Damage Dealt

Note: This story was originally published in the Daily Yonder. For more rural reporting, visit dailyyonder.com.

This story was produced through a collaboration between Daily Yonder and Climate Central. Climate Central scientist Daniel Gilford contributed data reporting.

The howling winds of a tornado jolted Jelessica Monard awake in the early morning hours last fall. She was five months pregnant with her first child when Hurricane Helene struck her rural Georgian town of Swainsboro. Along with devastating flooding and mudslides, the storm had been spinning up tornadoes throughout the Southeast that morning and knocked out power in her neighborhood.

“I opened up the door and I couldn’t see my hand,” Monard said. “You hear things breaking outside or lifting up and banging into something else.”

After the storm passed, the power remained out and no one had cell reception. Food spoiled within a few days without refrigeration.

“I had a food stamp card and had loaded up the house,” Monard said. “I had to throw a lot of that stuff out.”

Pregnant women and their unborn children face some of the sharpest health risks as atmospheric pollution raises temperatures, fueling more destructive storms, floods, wildfires and other climate disasters. Lower-income families are particularly vulnerable – as are rural communities, which can lack sufficient access to healthcare even in the best of times.

Not having food available exacerbated Monard’s pregnancy-induced nausea. And without a phone, she couldn’t call for help.

“I was hungry, I was pregnant,” Monard said. “And then if I wasn’t eating enough, I would throw up.”

To add to her stress, Monard’s pregnancy was considered high risk because she’d suffered a pulmonary embolism, or blood clot in her lung. To monitor the condition, Monard had to travel twice a week from her home in Swainsboro to a medical center in Savannah throughout her pregnancy, about a two hour round trip.

“Things started getting hard with the bills and keeping gas in the car,” Monard said. “It was just a whole trickle down spiral.”

Pregnant people and parents of infants across the American Southeast experienced domino effects like these after Helene cut its ruinous path, destroying homes and businesses, laying waste to infrastructure, knocking out power to millions of homes and killing more than 200 people.

Maternal care providers in storm-damaged communities in Georgia, North Carolina, Tennessee and Virginia said they’ve seen an uptick in postpartum depression among their patients. Though anecdotal, these observations are consistent with an emerging body of research indicating that surviving a severe flood catastrophe heightens the risk and severity of maternal mental health struggles, which in turn can impact the health and development of infants.

Helene crossed into Georgia from its southern border as a Category 2 hurricane. Before making landfall near Perry, Florida, it had intensified to a Category 4 storm under the influence of warm Gulf waters. A Climate Central forensic analysis showed that such marine heat in the Gulf has become at least six times more likely at that time of year because of the warming effects of greenhouse gas pollution.

Even in the best of circumstances, the hormonal and physiological changes that women go through during pregnancy and the months after giving birth can strain mental health. Postpartum depression and other mental health conditions are the most common complication of childbirth, afflicting about 1 in 8 people, only half of whom are diagnosed. These problems are the leading cause of pregnancy-related deaths, and contribute to the extraordinarily high maternal mortality rate in the U.S.

During the past decade, the federal government made significant investments in preventing and treating maternal mental health problems. Congress has funded outreach programs, a hotline for struggling parents, and an array of research on the topic. However, recent federal cuts to healthcare have jeopardized some of those programs.

Monard wasn’t diagnosed with a mental health disorder as the stressors piled up after the storm, but she became scared for herself and for her baby’s well being.

“I just know that if I go down, my baby goes down,” Monard said.

In August 2005, epidemiologist Emily Harville had just moved to New Orleans for a job at Tulane University when Hurricane Katrina devastated the city.

