The needs of a pregnant woman during a disaster are unique. You still need to follow any evacuation and preparation instructions given by your state, but here are some special things to consider.

This article is designed for pregnant women affected by a disaster. If you are pregnant or think you may be pregnant and have questions about the health effects of the disaster, please talk with a health care professional.

To support March of Dimes local efforts, you can donate directly to our chapters. For more information, visit the March of Dimes Web site.

BEFORE A DISASTER
Make sure to let your health care provider's office (doctor, midwife or nurse-practitioner) know where you will be.

Make a list of all prescription medications and prenatal vitamins that you are taking.

Get a copy of your prenatal records from your health care provider.

If you have a case manager or participate in a program such as Healthy Start or Nurse-Family Partnership, let your case manager know where you are going. Give him or her a phone number to use to contact you. 

If you have a high-risk pregnancy or you are close to delivery, check with your health care provider to determine the safest option for you.

DURING A DISASTER
Bring any medications you are currently taking, including your prenatal vitamins and your prescriptions.

Keep a copy of your prenatal medical records with you and contact information for your health care provider in case you need to visit another provider.

Remember that maternity clothes may not be available if you evacuate. Pack extra clothes for yourself, including undergarments.

AFTER A DISASTER
Food
Do your best to eat at regular intervals throughout the day. Do not eat spoiled food or any food you think may be spoiled.

Depending on what's available, try to choose food that is higher in protein and lower in fat. Carbohydrates like bread and pasta help to give you energy. For more information, read Healthy Eating.

The U.S. Centers for Disease Control and Prevention (CDC) provides information about food safety on its Web site.

If tap water is not safe, boiling is the preferred way to kill harmful bacteria and parasites. To kill most organisms, bring water to a rolling boil for 1 minute.

If you can't boil unsafe tap water, you can treat it with chlorine tablets or iodine tablets. Follow the directions that come with the tablets. Keep treated water out of reach of children and toddlers.

Drink at least six to eight glasses (8-ounce servings) of water, juice or milk every day.

Immunizations
Important: Pregnant women should not receive vaccines for varicella (chickenpox) and measles, mumps and rubella (MMR). For more information on vaccinations during pregnancy, read the March of Dimes article.

Labor Symptoms: Normal and Preterm
Stress is a risk factor for preterm labor. If you have any of the symptoms below, do not wait for them to just go away. If you are in a shelter, immediately go to the person in charge of your site. Tell him or her you need medical care right away.

• Contractions (your abdomen tightens like a fist) every 10 minutes or more often
• Change in vaginal discharge (leaking fluid or bleeding from your vagina)
• Pelvic pressure (the feeling that your baby is pushing down)
• Low, dull backache
• Cramps that feel like your period
• Abdominal cramps with or without diarrhea

If you are not in a shelter and have any of these symptoms, contact a health care provider.

For more about normal labor, read Giving Birth.  For more about labor that comes too early, read Preterm Labor.

Stress and Pregnancy: Physical Relief
If you are driving, be sure to stop, get out and walk every 1-2 hours.

No matter what your housing situation, take a little time (10 to 15 minutes) to lie down and put your feet up. Try to do this three times a day (such as after breakfast, lunch and dinner).

To have this time be most effective, try your best to:

• Go to a quiet spot.
• Clear your mind of worries for these few minutes.
• Take deep breaths from your belly, not your chest.

Stress and Pregnancy: Mental/Emotional Relief
Find someone to talk to for a couple of minutes a few times a day. Invite the person to be your "buddy." Share with him or her any concerns you may have about being pregnant in these difficult circumstances. The fact that you have someone to talk to is helpful all by itself.

Health care providers can help you cope with stress or refer you to other professionals. You can also get help from:

• A clergy member
• The department of psychology at a local college or university
• The local community mental health center.

If you ever feel like harming yourself or your baby, talk to a health care provider right away.

An emergency situation causes stress for a family. If you are concerned about your relationship and your safety, call the National Domestic Violence Hotline at (800) 799-SAFE (7233).

If you ever feel like harming yourself or your baby, talk to a health care provider right away.

MORE HEALTH INFORMATION
Read more health information on the Web site of the U.S. Centers for Disease Control and Prevention. 

POTENTIAL DANGERS
Flood Water in Streets and Buildings
Flood water may contain harmful substances. For instance, the water may contain bacteria that could cause serious disease. It's best if children and pregnant women avoid touching or walking in flood water.

If you do touch the water, use soap and clean water to wash the parts of your body that came in contact with it. Whenever possible, people who must come in contact with the water should wear protective clothing, such as gloves and boots.

If you are pregnant, be especially careful not to swallow any flood water. Try to keep it away from your mouth. If you feel sick in any way, talk to a doctor or nurse right away. Remember to tell them that you are pregnant.

Toxic Exposures During Pregnancy
If you are worried that you and the baby you are carrying may have been exposed to dangerous chemicals or substances, talk to a health care professional.

The Organization of Teratology Information Specialists (OTIS) offers free telephone counseling to pregnant women worried about toxic exposures. The service is available 8 a.m. to 6 p.m., central time, at (866) 626-6847.

Returning to Your Home
Pregnant women may face several possible dangers when returning home, depending on the extent of damage and their individual circumstances. If you are pregnant and your home has been damaged, it may be best to ask disaster workers, family members and friends to clean up. Possible hazards that could threaten your health and your pregnancy include:

• Pollutants such as bacteria and mold that have contaminated household items
• Hard physical work, such as carrying and lifting heavy items
• Falling while stepping over debris
• Electrical shocks

Your state and local health or environmental departments can tell you about pollutants in your area. For information on environmental hazards and pregnancy, read the March of Dimes fact sheet.

FOR OTHER HELP
American Red Cross
American Association of Poison Control Centers
American Mental Health Counselors Association
American Psychological Association
Center for Mental Health Services, Emergency Services and Disaster Relief Branch
Girls and Boys Town National Hotline 
National Mental Health Association 
Salvation Army
United Way