The Intersection of Water Salinity and Maternal Health: A Gender-Responsive Analysis of Water Sourcing Stress among Pregnant Women in Shoreline Communities of Akwa Ibom State, Nigeria

Abstract

Climate change-induced salinity intrusion is increasingly affecting freshwater resources in coastal regions, creating significant health challenges for vulnerable populations. Pregnant women living in shoreline communities are particularly exposed because they depend on local water sources for drinking, cooking, and household activities while simultaneously bearing the responsibility of water collection. Despite growing evidence linking saline drinking water to adverse health outcomes, limited research has examined how water salinity intersects with gendered labor responsibilities and maternal wellbeing in Nigeria’s coastal communities. This study explored indigenous perceptions of water salinity among pregnant women, examined the physical and social consequences of water sourcing stress, investigated household decision-making processes influencing access to safer water alternatives, and assessed selected maternal health indicators among women residing in salinity-prone shoreline communities. The study employed a mixed-methods (qualitative phenomenological design with an embedded clinical assessment component). Data were collected from 100 pregnant women and 20 key informants across ten shoreline communities in Akwa Ibom State through in-depth interviews, focus group discussions, participatory mapping, and field observations. A purposively selected sub-sample of 20 pregnant women underwent clinical assessment involving blood pressure and hydration measurements. Qualitative data were analyzed using thematic analysis guided by Feminist Political Ecology and the Social-Ecological Model, while clinical data were summarized using descriptive statistics. Participants described local water sources using sensory categories such as “sweet,” “heavy,” and “bitter,” which served as indigenous indicators of water quality. Narratives revealed concerns about swelling of the legs, persistent thirst, fatigue, and palpitations associated with the consumption of saline water. Women also reported travelling long distances to obtain perceived safer water sources, resulting in physical exhaustion and reduced time for household and livelihood activities. Findings further demonstrated that household financial constraints and gendered decision-making structures often limited women’s ability to access alternative drinking water sources. The experiences of pregnant women in shoreline communities reflect the complex interaction of environmental exposure, gendered labor burdens, and household economic inequalities. Integrating local knowledge systems into maternal healthcare and water governance frameworks may strengthen community resilience and reduce climate-related health risks among vulnerable populations.