Avoiding Disaster

Listening to the news can be scary. Reports of potential or imminent natural disasters seem to riddle newsfeeds daily or weekly. Following the recent devastation of Hurricane Harvey, and recalling the havoc that followed Hurricane Katrina in 2005, I wonder about the number of pregnant women and their families that were displaced from their homes, whether temporarily or permanently, and the impact that would have on their pregnancy and delivery. Often natural disasters, regardless of the event, are unpredictable, leaving little to no time to prepare in advance. However, I have learned from women who live in areas that are prone to natural disasters like hurricanes, blizzards, or tornadoes some basic preparation principles that are worth sharing here.  A natural disaster can happen anywhere (I, personally, never expected Hurricane Sandy to wreak as much damage as it did in 2012 because I thought I was relatively safe in the Northeast from that kind of danger). Preparation, then, is key, especially when pregnant.

Here are some tips I learned:

1) Know where you may evacuate to if necessary. For some, that may mean crossing county or state lines, or several state lines. The duration of an evacuation is uncertain so plan ahead in the event you may deliver in the state or county you evacuate to. Further, it may be unsafe for you to return home, especially pregnant, so you might be forced to stay wherever your evacuation plan takes you. Search for hospitals, then, in that area or ask your obstetrician or midwife for help in locating a hospital in that area that handles obstetrics (remember, not every hospital is equipped to deliver babies- find one that is)

2) Get copies of your prenatal records. Ask you obstetrician or midwife for the latest copies of your prenatal records because they will be needed if you deliver in a state or county outside of where you live. Further, electricity or computer lines may be down so obtaining your records after a disaster strikes is difficult. Copies of current records help Labor & Delivery units immensely to review your prenatal course and insure a safe plan of care is developed in a new hospital.

3) Check with your insurance company if a delivery or care in another state is covered. Some insurance plans or state-run insurance like Medicaid do not cross state lines. Find out what hospitals are included in your insurance plan and what services in those hospitals would be covered.

4) Inquire about what prenatal testing is required in the state you would evacuate to. Each state sets its own regulations about what standard prenatal care should entail. For example, some states make HIV or syphilis testing mandatory while others may not. You, or your baby, may have to undergo additional testing in a new state if there is no evidence that you were already tested during your pregnancy for specific diseases.

5) Inquire about the birth certificate registration in the state you may evacuate to. Remember, if you deliver in a different state or county your baby’s birth certificate will be generated there. While many counties and states have adopted electronic birth certificate filing, some may still require you to come in person to either sign the certificate or pick it up. Inquire in advance if the county or town clerk will mail your baby’s birth certificate to your home or alternative address (your home may not be safe to go back to for several weeks or months; some states will not deliver a birth certificate to a PO box or temporary address).

6) Do not rush back to your home. Following a natural disaster, it may still be dangerous to go back to your home pregnant or with a newborn. You, and your baby, will need a home with clean drinking water, electricity, and no chance of mold or standing water in your home.  If you need to remain in a different state or county, contact the state health or social service department to speak with a social worker to determine the next move. If you’re staying with family, insure they are willing to house both you and a newborn baby indefinitely until it’s safe to return home.

Natural disasters are incredible sources of stress and anxiety. Listen to your body- it will let you know when too much is too much. Be aware for contractions, cramping, bleeding, headaches, body aches, fatigue, or new swelling and seek help if you notice these symptoms coming. Further, if you’re evacuating over a long distance be sure to get out of the car and walk around a few times each hour to stretch your back and legs, drink water, empty your bladder, and eat a snack. Be assured that there are resources available to you and your baby when disaster strikes.