published inJournal of the American Association of Psychiatric Nurses.
Extreme weather events, which often result in disruptions to support networks as well as health care, employment and education, can become “potential downstream effects that have a significant impact on mental health,” researchers noted. authors.
In a July 2022 editorial forFrontiers in PsychiatryBarkin argued that more pregnant and postpartum women will bear these outcomes, noting that “there is an imminent threat (risk factor) on the horizon and its name is the climate crisis.”
The physiological effects of heat risk, which are intertwined with its impacts on mental health, are amplified during pregnancy — when symptoms like dehydration can have a particular impact on all organ systems, Barkin told The Hill.
A November 2023 Advocacy Summaryof the World Health Organization emphasized that “climate risks, including extreme heat, are associated with increased risks of developing complications that lead to adverse maternal and perinatal outcomes.”
Such effects, the document states, could “affect mental health and contribute to intergenerational trauma,” while also causing an increase in “stress, anxiety, and depression – known risk factors for adverse perinatal outcomes.”
When families choose or are forced to migrate due to climate change, the effects on pregnant women’s mental health are especially severe since they have a fetus to consider, Barkin stressed.
“If you’re pregnant and you’re in an evacuation center, with two other children and no obstetric care, what if you have an emergency?” Barkin asked. “Or what if you have your prenatal care, have your child’s pediatrician scheduled and suddenly need to move? I mean, it’s a huge stressor and a disruption in care.”
“Depression and anxiety are related to the severity of exposure,” she continued. “Were you crossing the floodwaters, directly breathing the smoke from the fire? All of this is linked to the severity of the consequences for mental health.”
In an evacuation center, Barkin continued, there is also the issue of cleanliness, infectious diseases or the inability to find dry clothing.
A January 2023 literature review also found that “environmental exposures related to climate change, including extreme temperatures, air pollution, and natural disasters, are significantly associated with adverse perinatal and maternal health outcomes in the United States.”
These effects included mental health problems such as the development of maternal depression after a natural disaster like Hurricane Katrina, according to the review published inInternational Journal of Environmental Research and Public Health.
Laura Geer, senior author of that review, explained that “a post-climate event can go in two different directions.”
In the first, she explained, a mother may be placed in a position of social isolation where she finds herself managing a family without adequate access to care, while also facing a potential “increase in intimate partner violence during this stressful time.”
“Either you are highly resilient, you have a lot of social support, you can manage and weather the weather, and that actually makes you stronger,” added Geer, chair of the environmental and occupational health sciences department at SUNY Downstate Health Sciences University.
But in many cases, severe climate disruptions can influence food and housing security, while sometimes leading to harmful coping mechanisms, such as illicit drug use, according to Geer.
“Someone’s ability to be resilient is directly linked to their mental health,” she said.
Even for families unlikely to face imminent displacement or natural disasters, the mental gymnastics associated with keeping children safe from the rising heat can be exhausting.
“I can think about it from a mother’s perspective: Do I want to send my kids to summer camp?” Barkin asked, noting that it is difficult to assess whether individual camp counselors are “aware of how to deal with heat risk.”
Detailing her own internal debate as a mother, Barkin said she discouraged her son from playing football — which requires the use of heavy equipment — in Georgia’s weather, adding that her daughter once fell ill from the heat at a tennis camp.
Mothers, she added, also often face the fact that their children “will inherit something they didn’t create.”
She found that more and more women are asking questions like: “Do I necessarily want to raise children? Is it really ethical to get pregnant?”
Geer echoed these sentiments, recalling the 2016 Summer Olympics in Rio de Janeiro and the coinciding rise of the Zika virus – a mosquito-borne pathogen known to cause birth defects. The spread of the virus in the region led many athletes of childbearing age to reconsider their participation, she explained.
“I definitely think this has created anxiety around family planning decisions, even in our country,” Geer said, noting the growing concern that this Zika vector could also move into the Southeastern US.
Another dilemma Barkin found mothers face is that while green spaces are supposed to be good for mental health, there is now growing uncertainty about whether certain green spaces have become “inhospitable or livable.”
Barkin cited several repeated complaints on the matter: “We’re stuck inside. I’ve got these kids running around and going crazy. I want to take them outside, but I can’t breathe, or it’s too hot, or I’m worried about breastfeeding the baby.”
In addition to women of childbearing age, much older women may be experiencing similar mental health impacts from climate change.
Earlier this month, the European Court of Human Rights sided with a group of more than 2,000 elderly women, who filed a complaint against the Swiss government demanding health protection against the effects of climate change.
Members of the Swiss association Verein KlimaSeniorinnen, or Climate Seniors, have argued that they are uniquely vulnerable to the effects of increasing heatwaves – citing significant climate-related health impacts on their daily routines. Among the effects they named were various physical symptoms related to the heat, as well as social consequences – due to their inability to leave the house.
Although these women may belong to a different generation, the mental turmoil they have endured reveals similarities to the struggle many young mothers face during the perinatal period.
Asked what doctors can do to ensure that maternal eco-anxiety doesn’t go unnoticed, Barkin said “the good news is that much of the infrastructure for screening for depression is already in place.”
Within this infrastructure is your ownBarkin Index of Maternal Functioninga patient-centered measure of postpartum functional status.
In the July 2022 editorial, Barkin advised organizations that help new mothers to “strongly consider incorporating the effects of climate change into their programming,” adding that health care providers should include environmental factors in physical and health assessments. mental.
She acknowledged that most obstetrician-gynecologists and pediatricians who work with perinatal women screen for depression — which Barkin said “will work to everyone’s advantage.”
“But the bottleneck is: Do they have somewhere to send them? And can they afford it?” she asked. “If you just had your house destroyed or you’re injured, or your whole family is on the run, can you stop and take care of your mental health?”
Pointing out that natural disasters are considered traumatic events, Barkin noted that such occurrences are likely to happen more frequently in the future.
“This will impact mothers,” she said, noting that they are often the primary caregivers, regardless of whether they also work full-time outside the home. “They are often like the CEO of family health.”
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