“There is a really important need in talking about knowledge equity around what is actually happening with the climate crisis, and what happens to maternal [and] neo-natal health as a result of it,” said Neha Mankani, Midwifery Association Capacity Assessment Strengthening Lead at the International Confederation of Midwives, at a recent Wilson Center event titled “Midwives Are Key to Climate Resilience.”

The event was hosted in partnership with the United Nations Population Fund (UNFPA), and its speakers examined the role that midwives can play in building resilience to climate change.

“Midwifery and investing in midwifery are so critical. Even the best climate models couldn’t predict how quickly things would start happening,” said Elena Ateva, Director of Climate and Disaster Resilience at Americares. “What we thought would happen in 100 years, we are experiencing it now.”

Harnessing the Knowledge of Midwives

Given the challenges that mothers face in a climate crisis, midwives are uniquely positioned to help. “There’s a whole spectrum of needs, and as midwives, we could meet a lot of those needs,” said Mankani. Midwives can navigate from the bedside to the policy level to strengthen health systems, said Pandora Hardtman, Chief Nursing and Midwifery Officer at Jhpiego. Their existing knowledge extends to both the practical pieces that are part of midwifery training—such as sustainable use of equipment and resources— as well as to the broader social justice and policy solutions.

Midwives’ strong relationships with the surrounding community mean that they can recognize their needs in a climate emergency, said Jacquelyn Ingram, Director of Clinical Services of the Healthy Mothers Healthy Babies Coalition of Hawai’i. One important step is for health workers to identify the cultural leaders and promote interagency communication. Mankani added that midwives also could rely more on collaborations with women’s groups who are often very well positioned in the community.

Mankani observed that Indigenous midwives possess traditional knowledge, and thus are more familiar with certain health conditions that have affected their communities. And Ingram, an Indigenous midwife and an active part of the Indigenous birth network, acknowledged that while there might not always be common practices across groups, there is still significant knowledge that can be shared.

Additional Responsibilities Require Additional Strategies

Midwives are well-positioned to use innovative practices to build climate resilience. “Midwifery as an approach is an innovation,” said Ateva. Hardtman added that midwives can play a role in both the mitigation and adaptation parts of the climate challenge.

Technological innovations can help midwives better provide care to those suffering from climate crises. Ingram noted that solar-powered mobile clinics were “innovatively used in a sustainable way” to provide maternal health protection during the Maui wildfires in 2023.

In climate disasters, additional responsibilities can arise that often shift a midwife’s priorities. It’s important to get “the message out there that midwives are [dealing with more than] pregnancy and birth,” said Ingram. These additional responsibilities can pose a heavy burden at times. Midwives play a critical role in providing emergency obstetric and newborn care, as well as HIV and sexually transmitted infection (STI) services, “while at the same time, undergoing the same [climate-related] trauma,” said Geeta Lal, Senior Technical Advisory on Maternal Health & Midwifery with UNFPA and moderator of the event.

Panelists also spoke about the need to facilitate sensitive care. Ingram stressed that basic training, such as on gender-based violence (GBV), would be instrumental in better supporting their communities. Point of care items such as rapid testing for STIs could also be part of the equation.

Lal highlighted that there is “no quick fix to mental health issues” that many mothers face in climate disasters. She also stressed that there needs to be a lot of psychosocial support offered in cases of GBV, and including midwives’ knowledge and skills can help improve responses to these cases.

Preparing for the Next Climate Crisis

Previous successes can help in planning for future climate disasters. Hardtman spoke about a successful campaign in India to educate the media and public about the value of midwives and nurses and added that midwives are “using different strategies to engage with the media” amid a shifting media landscape. Both Ingram and Mankani discussed collaborations with the military, who are often already present when climate-related disasters strike, in developing systematic approaches to care delivery.

Midwives see some of the greatest challenges to their work in the rise of displacement. Ateva argued that “our current healthcare system…is not set up for people on the move.” Mankani discussed her flood response work in Pakistan, putting a spotlight on the problem that infrastructure damage poses during pregnancy, delivery, and the postpartum period. She told the story of arranging an ambulance for a pregnant woman, who ultimately chose to stay in the tented city where she and her other children sought shelter instead of travelling to a health clinic. “She left and we never saw her again,” said Mankani. “When women are displaced, they experience a lot of loss of continuity of care while pregnant.”

Ateva stated that midwives must play a key role in designing future climate response plans: midwives need to be integrated in preparedness, response, and recovery efforts across national, subnational, and municipal levels. Mankani noted the example of Japan, where the government has integrated midwives into their disaster relief response planning, and she emphasized that this could be emulated by other governments. Lal stressed that plans for better preparedness are increasingly important to develop because of “the frequency with which we’re seeing these kinds of disasters happen in the world.”

Future climate resilience and adaptation strategies should rely on midwives’ skills and knowledge. “Midwives are key climate actors. They can and do and should play a role,” said Ateva. Their experience as advocates for mothers worldwide is also essential. “There’s always been that piece of strong advocacy that goes alongside midwifery,” noted Hardtman.

“Midwives need to be part of the response planning, the emergency response landscape, so that they can be better equipped when they need to respond. Give them a seat at the table because they know what it is that they and communities need in climate disasters,” said Mankani.