Maternal and child health challenges during and after flooding: a qualitative study in Makassar, Indonesia

Flooding is a recurrent and worsening public health threat in Indonesia, disproportionately affecting women and children in low-elevation urban areas. Pregnant and postpartum women in Indonesia experience unique physical and emotional burdens during floods, yet their lived experiences remain underexplored. Understanding how mothers adapt to recurrent flooding is critical for developing context-relevant interventions to improve maternal and child outcomes. This study aimed to explore (1) how recurrent flooding shapes the daily lived experiences and caregiving responsibilities of pregnant and postpartum women, (2) how flooding affects access to food, water, and healthcare, and (3) what community-informed interventions mothers identify as most impactful. We conducted a qualitative descriptive study using in-depth interviews with 20 women who gave birth within the past three years and reported prior flood experience in the Tallo District of Makassar. They were randomly selected from a mother-child cohort based out of Hasanuddin University. Sample size was determined by data saturation. Interviews were transcribed and translated from Makassarese into English. They were then coded and analyzed thematically using MAXQDA. Flooding occurs annually, with severity differing between years. Mothers bore primary responsibility for lifting furniture, protecting children, and cleaning contaminated homes. Recurrent floods disrupted food preparation and reduced meal variety. Floodwater contaminated government-owned piped water and borehole well water. Toilets overflowed and bathing was often skipped to conserve clean water. Prenatal and routine health visits were frequently postponed until floodwaters receded; however, many mothers reported wading through deep water to attend scheduled appointments. The distress of these burdens was worsened by lost income from disrupted work. Mothers identified food distribution, drain maintenance, and improved housing infrastructure as the most impactful interventions. These findings provide translatable insights for flood-prone coastal urban communities. Educating households about water preparation and implementing timely food staple distribution through existing community networks can reduce illness and hunger during flooding. Supporting neighborhood-based drainage maintenance and subsidizing incremental home elevation with locally available materials can address the burdens placed on mothers during flooding. Flooding is becoming more frequent and severe in many parts of the world, yet its effects on women’s daily lives and health are often overlooked. This study explores how recurrent flooding impacts mothers and their families living in the Tallo subdistrict of Makassar, Indonesia, a flood-prone community. We conducted in-depth interviews with mothers and found that flooding was often seen as a normal part of life, even though it caused repeated damage to homes, belongings, and routines. Many women described how their houses flooded every year, forcing them to constantly clean, repair, and adapt their living spaces. These repeated disruptions created ongoing stress, worry, and exhaustion. Mothers carried most of the responsibility for preparing for floods and recovering afterward. This included moving furniture and food to higher ground, protecting children’s belongings, cooking in unsafe conditions, and cleaning homes after floodwaters receded. During floods, families often struggled to access fresh food, clean water, toilets, and bathing facilities, increasing the risk of illness, especially for children. Flooding also made it harder for women to access healthcare, including prenatal and postpartum care. Some delayed or missed appointments, while others walked through floodwater despite fear of falling or harming their pregnancy. Mothers expressed strong concerns about keeping their children healthy and safe, particularly when floodwater was dirty or contaminated. Addressing flooding risks requires not only infrastructure improvements, but also greater attention to women’s health, caregiving responsibilities, and access to essential services.