Postpartum Mental Health of Mothers in Fukushima: Insights From the Fukushima Health Management Survey’s 8-year Trends

Abstract

With the aim of monitoring the mental and physical health of mothers and children following the Fukushima nuclear accident and providing them with necessary care, we have been conducting an annual survey of expectant and nursing mothers since 2011. The Pregnancy and Birth Survey is a mail-in survey of about 15,000 individuals, with a response rate of approximately 50.0% each year. In addition, because respondents to a survey conducted in the immediate aftermath of the disaster showed a particularly high rate of depression, follow-up surveys have been conducted at 4 years after childbirth. Reviewing the results of surveys from FY 2011 through FY 2018, we found that the prevalence of depressive symptoms among mothers was highest in the survey after childbirth and decreased over time. Data of follow-up surveys showed that the prevalence of depression was lower than immediately after childbirth and then decreased over time. The proportion of mothers with radiation anxiety was higher among respondents in the FY 2011 follow-up than in the FY 2014 follow-up, indicating the prolonged impact of the nuclear accident, especially among those who gave birth immediately after the disaster. Characteristics of mothers who received telephone parenting counseling included first delivery, caesarean section, living in evacuation zones, not being able to receive medical examinations as scheduled, and having radiation anxiety. Continuous care should be provided to mothers who gave birth immediately after the nuclear accident, including routine perinatal care and parenting support, provision of information on radiation, and long-term monitoring of their wellbeing.

Achievements and Current Status of the Fukushima Health Management Survey

“…The results of the survey from 2011 to 2018 showed that the prevalence of depressive symptoms among mothers was highest in the 2011 survey after the radiation accident and decreased over time. 12 The 4-year follow-up data from the survey showed that the prevalence of depressive symptoms was lower than the period immediately after the childbirth and decreased over time. 12 The proportion of mothers with radiation anxiety was higher in 2011 than in the 2014 follow-up survey, 12 suggesting lingering effects of the radiation accident, especially among mothers who gave birth immediately after the disaster.…”

“… 1 , 6 In brief, the FHMS consists of the Basic Survey 7 and four detailed surveys: the Thyroid Ultrasound Examination, 8 Comprehensive Health Check, 9 Mental Health and Lifestyle Survey, 10 and Pregnancy and Birth Survey (Figure 1 ). 11 , 12 The eligible population of the Basic Survey was mainly individuals registered as residents in Fukushima Prefecture between March 11 and July 1, 2011 (including evacuees) and residents of other prefectures who commute to Fukushima Prefecture, totaling approximately 2.05 million people. The eligible population for the detailed survey is shown in the methods section of each survey below.…”

“…The eligible people of the Pregnancy and Birth Survey is pregnant women in Fukushima Prefecture and pregnant women from other prefectures who are planning to give birth in Fukushima Prefecture. 1 , 12 , 25 The Pregnancy and Birth Survey has been conducted every year since March 11, 2011, eligible women who have registered their pregnancies during a specified period each year. Participants of the self-administered survey questionnaire were asked to respond by either mail or an online system that was available from 2016.…”

“…To support mothers with depression, we have been conducting a follow-up survey every year since 2015 for those who responded to the survey, eligible mothers in their fourth year after childbirth. 12 …”

“…Furthermore, the support system was established to alleviate anxiety by having midwives and public health nurses provide consultation and support by telephone or e-mail to respondents who needed support based on their responses in the Pregnancy and Birth Survey and the follow-up surveys. 12 …”