Characteristics of childbirth in women–temporarily displaced persons who have experienced stress as a result of military aggression
Authors: Heryak S.M. , Kuchmiy V.Yu. , Buryak M.V. , Bahniy L.V. 
Published: May 2024

The negative impact of stress on women-temporarily displaced persons (TDP) is accompanied by the development of obstetric complications and perinatal stress. At the same time, the lack of systematicity and a single evidence-based approach to the management of such pregnant women often leads to completely opposite recommendations for treatment and rehabilitation.The objective: to study the features of manifestations and the possibilities of correction of psycho-emotional disorders, as well as the features of the course of childbirth in pregnant women-TDP.Materials and methods. Retrospective analysis and prospective cross-sectional study of 569 histories of pregnancy and childbirth: TDP women and 30 pregnant women who permanently lived in the region (control group) were conducted.In accordance with the implementation of antenatal measures of psychoprophylaxis and analgesia during childbirth, women-TDP were divided into two groups: 409 women in labor (main group), who had stress prevention during childbirth and medical analgesia, and 130 patients (comparison group), who did not have psychoprophylactic measures. Assessment of the psycho-emotional state was carried out by determining the index of stress resistance, cortisol and serotonin levels in the blood.Results. It was established that, due to a full-scale war during pregnancy and childbirth, women-TDP there is a decrease of stress resistance index compared to healthy women, which is manifested by a high level of anxiety and a low level of functional possibilities of mental adaptation to childbirth and a very low threshold of pain sensitivity. During pregnancy these women had pronounced clinical manifestations of stress and anxiety, accompanied by increased levels of the stress-associated hormones serotonin and cortisol both before childbirth and in the postpartum period.An increased level of anxiety during childbirth and before its end was found in 93.1% of women-TDP, which increased the frequency of operative delivery for emergency indications (fetal distress, labor abnormalities, placental abruption).Conducting psychotherapeutic correction before childbirth contributed to the stabilization of the psycho-emotional state and the normalization of the concentration of stress-associated hormones (serotonin and cortisol), which was manifested in an increase in the number of women with a high and moderate level of stress resistance and a normal course of childbirth, a decrease in the frequency of obstetric and perinatal complications three times compared to pregnant women without psychotherapy during pregnancy and childbirth.Conclusions. In pregnant women who are temporarily displaced persons and experienced stress as a result of military aggression, there is a decrease in the index of stress resistance, which is accompanied by an increased level of the stress-associated hormones serotonin and cortisol both before childbirth and in the postpartum period and leads to an increase in the frequency of obstetric and perinatal complications during delivery.Conducting psychotherapeutic correction and medical analgesia during childbirth helps to stabilize the psycho-emotional state, normalize the concentration of stress-associated hormones (serotonin and cortisol), increase the level of stress resistance, and reduce the frequency of obstetric and perinatal complications three times compared to pregnant women who did not receive psychotherapy during pregnancy and childbirth.