Under normal circumstances, pregnancy, childbirth, and the postpartum period can take an emotional and physical toll on the mother. Giving birth during a war and specifically under missile attack was the subject of a study conducted a few years ago at Rambam Health Care Campus (Rambam) in Haifa, Israel.
A mother receives support from one of Rambam’s midwives. Photography: Nitzan Zohar.
We are aware of the effects war has on people’s lives, but what about the repercussions on the fetus and newborn infant? There are a few published studies indicating that wartime stress can have a significantly negative effect on the fetus and newborns. However, the nursing team in Rambam’s Division of Gynecology and Obstetrics wanted to explore the impact on babies born during the 2006 Second Lebanon War, when Haifa was under constant attack for nearly a month. At that time, 205 babies were born at Rambam’s Division of Gynecology and Obstetrics.
Post-war debriefing led to an in-house study at Rambam, “Birth Under Fire,” so that lessons learned could be used to better prepare them for future situations. The study was led by Miriam Rabinovitch, Deputy Head Nurse of Rambam’s delivery room and Michal Kranzler, Director of Nursing, Division of Gynecology and Obstetrics. As part of the study, the new mothers were asked to share their experience of giving birth “under fire.”
They found that the mothers experienced difficulties in creating the maternal bond, with breastfeeding, and in interacting with their newborns. These challenges may be linked with the traumatic experience and high levels of stress that the mothers endured due to the war. In addition, the usual fears and anxieties accompanying childbirth increased significantly, and the mother’s need to feel in control, strong, secure, and be fully aware throughout the birth process were heightened.
Other Israeli hospitals have also examined the effects of two Gaza military operations on pregnant women and their newborns. Both Soroka Medical Center in Be’er Sheva and Ben-Gurion University found that frequent air raid sirens, stress, and anxiety during the conflicts could be linked to an increased rate of premature births. They also found a correlation between increased instances of fetal bradycardia (low heart-rate) among mothers hearing sirens during childbirth.
Kranzler and her team have implemented the lessons learned from their experience during the Second Lebanon War. “Should the need arise, in manmade or natural mass casualty situations, we are prepared to relocate to the Rambam’s fortified underground emergency hospital, which includes a dedicated labor and delivery area,” says Kranzler. “We are working under the assumption that the new mothers will not be separated from their infants after birth, and will continue to be supported by our expert medical and nursing teams who will respond to the needs of the new mother.”
Rambam’s Department of Obstetrics and Gynecology operates a hotline for expectant mothers. A team of midwives and psychologists are available to answer pregnancy-related questions. Expectant mothers can request either a remote or face-to-face meeting with a midwife.
Based on an article that first appeared on the Kikar news website.
