“The effects of climate change can begin in the womb,” said Sarah Barnes, the Project Director of the Maternal Health Initiative at the Wilson Center at a recent event on the impact of climate change on maternal and newborn health outcomes, hosted by the Wilson Center and UNFPA. It is a connection that “[makes] it imperative that climate change and maternal and newborn health leaders work together to tackle climate change and improve maternal and newborn health outcomes, globally.”

The event was part of a Wilson Center series on climate change and population, meant to spur necessary discussion on the significance of women and children in discussions on climate change. As global focus turns to the COP27 now taking place in Egypt, the protection of vulnerable populations and countries are high priorities on the conference agenda. Calls for investment are expected, as well as demands that wealthier countries provide compensation for a problem they have created.

“It’s important to acknowledge the major inequities around the world as to who is most impacted by climate change. Research shows that in many cases, the people least responsible for causing climate change are the ones suffering the most from its effects,” said Barnes. The International Conference on Family Planning—occurring in Pattaya, Thailand at the same time as COP27— is taking up important discussions on the impact of climate change on family planning access, uptake, and satisfaction.

“Climate change represents one of the largest global health threats in the 21st century, primarily affecting populations that have the least ability to adapt to climate change,” said Paulina Ospina, the Associate Director of the Maternal Child Health Program at Direct Relief. “Pregnant women and newborns are increasingly being recognized as vulnerable populations in the context of climate change.”

Heat and Disasters Threaten Maternal and Newborn Health

Climate change has resulted in changing weather temperatures and patterns across the globe. Extreme heat exposure, wildfire smoke, air pollution, changes in sea level and water saliency and water-borne diseases greatly impact the health of a pregnancy, for both women and children, noted Barnes.

Increases in average temperature—and the number of hot days— everywhere across the globe poses a threat to maternal and newborn health. “Heat and high temperatures increase the risk of several serious maternal outcomes, including preeclampsia,” said Sari Kovats, an Associate Professor of Public Health at the London School of Hygiene & Tropical Medicine. She noted that the likelihood of congenital defects, preterm birth, and low-birth rate are also heightened with heat exposure.

Ospina said that climate change has increased the frequency and severity of natural disasters. Historically, Direct Relief responded to one or two major events a year, but the organization now responds to seven large-scale disasters in a single year, including hurricanes, cyclones, floods, and wildfires.

“Research shows that extreme weather like floods, droughts, hurricanes, tornadoes, landslides and mudslides directly impact women during pregnancy and the postpartum period, as well as the fetus, and can have lasting implications on child health,” said Barnes. She added that climate-related crises can also lead to diminished access to necessary sexual and reproductive health services: “Individuals forcibly displaced as a result of extreme weather events face enormous barriers to access necessary health care.”

How Impacts Play Out Globally 

Displacement because of extreme flooding in Pakistan has greatly impacted women and girl’s health. More than 33 million people were displaced and 7 million of them live in camps and roadside, said Talib Lashari, the Technical Advisor at the Population Welfare Department for the Government of Sindh, Pakistan. As families experience heightened pressure from climate-related displacement, most of the resulting duress falls on the women and girls, resulting in gender-based violence, he said. For instance, a report from the UNFPA recently observed that women in Pakistan are struggling with hunger because of the floods, and that this is preventing them from breastfeeding.

In the United States, wildfires differentially impact and displace low-income families. “While there is much greater awareness from public health that wildfire smoke is bad for pregnancy health, the advice that’s given is not very actionable,” said Skye Wheeler, Senior Researcher in the Women’s Rights Division at the Human Rights Watch. She added that while families are told to leave the smoke-filled area, hotels in smoke-free area price gouge those who flee, placing financial burdens on low-income families, or exposing them more to smoke if they cannot afford refuge.

“It’s important for us to realize that responding to climate change might not only be in the context of natural disasters,” said Ospina. “As we have seen sustained droughts and heat waves, these kinds of events might not have an acute beginning and end.”

Long-term changes to the sea level pattern in Indonesia have a direct impact on pregnancy, said Nila Wardani, a Coordinator in the Research Division at the White Ribbon Alliance, Indonesia. The increase of salinity will increase a person’s salt intake and can adversely affect pregnancy by leading to hypertensive disorder, said Wardani. Maternal hypertensive disorder (high blood pressure), particularly eclampsia and severe pre-eclampsia, is a leading cause of maternal and fetal disease and death; and is associated with several diseases in offspring from birth to young adulthood.

Seeking Solutions

Several speakers saw better integration and training of community health workers to address some of the health issues created by climate change as one solution. Lashari noted that in Pakistan, his office is working with development partners to train community workers in emergency situations and developing family planning and reproductive health guidelines as part of the response.

Kovats said that training nurses and midwives about heat-related risks is important because it is not always covered in previous training. The challenge is not just about seasonal extremes or crisis situations, she added. Some places in the world experience hot temperatures yearly and knowing how to address it should be a part of overall clinical care.

The importance of thinking about climate change and maternal and newborn health as overlapping issues when developing policy and programming was also part of the conversation. Jorge Matine, Director of Ipas, Mozambique, urged the audience to consider how climate events are jeopardizing recent gains in girl’s education and access to health services, which are undermined by natural disasters.

Humanitarian responses disproportionately provide less resources for reproductive health needs, continued Matine, so “we need to revise this response and make it more integrated.” Ipas Mozambique designed a standard set of guidelines to respond to humanitarian needs, and particularly unmet reproductive health needs during climate events. The goal is to integrate reproductive health into general humanitarian response practices, he said.

Wheeler noted that “[in the United States], we are still seeing cities, and counties, and states write climate action plans with no input from reproductive health groups or pregnant people.” While the Biden administration is taking steps to prioritize environmental justice, she added, they need to pull in the reproductive justice experts, as well.

“The reproductive justice movement was established by women of color here in the United States, and Black women in particular,” said Wheeler. As a movement that has always stressed that a healthy environment is a core component of a person’s right to sexual and reproductive health, she continued, it is a positive development that more people are coming to understand this crucial connection.

Wardani noted that there was a need for researchers to develop more evidence around maternal and child health and climate change; and to bring these issues to the global dialogue as something urgent, in all the dimensions of life, but especially for women and children.

The event was part of this effort, concluded Barnes. “Bringing maternal and newborn health and climate change together in one conversation is necessary to truly understand the long-term and generational impacts climate change is having now and will continue to have, unless significant and impactful efforts are made, for generations to come.”

Read more:

• The relationship between population growth and climate change is complex
• Climate change increases food insecurity in Alaska Native families, impacting maternal and child health
• Black mothers are disproportionately harmed by climate change
• Using reproductive justice as a framework to drive policy solutions for addressing maternal health and climate change