Expressive writing for wildfire-affected pregnant women: Themes of challenge and resilience

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Abstract

The worst disaster of natural origin in recent Canadian history occurred in May 2016 in the northern Alberta community of Fort McMurray Wood Buffalo (FMWB). Among the 88,000 people abruptly evacuated amidst a raging wildfire were approximately 1850 pregnant or pre-conception women. Based on the Allostatic Load and Preterm Birth Conceptual Framework (Olson et al., 2015) [1], a simple, cost-effective expressive writing intervention following Pennebaker's work (Pennebaker and Beall, 1986; Pennebaker et al., 2007) [2,3] was implemented in a primary study to help mitigate the negative effects of stress on a sample of these women and their unborn children. Journal writing served as an intervention in the primary study while the contents of the journal entries became the data analyzed in this qualitative study. This study utilized both inductive and deductive thematic analysis of journal entries completed by 54 women over four consecutive days (15 min/day). Deductive analysis followed a coding structure that was generated from two resilience scales. Themes that emerged during inductive analysis were also coded. The main themes that emerged described the women's challenging experiences: fears for themselves and their offspring, fire-related and past trauma, and relationship changes. Resilience characteristics and practices also emerged from the writings and mirrored those found in the literature: (a) post-traumatic growth, (b) adaptability, (c) emotional/social connectedness, (d) composure, and (e) reasoning. This paper highlights the challenging experiences of pregnant women exposed to a disaster and the resilience they demonstrated in the face of the tragedy.

Section snippets

Background

In May 2016, the 88,000 residents of northern Alberta's remote community of Fort McMurray Wood Buffalo (FMWB) were expeditiously evacuated due to a massive wildfire. Nicknamed “The Beast,” the wildfire burned 579,767 ha of land [4,5] between April 30th and June 1st. Damaging or destroying over 2400 buildings at a cost of $4.5 billion US dollars and $3.7 billion Canadian dollars in insured losses [6,7], it became the costliest disaster in Canadian history. Furthermore, 7.6 million work hours

Purpose

The purpose of this article is to report on the themes that emerged in the course of the qualitative analysis of the EW journal entries of women who were pregnant or pre-conception at the time of the wildfire. A report of the effects of the EW intervention on the negative impacts of stress in this population is beyond the scope of this article.

Research questions

The following research questions were developed in keeping with those that the women were invited to write about, as well as others for which the research team sought answers: (1) What were the women's worst fears related to the wildfire? (2) How did relationships change during and after the fire? (3) Was the wildfire the most traumatic experience of the women's lives; if not, what were other traumatic experiences? (4) What conflicts had the women experienced? How had they dealt with these

Sample criteria

Study participants included women who were (1) residents of FMWB in May 2016, (2) able to read and write in English, (3) of childbearing age (15–45 years) and (4) pregnant at the time of or became pregnant within 6 months after wildfire. Given that the entire population of FMWB, except for emergency workers, was rapidly ordered to evacuate using one of two roads out of the city, it was assumed that all residents had some degree of exposure to the wildfire.

Recruitment

The research study and recruitment were

Demographics

Participants included 54 women, ranging in age from 24 to 42 years (M = 31.15, SD = 8.41), who were married (n = 42, 77.8%), living with a partner (n = 11, 20.4%), or divorced (n = 1, 1.9%). Participants held Bachelor's degree (n = 20, 37%), had attended college (n = 19, 35.2%), had a high school diploma (n = 7, 13%), master's degree (n = 4, 7.4%), technical/associate's diploma (n = 3, 5.6%) or a doctoral degree (n = 1, 1.9%). Most of the participants (74.2%) reported an annual household income

Discussion

This article presents the findings of a qualitative analysis conducted on EW entries penned online by women who were pregnant or soon to conceive at the time of the FMWB wildfire. The purpose of the study was to identify themes emerging from analysis of the women's EW. The findings captured details of the women's challenging experiences as well as practices, strategies and characteristics of resilience. In conducting the qualitative thematic data analysis, four unexpected findings emerged.

Conclusion

Study findings offer insight into the experiences of pregnant women exposed to a disaster of natural origin and the resilience they possessed amidst the most difficult of life circumstances. Study participants wrote about their fears, changes to their relationships, and prior experiences with trauma. While it is evident that the wildfire was a profoundly stressful and life-altering experience, the women's EW entries also highlight the resilience that they possessed and strategies and practices

Funding source

Project funded by the Canadian Institute for Health Research (CIHR- 2-year, $500,000, #381589).

Declaration of competing interest

There are no conflicts of interests to declare.

Acknowledgments

The authors would like to acknowledge the women and community of FMWB who generously gave of their time and experience for the benefit of the community at large, and other populations who might endure similar experiences.

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