The Nexus between Climate Change and Maternal Health

By Jenna Van Holten

Climate change is one of the world’s largest global health threats of the 21st century, but the vast preponderance of discussion on climate change leaves out maternal health. The siloing of the two topics perpetuates the misconception that there is no intersecting relationship between a changing climate and adverse maternal health outcomes and that these two topics are mutually exclusive, but that is far from the truth.

Image source: “The Changing Climate and Pregnancy Health”

Climate change has both direct and indirect impacts on maternal health. The volatility, frequency, and severity of extreme weather events and environmental factors such as heat exposure, water quality, and air pollution are being exacerbated by a changing climate. As a result, climate change poses a risk to factors that are associated with health and wellness, such as clean water, food security, and stable housing. Global food security is threatened by climate change as extreme weather events like hurricanes, floods, droughts, and wildfires can destroy crops and decrease yields. Maternal malnutrition is consequently impinged by food insecurity and can lead to increased mortality risk, low birth rates, and obstetric complications. Exposure to extreme heat has been ascribed to an increased risk of preterm birth, premature rupture of membranes, low birth weight, and stillbirth. Dehydration due to sweating while the body thermoregulates to higher temperatures can influence the onset of early labor and prolong the duration of labor. Extreme weather events have been shown to have mental health effects on pregnant women. A study done after Hurricane Katrina found that the frequency of post-traumatic stress disorder (PTSD) and depression was significantly higher in pregnant women who had severe hurricane experiences, which can lead to negative pregnancy outcomes and adverse developmental effects for the newborn. After Hurricane Sandy hit in 2012, a study conducted by  Nomura et al. in 2022 revealed that prenatal exposure to stress induced by the hurricane led to elevated diagnostic rates of generalized anxiety disorder (53%) and attention-deficit/hyperactivity disorder (30%) in children.

Discussions on climate change and maternal health often give little attention to how racial and social disparities influence maternal health outcomes. For example, Black women are more likely to not have health insurance and often face obstacles to obtaining access to quality health care, thus making them particularly more vulnerable to environmental hazards and risk factors. Existing research supports the notion that climate change has disparate impacts on the maternal health of Black women. A study completed in 2017 found that in California, for every 10-degree Fahrenheit temperature increase, preterm birth increased by an average of 8.6%, and for Black women, the average increased to 14.9%. An additional study revealed that after an extreme weather event, Black women are more likely to report the loss of resources at a higher rate, resulting in an increased prevalence of postpartum depression after the climate disaster.

Although there is still much more that can be done, governmental efforts have taken strides in the right direction to incorporate maternal health in the discussion of climate change. For the first time, the latest Intergovernmental Panel on Climate Change (IPCC) report encompassing an overview of global climate change trends and projections mentions maternal health. In addition, Representative Alma Adams (D-NC), Representative Lauren Underwood (D-IL), and then-Senator Kamala Harris (D-CA), alongside members of the Black Maternal Health Caucus introduced the Black Maternal Health Momnibus Act of 2020. This piece of legislation works to mitigate adverse maternal health outcomes associated with climate change. Another bill, the Protecting Moms and Babies Against Climate Change Act, has been reintroduced by Representative Lauren Underwood and Senator Ed Markey of Massachusetts (D-MA). This particular legislation works to develop an all-inclusive strategy to identify areas with high risk of adverse maternal and infant health outcomes due to climate change, invest more federal funding in community-based organizations to address the risks, and advance research on climate change and maternal health. It also calls on the National Institute of Health to establish the Consortium on Birth and Climate Change Research to help identify climate change-related risks and work to end racial disparities.

Climate change knows no bounds and is a burgeoning matter of conversation and action to create a more conducive world for the health and well-being of women and their newborns. Governments can no longer stay idly by while witnessing the injustices that a changing climate inflicts on the maternal health of women on a global scale.

Jenna Van Holten is a MEPP student at Tufts University.