Her graduate research had focused on the impact of stress during the perinatal period–the months before and after giving birth – so in Katrina’s aftermath she began visiting hospitals in New Orleans and Baton Rouge. She and her colleagues ultimately interviewed hundreds of women who were pregnant when Katrina hit or who became pregnant soon thereafter. Many had faced a life-threatening situation, lost a loved one to the storm, or had their property demolished. Those who had suffered at least two serious hardships had a 77% higher rate of postpartum depression and a 268% higher chance of post-traumatic stress disorder than those who had not. Researchers have since found the same phenomenon among pregnant people who survived the 2008 Iowa floods and megastorms in other countries. Others have pinpointed developmental and health impacts on children who were in utero during the Iowa floods, the 2012 Hurricane Sandy along the eastern seaboard and 2018 Hurricane Michael in Florida,

Those results aren’t entirely surprising, Harville said. The risk of depression and trauma goes up after a storm no matter who you are, but the effect is stronger in women and parents, as well as among poor, non-white and less educated people; new moms disproportionately fall into those categories.

When a new mom is disabled by depression, she’s not the only one who struggles.

“When a mother is depressed, she’s less able to bond with and take care of her baby,” Harville said. This can affect her infants’ development and stymie her ability to care for other children. Since mothers carry a disproportionate amount of the burden of household management, when they are affected by a mental health disorder, she said, “the family doesn’t work as well.”

Perinatal health care practitioners in the hardest hit parts of the Southeast said they’ve been watching this phenomenon play out in their communities since Helene. Before the storm, Heather Herman, a perinatal psychiatric nurse practitioner in West Jefferson, N.C., already had a full schedule of patients who were navigating depression and other challenges. In the immediate aftermath of the storm, many abruptly stopped reaching out for help. When she finally got ahold of them again, they said their lives were too chaotic to worry about their mental health. Families lost childcare when schools and daycares closed for weeks. Many lost cars to the floods, limiting their transportation options. With so much to repair or replace and lost wages, many families’ financial stability faltered.

“When there’s a storm like this, everybody is going to prioritize basic needs first, that’s just part of the human condition,” Herman said. “Parents are going to prioritize their kids and put themselves last. Unfortunately, that has a negative impact on the kids as well.”

In some cases, parents struggled to even feed their infants. Parts of western North Carolina went nearly two months on a boil water notice because the floodwaters had contaminated drinking waters. Some parents had no clean water to add to formula, said Katherine Hyde-Hensley, a perinatal psychologist who sees clients in and around Asheville. There are few greater stressors for new parents than not being able to safely feed their infant, she said.

Hyde-Hensley said some clients evacuated to homes of friends and family elsewhere, but that didn’t protect them from weeks of instability and chaos as they tried to return home.

“They were trying to figure out, ‘Can I come back?’” Hyde-Hensley said. “‘Can I wash bottles? Can I wash dishes? Can I wash diapers? How am I going to bathe my baby?’”

Allison Rollans, a doula, childbirth educator, infant specialist, and owner of High Country Doulas, serves clients in eastern Tennessee, northwestern North Carolina, and southwestern Virginia, all of which sustained major damage in the storm. She said many of her clients have yet to fully grasp the stress of what they’ve lived through.

“When you’re in it, you’re just sort of going through it, you’re in survival mode,” Rollans said. “It will take years of reflecting on this to see the real impact of it.”

As temperatures rise and as neighborhoods continue to be built and expand in vulnerable places, weather disasters are striking more frequently and with more ferocity. Helene was one of 27 disasters across the U.S. to cause at least $1 billion in damage last year. Thirty-five years ago, the U.S. experienced an average of nine such disasters each year.

The growing risks are not lost on new parents, said epidemiologist Jennifer Barkin, a professor at Mercer University School of Medicine in Macon, Georgia.

Maternal mental health has always been a focus of Barkin’s research. Recently, she’s begun to focus on the impact of climate disasters. In one study, Barkin’s team surveyed 101 postpartum women in Australia about their levels of distress. Unsurprisingly, the more aware the women were of the growing risk of climate catastrophes, and the more vulnerable they expected to be when one struck their community, the higher their rates of anxiety and distress.

