The U.S. Is Facing a Maternal Health Crisis. Is Climate Change Making It Worse?

The U.S. Is Facing a Maternal Health Crisis. Is Climate Change Making It Worse?
5/16/2022 by Danielle Renwick
Soaring temperatures, air pollution and extreme weather contribute to adverse pregnancy outcomes—especially for women of color.

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Black and Brown communities are more likely to live in urban heat islands, work outdoors and breathe in polluted air. Black women are also 50 percent more likely to give birth prematurely and to underweight babies, and their pregnancies are more than twice as likely to end in stillbirth. (Pixabay / Creative Commons)


Esther McCant, a doula in Miami, has visited clients in sweltering apartments without air conditioning. She has seen them exhausted from long days working on their feet in the South Florida heat. In 2017, she even helped one client, who was well into her third trimester, evacuate during a hurricane. It was soon after she helped that client get safely to Georgia that she started thinking about the connection between climate change, extreme weather and the health of her clients.“It was then that I realized there’s not really a lot of guidance for pregnant moms during those types of situations,” McCant said. “In general, it’s every family for themselves.” McCant had become a doula partly out of a desire to help address another growing crisis.

The United States has the highest maternal mortality rate among developed countries, with nearly 24 deaths per 100,000 live births in 2020, according to national statistics. A recent report found a sharp increase in maternity-related deaths during the first year of the pandemic. The crisis is particularly acute for Black women like McCant: Black women are about three times more likely to die during pregnancy or shortly after birth than white women. They are also 50 percent more likely to give birth prematurely and to underweight babies, and their pregnancies are more than twice as likely to end in stillbirth. Hispanic and Indigenous women also have worse pregnancy outcomes than white women. There are a range of factors that contribute to these disparities—among them, barriers to access to care, higher levels of stress owing to systemic racism and discrimination in the medical system that leads to poorer care.

But experts are increasingly looking at climate-related environmental factors that also play a role in perpetuating the divide in maternal health. Exposure to extreme heat, hurricanes, flooding and wildfires, all of which are becoming increasingly frequent and intense due to climate change, are linked to preterm birth, low birth weights and other negative outcomes. Black and Brown women are the most affected, researchers say.
Black women are about three times more likely to die during pregnancy or shortly after birth than white women. A range of factors contribute to these disparities—barriers to access to care, higher levels of stress owing to systemic racism and discrimination in the medical system that leads to poorer care.
“When you do the digital analysis [of birth records], the racial health disparities come through very clearly,” said Dr. Nathaniel DeNicola, an obstetrician-gynecologist and co-author of a 2020 report that linked some effects of climate change to negative pregnancy outcomes.

Black and Brown communities are more likely to live in urban heat islands, work outdoors and breathe in polluted air, he said. “The way cities were designed for decades [poses] a disproportionate health risk to many minority communities.” It’s not just chronic exposures. Extreme weather, like flooding and wildfires, also disproportionately affects Black and Brown women. DeNicola completed his residency in New Orleans in the aftermath of Hurricane Katrina and now practices medicine in Southern California, which is prone to wildfires. He said these events tend to correlate with more pregnant people needing emergency care.
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