Factors relating to the mental health of women who were pregnant at the time of the Great East Japan earthquake: analysis from month 10 to month 48 after the earthquake

A characteristic feature of this earthquake is that in addition to the effects of the earthquake itself a giant tsunami struck a wide stretch of the coastal area along the Sanriku coast, sweeping away almost all homes and workplaces. This unprecedented major disaster destroyed the infrastructure supporting residents’ daily lives, and many residents had close friends or family members who were among those killed. It is easy to imagine that these circumstances have left the child-rearing generation with no clear prospects for establishing a future life for themselves, thus increasing their anxiety.

The fact that many of the mothers with a high risk of postnatal depression, according to the EPDS survey at month 10 after the earthquake, were those whose homes had been completely destroyed or had experienced the tsunami tells us about the large scope of the influence of this earthquake. When postnatal depression actually occurs, it is a predisposing factor for attachment disorder [1‐6] in the child, and therefore we have been active in providing assistance for persons with high-risk EPDS scores in disaster-affected areas [13‐16].

However, continued observation of the mental health of the same set of mothers, using the GHQ-28, showed that the percentage of subjects with high-risk scores remained high over time, with levels of 66.7 % (month 16), 55.3 % (month 24), 55.6 % (month 36), and 56.9 % (month 48). The percentage of Japanese adults with high-risk GHQ-28 scores is 14 % [12], thus the psychological distress among the subjects in the present study is considerably more widespread. (The GHQ-28 data of women raising children is not available) It is likely that the subjects are raising children under such conditions. Examining possible sources of psychological distress as indicated by the high-risk GHQ-28 score, marital dissatisfaction was found at months 16 and 24. In a dangerous situation, it is likely that the degree of trust between a husband and wife will be important. Kubo et al. [17] stated that “in the severely dangerous situation that is a disaster, mothers take the view that they want to rely on their husbands.” Husbands are looked upon to respond to this expectation, but there is little prior research into the mental health or role of fathers during a disaster. It is possible that fathers in such a situation experience psychological distress and marital dissatisfaction as well.

At months 36 and 48, marital dissatisfaction was a factor as well, but in addition there were financial worries. Ten months following the earthquake, the EPDS score of non-working mothers was higher than that of working mothers. The study was conducted at 24, 36, and 48 months following the earthquake and the percentage of working mothers increased at every stage. It is reasonable to assume that mothers had to engage in economic activities. Another aspect of damage to homes from the tsunami and earthquake is the financial burden it has imposed.

Those affected by the disaster have been forced to raise their children in temporary housing, which provides a poor living environment. The financial situation of the child-rearing generation may make it difficult to find a place to live that offers a better environment. In addition, because many places of work were swept away by the tsunami, many people may have lost their place of employment or have jobs that have been suspended for long periods.

The presence of someone to provide support with childcare can help mothers with newborn children maintain a healthy mental state. Scores on the GHQ-28 at month 48 were potentially influenced by having the support of the husband or the mother’s parents. In addition, friends can provide psychological support, even if they do not provide direct or material assistance.