s temperatures soar across Africa, the most vulnerable in society – mothers and infants – find themselves at heightened risk. Matthew Cherisch, an expert in climate change and maternal health, provides insights into the critical challenges faced by expectant mothers and newborns in this era of escalating heat.
The Vulnerability of Pregnant Women to Extreme Heat
A significant portion of women in Africa grapple with limited protection against the perils of extreme heat, with pregnancy emerging as a particularly vulnerable phase. High ambient temperatures can overwhelm a pregnant woman’s ability to regulate her body temperature effectively. The phenomenon is compounded by various factors, including the heat generated by fetal metabolism within the mother’s body. Moreover, the added weight gain during pregnancy, heat-retaining fat deposits, and the exertion endured during labor and childbirth place additional stress on expectant mothers.
Notably, a developing fetus tends to maintain a temperature approximately 0.5℃ warmer than the mother. Consequently, if a pregnant woman experiences heat stress or fever, the fetus’s temperature can rapidly escalate to perilous levels. The most precarious period is often during childbirth, where the mother generates substantial heat, and in cases of concurrent heatwaves, complications such as prolonged labor, increased emergency caesarean sections, and maternal hemorrhage may ensue.
The Vulnerability of Infants
Infants, entirely reliant on caregivers for protection from heat exposure, face a unique set of challenges as global temperatures rise. Certain practices, like excessive swaddling, pose considerable risks in this context. Dehydration becomes a major concern among young children, driven by water loss through sweating and an increased prevalence of food- and water-borne pathogens in warm weather.
Mothers may supplement breastfeeding with water, which can be problematic in areas where water safety is compromised due to inadequate infrastructure. Furthermore, hot weather can make breastfeeding uncomfortable for both mother and child, leading to shorter breastfeeding durations, as evidenced by a study in Burkina Faso, where breastfeeding periods were approximately 25 minutes shorter on hot days compared to cooler ones.
Quantifying Climate Change’s Impact on Pregnant Women and Infants
While we can calculate the relative risk of adverse birth outcomes, such as preterm birth, during heatwaves (a 1.15-fold increase), quantifying the absolute number of additional adverse outcomes attributable to climate change remains a challenge. Nevertheless, understanding these figures is crucial to grasp the full implications of climate change on maternal and child health. Alarming statistics from some studies indicate that without significant reductions in carbon emissions, heat-related child mortality in Africa could surge to over 38,000 annually by 2049.
For instance, research conducted in Johannesburg revealed an alarming 80% increase in severe hypertensive disorders in pregnancy when temperatures exceeded 23℃ in early pregnancy.
Distinguishing Health Impacts on Mothers and Children
While the detrimental effects of extreme heat on pregnant women are well-documented, distinguishing how much of this added disease burden can be attributed to climate change versus natural temperature variations remains a challenge. Nonetheless, ongoing developments in methodologies are enhancing our ability to make this distinction. What is clear is that if South Africa experiences temperatures akin to those witnessed in Europe and North America in 2023, thousands of additional pregnancy complications will be directly linked to climate change.
Practical Solutions in the Face of Escalating Heat
Several cost-effective “cooling” interventions could be deployed on a large scale, provided that high-income countries fulfill their climate financing commitments. While annual promises of $100 billion were made in the 2015 Paris Agreement, only a fraction of this amount has been delivered to date. Low-cost solutions include applying reflective white paint to roofs, distributing fans with evaporative cooling, ensuring access to cool water during labor, and establishing “cooling centers” where women can seek refuge during heatwaves.