Days after her team submitted the Australian paper for publication last fall, Helene arrived in southern Georgia. Although the storm didn’t hit Barkin’s home in Macon directly, it caused widespread flooding and power outages in the rural counties south of town, where Barkin’s research team works with pregnant and postpartum women.

“I don’t think that area had ever seen a storm like that before,” Barkin said. “We weren’t able to conduct business as usual because [my team] didn’t have access to gas or electricity.”

In the months since, her team interviewed 24 new moms in Georgia, including Monard, about their experiences and their feelings of ongoing safety.

Hyde-Hensley said the planet’s environmental future has come up again and again in her conversations with clients. Even before the storms, many new parents felt profoundly worried about “what their child is going to have to deal with for the next 60 to 80 years,” she said. The storm made that threat tangible, and plunged some into anxiety about future storms.

That fear is rational, because stakes get higher as more climate disasters strike a community, Barkin said.

“You’re more resilient if it’s not chronic. When an area is getting flooded over and over, the community can’t bounce back the same way,” she said.

“It was pitch black and you couldn’t see anything, but all you could hear was the storm, the trees just literally snapping, sounding like popsicle sticks breaking off into the distance,” said Allyson Byrd, whose son was three months old when Hurricane Helene hit. “That was such an eerie, kind of an ominous type feeling.”

Byrd, who has three older children from ages six to nine, said the storm took a mental toll on her. Byrd lives with her four children and her parents in her hometown of Swainsboro, Georgia.

“It was hard to keep [my children] afloat and myself afloat mentally,” she said.

Even Byrd’s older children were too young to fully understand what was happening, why the lights were out for so long, and why there was nothing else to keep them busy except each other’s company.

“That was a lot mentally for me to try to balance,” Byrd said. “I needed to stay stable myself while keeping the kids mentally stable and not let them see me fall apart.”

There was also the stress of trying to figure out how to store breastmilk at a safe temperature without a working refrigerator. When the storm made landfall in South Georgia, Byrd was trying to make the transition from breastmilk to formula with her new baby. But it was hard to locate ice to keep the milk from spoiling.

“Once people were able to get some type of cellular service they were making social media posts to get cans of milk from people,” Byrd said.

Despite the hardship, Byrd said it was encouraging to see her community come together to support each other during the storm.

“Economic status and where you stood as far as salary level, all of that just got put in the background,” Byrd said. “It didn’t matter.”

Herman, the psychiatric nurse practitioner in West Jefferson, has observed that both giving and receiving this kind of community support has served her clients. “It’s so helpful to us, as humans, to be able to extend help to one another, and I think that was protective to people who had that opportunity.”

Research by Harville’s team and others has confirmed that social support can shield pregnant people from the worst mental health outcomes of a disaster. Among other things, Harville’s team found that people who had sustained major intangible losses – family stability, feelings of closeness and companionship with loved ones, a daily routine, and time for sleep – suffered far more depression than those whose losses were mainly tangible – cars, homes, possessions, even access to food.

This critical support can come from a trusted maternal health provider. After experiencing major floods in Queensland, Australia, women who had a strong and continuous relationship with their midwife throughout the disaster had fewer symptoms of anxiety and depression than those who didn’t.

Birth doulas, whose roles include helping postpartum mothers meet their emotional and physical needs, may have played a similar role for their clients during and after Helene. “As a birth doula, we have very close contact with our clients personally before labor and after labor,” said Emily Bohannon, executive director of the Birth Circle Community, a nonprofit organization aimed at empowering families through efforts like birth preparation classes and postpartum social support in Statesboro, Georgia.

When Helene hit, the group amped up their support for families with new babies, organizing a supply drive for clean water, formula, and diapers. The community support was overwhelming; at the end of the drive, the Birth Circle Community ended up with double the amount of items they started with.

“Within a week, we were able to get hundreds of items from local people and nonprofits and business owners,” Bohannon said. “The day of the supply drive, we had dozens of families show up and get their items that they needed.”

