During the Katrina disaster, Robbie Prepas, a certified nurse midwife from California, delivered five babies in the New Orleans Airport and twins in an ambulance en route to Baton Rouge. She triaged several hundred pregnant moms by listening to their fetal heartbeats, providing antenatal and postpartum care.
"I have worked in disaster situations all over the world, and Hurricane Katrina was the worst I have ever been involved in," said Ms. Prepas, a member of the White Ribbon Alliance for Safe Motherhood. "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."
Across the Gulf Coast, doctors, nurses and other health care providers evacuated newborns and their mothers by boat, helicopter and ambulance. Health care providers demonstrated resourcefulness and courage in caring for pregnant and laboring women, fragile infants and newborns despite the lack of disaster plans or training to help them care for these populations in an emergency.
As a Mother's Day gift to the survivors of Hurricane Katrina, maternal and infant health groups across the country have pledged to prepare for the next disaster now so that no family has to experience another Katrina.
As we saw on our TV screens last year, mass chaos, including the lack of medical care, destruction of health care facilities, food and water shortages and separation of families, is disastrous to communities. Pregnant women and newborns are particularly vulnerable to these events. During disasters, women experience greater rates of health complications associated with pregnancy, including premature births, low-birth-weight infants and infant deaths.
International and U.N. organizations have a master plan to help pregnant women, infants and new mothers when disasters strike. International relief organizations used these guidelines to provide a health care response after the tsunami, mudslides and earthquakes of recent years.
They were able to care for thousands of mothers, children and families during these disasters. Immediate responses included assessing the needs of the community, restoring basic medical services and providing mental health support for pregnant women and new mothers.
In this country, the White Ribbon Alliance for Safe Motherhood, in association with the March of Dimes, the American College of Gynecologists and Obstetricians, the American College of Nurse Midwives and other national maternal and child health organizations, is working to develop similar guidance documents for domestic organizations to use in preparing for the next U.S. disaster.
Such a plan could be customized to work with existing and evolving disaster plans at the federal, state and local levels so that the special health care needs of pregnant women, babies and new mothers are addressed during a disaster.
Any disaster plan for pregnant women, newborns and new mothers should include:
A synchronization of federal, state and local emergency preparedness plans.
A Web site and toll-free number for maternal health resources and reporting.
A system to match pregnant women and new moms with health care professionals.
Training for emergency first responders in the special needs of pregnant women, infants and new moms.
A plan to keep families together, especially in regard to mothers and infants, if evacuations occur.
Shelter plans that provide separate living areas for nursing mothers, new mothers and their families.
Attention to security to protect women and children against domestic and sexual violence.
Ensuring healthy births, healthy babies and healthy mothers should be important not only to families affected by disaster but to all of us. We can take the hard lessons learned from Katrina to ensure the health and safety of pregnant women, new mothers and infants when disaster strikes next.
Theresa Shaver is executive director of the White Ribbon Alliance for Safe Motherhood. Adrienne Oleck is founder of Safer Maternity. Their e-mails are firstname.lastname@example.org and email@example.com.