Abstract:
War reshapes the conditions under which reproductive decisions are
made and pregnancy is experienced. Prolonged insecurity, displacement, economic
instability, disruption of healthcare, and reduced social support may lead women and
families to postpone pregnancy or face pregnancy and childbirth under constrained
conditions. These challenges highlight the need for research on how war-related
stress and trauma affect women’s reproductive behavior and perinatal mental health.
Method: This prospective cohort study will recruit at least 328 women through
healthcare institutions providing reproductive and perinatal care. Eligible
participants will include non-pregnant women, pregnant women, and women
within the first year postpartum. Where feasible, partners of enrolled women will
also be included to provide complementary dyadic data. Participants will be
followed from baseline to 3, 6, and 12 months. Data will be collected through
web-based questionnaires and routine clinical records. No experimental
intervention will be delivered, and participation in the study will not modify
standard clinical care. Repeated measures will capture mental health,
reproductive intentions and behavior, war-related and perinatal experiences, and
key sociodemographic and obstetric characteristics. Primary analyses will use
mixed-effects models to examine mental-health trajectories, with reproductive
status modeled both as a baseline cohort characteristic and, where participants
change status during follow-up, as a time-varying covariate; reproductive
transitions will also be examined as secondary longitudinal outcomes.
Discussion: This protocol addresses an important gap by using a longitudinal
design to examine women’s experiences in a wartime setting. By situating mental
health within disrupted reproductive plans, insecurity, healthcare strain, and
family-level experiences, the study may help identify how armed conflicts
shape both psychological vulnerability and reproductive decision-making. The
findings may inform more responsive care for women affected by war.
