The Life Needs to Go on: Experiences of Pregnancy and Childbirth Among Syrian Refugee Mothers Living in Lebanon

Background and Purpose: As a result of the ongoing civil war in Syria, approximately 6.5 million Syrians have been displaced within Syria and an additional three million have been exiled as refugees in neighboring Turkey, Jordan, Lebanon, and Iraq. Approximately 50% of refugee populations are women and girls. 50% of these women and girls are of reproductive age, with one in five likely to become pregnant at any time during the course of war, flight, and displacement. Pregnant women are particularly affected by war, facing violence, displacement to unfamiliar surroundings, disruptions of social support systems, and lack of access to basic needs. Although all war-affected populations may experience stress associated with conflict, flight, and displacement, pregnant women may suffer from this stress differently, as they find themselves struggling to meet the needs of their family while also meeting their own physical needs. Despite the importance of support for pregnant women living in the context of war and displacement, there is little research directly addressing pregnant women’s experiences in extreme adversity.

Methods: This presentation draws from a larger mixed methods study with 46 Syrian refugee families who had fled Syria and were living in Lebanon. Families were purposively sampled from three different geographic regions in Lebanon: northern Lebanon (n=20), Beirut (n=11), and the Bakaa Valley (n=15). Methods of data collection included collaborative family interviews, GPS-tracked neighborhood walks, and weeklong family activity logging. To specifically explore the experiences of mothers, qualitative data from a sub-sample of 43 mothers (mean age 35) were analyzed using grounded theory and organized with the web-based platform Dedoose.

Findings: The findings described how mothers experience pregnancy and motherhood—from the prenatal (pregnancy) to postnatal (early childhood) period—in a context of extreme adversity. The analysis uncovered four themes: (1) apathy, (2) stress, (3) lack of access to services, and (4) lack of social supports. (1) While pregnancy is often a time of excited anticipation, the mothers in this study described their experiences of pregnancy with a sense of apathy and detachment. (2) Mothers noted high levels of stress during pregnancy related to the highly volatile context within which they were living. (3) In contrast to their childbearing experiences in Syria, Syrian mothers in Lebanon noted extreme difficulties in accessing prenatal care and access to delivery services such as using a midwife or delivering in a hospital. (4) Mothers noted extreme anxiety due to not having their female relatives (e.g., mothers, sisters, etc.) available to support them during pregnancy and delivery.

Conclusions & Implications: This research adds substantially to the sparse literature on the experiences of pregnancy among war-affected women, suggesting recommendations for social work practice, policy, and research. Social work practice should emphasize continuous support for mothers from prenatal to postnatal periods, while also engaging fathers and extended family members. Refugee policies should encourage social connectedness among families and communities to support pregnant women. And future social work research should continue to explore the impact of extreme adversity on pregnancy, child development, and family outcomes.