Regardless of what type of disaster may strike or how severe it is, there will always be pregnant women in need of special assistance. Pregnant women are among those most at risk in disaster situations, in part because severe stress can trigger premature labor, but also because so many women are forced to give birth under precarious circumstances. When hospitals may be over-flowing with sick and injured survivors, roads or transportation inaccessible, and electricity likely unavailable, women who would otherwise have given birth at the hospital will have to seek alternatives. It is also a possibility that hospitals will only have resources for the most high-risk pregnant women, leaving low-risk mothers to give birth with little or no assistance from staff. Even in the absence of a large-scale disaster, on just an ordinary day-to-day basis, sometimes a birth happens too quickly to make it to the planned location or before a qualified birth attendant can be present.
Robbie Prepas, a certified nurse-midwife, saw many such births first-hand during the Hurricane Katrina disaster. She delivered five babies in the New Orleans airport, twins in an ambulance, and provided impromptu care to hundreds of pregnant and postpartum women, checking fetal heart tones, etc. She explains, “There were no policies or procedures in place to care for pregnant women or mothers and their babies after Katrina. We even lacked such basics as diapers, formula, baby bottles and clean clothes” (“Disaster Preparedness for Mothers & Babies: Getting Prepared”). Midwife Mary Callahan, CNM, MS, also assisted in the Hurricane Katrina relief effort, providing midwifery services to displaced women in a large shelter and assembling emergency birth and prenatal kits for use in other area shelters (“Chicago Midwives Travel to Baton Rouge”). While we may be fortunate to cross paths with a doctor, midwife, or paramedic with birth supplies in an emergency childbirth situation, we can’t be certain of such luck. Given all of the possibilities, the best course is to have plans and supplies in place so that we can meet our specific needs in emergency situations.