Social support can also come from public programs. Harville’s team compared Katrina-affected pregnant women who had standard prenatal care to those who also received services from New Orleans Healthy Start. Healthy Start, a federal program started in 1991, provides services to families in 115 American communities, from pregnancy until the child reaches 18 months old.

Healthy Start outreach workers provide prenatal care and education, help families navigate housing and food services, promote fathers’ involvement, and facilitate mental health screenings and referrals.

Harville’s team found that compared to the women who received standard prenatal care, those in Healthy Start were disproportionately young, low-income, unpartnered, and Black, had suffered worse experiences in the storm, and had more symptoms of depression and post-traumatic stress than their better-resourced peers outside of the program – all factors associated with worse birth outcomes. Through Healthy Start these women received mental health counseling and prenatal education, and their birth outcomes were no different than their better resourced peers’.

Awareness of postpartum depression has exploded over the last decade, said Wendy Davis, president and CEO of Postpartum Support International (PSI), a nonprofit that provides support to new parents struggling with their mental health and trains health care professionals on the issue. Compared to 10 years ago, more providers are educated about postpartum depression, some states require insurance companies to cover it, the screening rate has increased, and there are better services for those who suffer.

At the end of President Donald Trump’s first term, he signed a bill creating the Maternal Mental Health Hotline, whose counselors answer calls and texts 24 hours a day in English and Spanish. The hotline is operated by PSI, whose counselors provide a listening ear, advice, and connections to local therapists and support groups for parents struggling with their mental health. Davis said that use of the hotline has steadily climbed since it launched on Mothers Day 2022, and it now receives thousands of calls and messages every month. Davis said that outreach to the hotline spikes after hurricanes, tornadoes, and forest fires.

The Biden-Harris administration also embraced the issue, releasing a blueprint for lowering the country’s sky-high levels of maternal mortality, which is highest for Black mothers.

It’s unclear if these new investments in the wellbeing of young families will remain intact under Trump’s second administration, which has pursued sweeping cuts to health services and research. Within weeks of Trump’s inauguration, the administration paused the Pregnancy Risk Assessment Monitoring System, an annual survey of maternal and infant health widely considered the gold-standard for maternity mental health data. At the end of March, the entire staff overseeing the survey was placed on administrative leave. The administration has also revoked billions in grants that had already been given to state health departments, including some that had funded maternal mental health services.

Research on maternal and infant mortality has also been affected. Much of the Centers for Disease Control and Prevention’s Division of Reproductive Health, which studies maternal health, was shuttered, as was its Birth Defects Center. More than a dozen research centers designed to investigate and improve maternal health were established in 2023 through a $168 million initiative by the National Institutes of Health; their funding is now in question.

Harville says her current disaster research is not federally funded, but she has other grants she’s “keeping a nervous eye on.”

Healthy Start was among the programs whose funding was briefly suspended by a Trump executive order in January before a federal judge blocked the move. Late last year, some versions of the Republican-proposed House budget bill sought to eliminate funding for Healthy Start. The administration is also reported to be considering deep cuts to Medicaid, which finances at least 42% of all births in the country.

Davis said the hotline seems to be safe for now. The federal workers who provided administrative oversight of the Maternal Mental Health Hotline were laid off as part of the DOGE workforce reduction, said Davis, but other agency officials have stepped in to do that work, and the hotline remains operational and well supported. She said PSI’s contract was recently re-upped for three years, which she hopes will protect them from cuts. But she said it is painful to see other funding setbacks, which could slice into the real progress made on the issue over the last decade.

“It’s been so promising to see state and health care policy start to focus on this very vulnerable and important time,” she said.

In February 2025, five months after Hurricane Helene made landfall, the Swainsboro resident, Jelessica Monard, gave birth to a healthy baby girl. With power restored and her fridge back up and running, Monard’s fiance visited for several weeks in February and into March, taking time off from his job in New Jersey to help with their daughter.

“I could get some sleep. I could pump. I had a schedule,” Monard said. “It was easier.”