The Impact of Disasters on Sexual and Reproductive Health Needs: A Qualitative Analysis from Providers and Responders in Louisiana

Background: Sexual and bodily autonomy including self-determination about whether and when to have children is a foundation for quality of life. Emergencies and natural disasters have a significant impact on public health, health infrastructure, and the delivery of healthcare that affect contraceptive access and service delivery. Louisiana is prone to disasters and faced overlapping disasters during the study period, including the Covid-19 pandemic and Hurricane Ida in 2021. Women, girls, birthing people, and other gender-diverse people are disproportionately affected by disasters and face multiple sexual and reproductive health (SRH) challenges and risks. Inadequate or interrupted access to SRH services can result in increased adverse and life-changing outcomes (e.g., maternal mortality or morbidity; unintended or unwanted pregnancies; complications related to unsafe abortions; sexual and gender-based violence; and an increased incidence of sexually transmitted infections).

Methods: A qualitative description methodological approach was employed to understand current practices, gaps, and strategies for improved coordination and integration of SRH in disaster planning, preparedness, and response activities. Semi-structured interview guides were created through a collaborative and iterative process with six researchers. They were then further adapted based on feedback from disaster management and sexual and reproductive health provider feedback. Researchers asked Sexual Reproductive Health Service Providers (n=12) and Disaster Management and Emergency Preparedness Service Providers (n=3) to share their experiences providing services during disasters from 2021-2022.

Results: Participants were asked to share their experiences providing services during disasters, and several themes arose from these conversations. They recounted their experiences with disasters (e.g., the Covid-19 pandemic, hurricanes, and flood events) and shared the different ways service provision was impacted. Themes are categorized as a) Different forms of disasters and their impact on SRH service provision, b) Disaster funding source's impact on SRH needs, and c) The impacts disasters have on the people they serve.

Conclusions: Few disaster management providers participated in the study, underlying the importance of including these providers and SRH providers in conversations about integrating SRH services. While some coordination exists within the Louisiana Department of Health, few outside organizations can connect with disaster response systems. Disaster response funding allocated to reproductive care and resources is needed. Telehealth can be a resource to re-establish care when it is desired by providers and the people they serve.