Perinatal Mental Health in a Post-Katrina New Orleans

Background: Six years after Hurricane Katrina devastated New Orleans, childbearing women living in the recovering communities remain vulnerable to mental and physical health disruption as they face reduced access to health care, neighborhood instability, reduced social support and poverty. Methods: Cross-sectional data was collected from interviews with prenatal women (n=77, 24-40 weeks gestation). Measures analyzed included previous disaster exposure, depression (Edinburgh Depression Scale), post-traumatic stress disorder (Post-traumatic Checklist), pregnancy-related distress (Lobel scale), and their perception of disaster recovery. Linear regression was used to model mental health outcomes, with adjustment for race, marital status, education, employment, age, and smoking. Results: Women interviewed were predominately African American (73%), single (71%) and with family income less than $15,000/year (55%). Disaster exposure was generally high: 32% walked through flood waters; 63% had some or enormous damage to their homes; and 22% saw someone die. Mental health measures indicated 60% scored “at risk” for depression, while 13% were likely experiencing PTSD. Women who reported high exposure to Katrina scored significantly higher on the PTSD and pregnancy-related distress scales, and feeling that one's life was still disrupted (40%) was strongly associated with depression and pregnancy-related distress (p<0.01), even after adjustment for experience of the hurricane. Higher social support and optimism about the future were associated with better mental health, as was use of massage to improve mood. Conclusions: Childbearing women living in a disaster recovery area remain at risk for poor mental health outcomes and require prenatal care that addresses risk and includes social intervention.