Climate-related disasters are associated with increased risk for maternal health, including gestational complications, pregnancy loss, delivery complications and restricted foetal growth, among others, based on multiple studies
Climate change is one of the largest global health threats, disproportionately impacting vulnerable populations, including women. Changing climatic conditions affect health through poor air quality, heat, and extreme weather events that cause climate-sensitive infectious diseases, reduced water quality, and decreased food security.In 2023, the Earth was 1.5 degrees warmer than preindustrial times.
According to the Indian Meteorological Department, 2023 saw the warmest February since 1901, with a maximum temperature of 29.5 °C (85.1 °F). In addition, the total number of extremely hot days and heat waves has been increasing across the country.
According to the World Health Organisation, women are at higher risk during extreme weather events due to biological, political, and cultural factors, thereby widening the existing gender-based health disparities.
Based on current estimates in India, the number of women who die each year on average due to heat-related excess mortality is projected to more than double to 73,500 by 2050 under current climate conditions. The recent Call to Action released by WHO, UNICEF, and UNFPA highlights the need to prioritise women’s, children's, and adolescent’s health in the climate crisis.
Climate-related disasters are associated with increased risk for maternal health, including gestational complications, pregnancy loss, delivery complications, and restricted foetal growth, among others, based on multiple studies. Pregnant women are particularly vulnerable to extreme heat and heat waves, which can lead to elevated blood pressure and, as a result, possible preeclampsia, one of the leading causes of maternal deaths globally.
They are more susceptible due to their compromised thermoregulation, a mechanism responsible for maintaining a steady internal temperature, and homeostasis ability, the process of self regulation by which the body maintains stability.
Prolonged heat exposure triggers stress responses that promote endothelial dysfunction, causing arteries to narrow and increasing blood viscosity.
Augmented metabolisms impact the ability to maintain heat balance, causing heat shock proteins to be released, which can have physiological and biological effects that are detrimental to maternal and perinatal health, including the neonatal period. In addition, it can stimulate maternal antidiuretic hormone and oxytocin, which reduce uterine blood flow and switch foetal metabolism to catabolic pathways that could adversely impact foetal growth.
Pregnant women giving birth following natural disasters have been found to have an increased risk of complications, including preeclampsia, uterine bleeding, and low birthweight infants. They are also at increased risk of depression and posttraumatic stress disorder after extreme weather events.
Further, women are typically more calorie-deficient compared to men, making them more vulnerable to resource shortages during changing climatic conditions.
Timely antenatal and intrapartum care are crucial to detecting and treating pregnancy-related complications that can arise from extreme heat. The World Health Organisation has recommended increasing the number of antenatal care visits to a minimum of eight.
This would require investment in primary healthcare to improve geographic and financial access to antenatal and intrapartum care and improve the health system's resilience to climate change. In addition, behavioural change and community engagement strategies should include awareness about health stress related risks and approaches to mitigation.
Beyond care, to mitigate the risk of heat on adverse maternal health outcomes, it is imperative to identify pregnant women as a risk group during climate-related events. However, little is known about the differential impacts across various socioeconomic, religious, and cultural settings.
Research is critical to assess and quantify the impacts as well as understand the true burden and attribution, particularly in vulnerable populations, who are more likely to be affected by climate change.
Although climate change threatens to widen gender-based health disparities, there is an opportunity to identify solutions through women’s full, equal, and meaningful participation in equitable decision making.
Policymakers and governments must move beyond sectoral thinking of gender, health, and environment and embrace proactive gender-based solutions to protect maternal health and mobilise their potential to mitigate and improve adaptation to climate threats.
(Nymisha Herrera Nimmagadda is a public health technical specialist at Swasti Health Catalyst.)