A scoping review of natural disasters, environmental hazards, and maternal health: Are all potential outcomes accounted for in conceptual frameworks?

Abstract

Natural disasters and extreme weather events are increasing in frequency and intensity, in part due to climate change. These events can have severe impacts, including on maternal health. We review the existing research on natural disasters, environmental hazards, and maternal health outcomes – focusing specifically on relevant conceptual frameworks and termination of pregnancy as an outcome of these events – published between January 2004 and May 2024. We retrieved eight frameworks and 26 additional research articles. None of the frameworks identified pregnancy termination as an outcome of natural disasters, though there is ample evidence to suggest that pregnancy termination and related outcomes must be included in these frameworks. We propose a new, comprehensive framework in which all reproductive outcomes with the potential to affect maternal morbidity or mortality, including pregnancy termination (i.e., induced abortion), are considered. We hope that the Natural disasters, Environmental hazards, and Maternal Outcomes (NEMO) framework will inform emergency response planning to improve service delivery that empowers individuals to make informed reproductive health choices in the wake of these crises.