When the Waters Rise: How Climate Change Is Threatening Maternal Mental Health in Bangladesh

Expecting a child should be a time of hope, not fear of the next flood. But for many pregnant women in rural Bangladesh, climate change is turning everyday rainfall into a mental health crisis.

A new study led by Suni Hanif, a master's student in Stanford's Department of Epidemiology and Population Health, and Jade Benjamin-Chung, assistant professor of Epidemiology and Population Health, reveals that recent flooding of an expecting mother’s home is associated with more than twice the risk of prenatal depression and more than eight times higher thoughts of self-harm among pregnant women. The research, published in PLOS Global Public Health, combines satellite data, household surveys, and focus group interviews to show that flooding is profoundly harming maternal mental health.

The study's findings go beyond statistics: they reflect the lived experiences of women navigating pregnancy under environmental and social stress. Focus group participants described how flooded latrines, food shortages, financial losses, and gendered caregiving burdens contribute to anxiety and emotional strain. The most common coping mechanism, temporary relocation, often introduced even more stress, especially when sanitation and safety were compromised. 

Flooded latrines were especially harmful, associated with a 3.6-fold increase in depressive symptoms. Notably, even in the absence of visible flooding, elevated ambient water levels were linked to poorer mental health outcomes.

“Many rural, low-income households in Bangladesh lack adequate sanitation and hygiene infrastructure,” said Benjamin-Chung. “When latrines are flooded, pregnant women face a double burden - they have greater physiological needs for bathroom access, but also face cultural barriers and safety risks when forced to seek alternatives outside their homes. This helps explain why we found such strong links between latrine flooding and prenatal depression.”

This interdisciplinary research, which blends geographic information systems (GIS), remote sensing, and mental health diagnostics, underscores the need for integrated public health responses. 

“Our findings suggest that depression screening during antenatal care, mental health services in post-flood settings, and resilient infrastructure like flood-proof homes and latrines may promote resilience to flooding in similar populations,” said Hanif. “These interventions are especially urgent in low-resource, high-risk regions where pregnant women are disproportionately vulnerable to the cascading effects of climate change. We hope this study helps underscore the importance of understanding the impact of flooding, which is expected to increase with climate change,  on the health of both expecting mothers and their unborn children.”

As climate-related flooding is expected to intensify, the researchers emphasize the need for global health systems to prepare for its mental and physical health impacts, particularly among the world's most vulnerable.