Effects of conflict on women's reproductive health need to be managed sensitively

July 4, 2014, Wiley

Clinicians need to be sensitive and aware of the unique challenges of women's reproductive health needs in times of conflict, suggests a new review published today (4 July) in The Obstetrician & Gynaecologist (TOG).

Approximately 1.5 billion people are currently living in countries affected by conflict, fragility or large-scale violence. Women and children account for approximately 75% of those displaced by conflict and roughly 20% of those displaced are women of reproductive age and one in five will be pregnant.

This new review looks at how conflict can negatively impact all aspects of reproductive health, directly through damage to services, gender-based violence and forced displacement of populations and indirectly through reductions in the availability of basic healthcare.

The review states that gender-based violence, sexually transmitted infections (including HIV), and maternal and neonatal mortality and morbidity all flourish in times of conflict. Furthermore, the loss of access to adequate family planning and basic also increases reliance on traditional or harmful methods, including unsafe termination of pregnancy.

Looking at maternal mortality specifically, high rates are frequently encountered in conflict-affected populations; eight out of the ten countries with the highest ratios have experienced current or recent conflict. Moreover, the review notes that approximately 15% of displaced will encounter a potentially life-threatening complication, such as haemorrhage, sepsis, obstructed labour or eclampsia.

The authors of the review therefore emphasise the importance of appropriate and timely recognition of, and response to, obstetric emergencies as the key to saving lives. However, in the context of conflict and displacement, services are often scarce, resulting in delays in reaching the care required. Furthermore, the poor security conditions, exodus of healthcare providers, lack of transport and loss of facilities result in heightened vulnerability and reduced access to life-saving interventions.

Clinicians in the UK may treat women migrating from conflict affected areas, and should therefore be sensitive to the reproductive health challenges faced by these women, the review states. The authors conclude by saying that awareness and recognition by medical staff to these issues may be beneficial to the women's care and aid them in accessing the appropriate services.

Dr Benjamin Black, Specialist Trainee in Obstetrics and Gynaecology currently working with Medecins Sans Frontieres in Sierra Leone, and lead-author of the review said:

"In an increasingly globalised world a working knowledge of reproductive health during conflict allows to approach subjects sensitively with women, building a relationship of trust and understanding, allowing women to gain access to services they need.

"Recognition and response to the reproductive health needs of women during humanitarian emergencies has advanced. However, much more needs to be done around the time of the crisis and post-crisis, and more awareness is needed of these issues."

Jason Waugh, TOG Editor-in-Chief added:

"For twenty years, has been formally recognised as a human right and this highlights the importance of providing adequate services in conflict and displacement settings.

"Clinicians working in the UK will come across who have experienced conflict zones who may have certain health needs as a result. Therefore, an understanding of the difficulties they may have faced will enhance the care given."

Explore further: Family planning in conflict

More information: B O Black, P A Bouanchaud, J K Bignall, E Simpson, M Gupta. Reproductive health during conflict. The Obstetrician & Gynaecologist 2014; dx.doi.org/10.1111/tog.12114

Related Stories

Family planning in conflict

July 13, 2011
Many areas of the world are at war and both the conflict and aftermath have dire consequences for the health of people affected. New research published in BioMed Central's open access journal Conflict and Health reports that ...

Research needed on approaches to prevent attacks on health care during armed conflict

June 24, 2014
Deliberate attacks on patients, hospitals, and clinics during armed conflict are atrocious acts, state the PLOS Medicine editors writing in an editorial in this week's PLOS Medicine, and call for more research on the practical ...

Healthcare professionals must be aware of rarer causes of headaches in pregnancy

May 23, 2014
Most headaches in pregnancy and the postnatal period are benign, but healthcare professionals must be alert to the rarer and more severe causes of headaches, suggests a new review published today in The Obstetrician & Gynaecologist ...

Calls to end all violence against women and girls in conflict zones

June 10, 2014
Women in conflict zones are likely to suffer from sexual or physical violence at the hands of their husbands or partners before, during and after a period of conflict, warn experts from the London School of Hygiene & Tropical ...

Suicide linked to partner violence for New Zealand women

November 1, 2013
New Zealand women who have experienced partner violence are more likely to contemplate suicide, according to New Zealand findings published in the Australian and New Zealand Journal of Public Health last week.

Recommended for you

Rise in preterm births linked to clinical intervention

January 18, 2018
Research at the University of Adelaide shows preterm births in South Australia have increased by 40 percent over 28 years and early intervention by medical professionals has resulted in the majority of the increase.

New report calls into question effectiveness of pregnancy anti-nausea drug

January 17, 2018
Previously unpublished information from the clinical trial that the U.S. Food and Drug Administration relied on to approve the most commonly prescribed medicine for nausea in pregnancy indicates the drug is not effective, ...

New study finds 'baby brain' is real, but the cause remains mysterious

January 15, 2018
So-called "baby brain" refers to increased forgetfulness, inattention, and mental "fogginess" reported by four out of five pregnant women. These changes in brain function during pregnancy have long been recognised in midwifery ...

Sleep quality improves with help of incontinence drug

January 12, 2018
A drug used to curtail episodes of urinary incontinence in women also improves quality of sleep, a researcher at the Stanford University School of Medicine reports.

Frozen embryos result in just as many live births in IVF

January 10, 2018
Freezing and subsequent transfer of embryos gives infertile couples just as much of a chance of having a child as using fresh embryos for in vitro fertilization (IVF), research from Ho Chi Minh City, Vietnam, and Adelaide, ...

Study suggests air pollution breathed in the months before and after conception increases chance of birth defects

January 8, 2018
A team of researchers with the University of Cincinnati and Cincinnati Children's Hospital has found evidence that indicates that pre-and post-pregnant women living in an area with air pollution are at an increased risk of ...

0 comments

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.