Date of Award

4-9-2026

Embargo Period

4-26-2026

Document Type

Dissertation

Degree Name

Doctor of Philosophy (PhD) in Health & Rehabilitation Science

Department

Health Sciences and Research

College

College of Health Professions

First Advisor

Kit Simpson

Second Advisor

Annie Simpson

Third Advisor

Constance Guille

Abstract

Mental health conditions are a leading cause of death among pregnant and postpartum women, and untreated mental health conditions are associated with adverse maternal and birth outcomes. Major disruptions, such as pandemics, hurricanes, or wildfires, create unprecedented challenges and may impose additional stressors during an already vulnerable time. Community or medical care disruptions during such events may lead to adverse health outcomes. This dissertation seeks to characterize the impact of a recent major disruption on mental health outcomes among pregnant women using administrative claims data for all births in South Carolina in 2019 and 2020. By leveraging unique data sources, we assessed the overall impact and differences by community-level risk factors. Monthly rates of mental health outcomes showed consistent and upward trends in the post-event period. Pregnant women giving birth were more likely to be diagnosed with a mental health condition post-event. Women living in rural counties, or counties with a high social vulnerability, or very high/high maternal vulnerability, were most impacted. Findings are important for healthcare planning, with special consideration for the pregnant population and at-risk subgroups to ensure mental health needs are met, and equitable access, minimal disruption, and optimal care are given, particularly during major disruptions.

Rights

Copyright is held by the author. All rights reserved.

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