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US National Climate Report Highlights Climate Harms to Pregnancy, Newborns

Phasing out Fossil Fuels and Targeting Racial Inequities in Maternal Health Urgently Needed

A doctor examines a pregnant woman to measure the heartbeat of the fetus, Jackson, Mississippi, US, December 17, 2021.  © 2021 Rogelio V. Solis/AP Photo

(Washington, D.C.) – The US government should direct environmental justice funds from President Biden’s climate law to protect pregnant people and address reproductive justice in communities most at risk, a group of organizations said today. The group of mostly maternal health rights organizations called for the US to phase out fossil fuel operations in the US, and better regulate products derived from fossil fuels with known harms to fetal development and other maternal health.

Studies on how the climate crisis is harming maternal health impacts are included in the US government’s congressionally mandated fifth National Climate Assessment published today. For the first time the assessment included a sub-section on women’s health, noting not only that “pregnant cisgender women are particularly vulnerable because exposure to heat, particulate matter, and disaster-associated stressors leads to poor pregnancy outcomes, including miscarriages and low birth weight” but also that “[t]hese outcomes are more likely in groups that have been marginalized, particularly Black pregnant people, exacerbating existing social inequities. The report also noted climate impacts contribute to US maternal mortality rates, which are high compared to other industrialized nations and rising.

This assessment, other scientific and medical studies, and lived experiences in low income communities show biological and socioeconomic vulnerabilities during pregnancy to air pollution, climate disasters and other environmental harms, including fracking and other fossil fuel extraction. In one example of how climate changes drive racial inequities, studies show that extreme heat has adverse effects during pregnancy, with Black pregnant people especially affected.

“Extreme heat, wildfire smoke and disaster exposure  have negative impacts on pregnant people and newborn health with lifelong health consequences,” said Zainab Jah, senior analyst at RH Impact, a Black-led reproductive justice organization. “Climate impacts are deepening unjust inequities between Black, Indigenous, and people of Color (BIPOC) pregnant people and their white counterparts, who already get better maternal health outcomes across income levels.”

In addition to RH Impact, organizations making today’s call include Metro Mommy Agency, the March of Dimes Mom and Baby Action Network, the National Association of Nurse Practitioners in Women’s Health (NPWH), Nurturely, and Human Rights Watch.

The US is in a deepening maternal health crisis, with rates of preterm birth rising, along with the number of maternal deaths, severe morbidity and some maternal health illnesses.

Disparities between preterm (premature) birth, low birth weight, still birth, maternal illnesses, and infant deaths between Black and white women are particularly pronounced. According to 2021 US Commission on Civil Rights research, white advantages are in part a result of white pregnant people being better-treated in the maternal health system than Black pregnant people.

Other communities of color also face worse health outcomes than white communities. New provisions US government data released in November shows that US infant death rates increased three percent (in 2022 over 2021). This represents the largest percentage increase in two decades, accoding to the March of Dimes, a maternal and newborn health organization, noting: “[w]hile infant mortality increased for nearly all racial and ethnic groups, American Indian/Alaskan Native [AIAN] and Black families face significantly higher risk, a trend we also see in preterm birth, as well as maternal mortality and morbidity. While AIAN infants saw a staggering 21% increase last year, the infant mortality rate for Black babies is the highest among all other groups.”

Climate change is linked to more frequent and more serious weather and climate disasters, according to the National Oceanic and Atmospheric Administration, and 2023 has already seen record-breaking 25 such disasters causing more than US$1 billion dollars in damages (the 1980 – 2022 average is 8.1 such events, but the last three years have averaged 20 such events a year). Black and other US residents of color bear a greater burden from flooding, extreme heat, and other climate harms.

Pregnancy, birth and the postpartum periods are extremely relevant to the lifelong health of the pregnant person and newborn. These periods, however, also place significant pressure on the health of the pregnant person. This and the extreme vulnerability of the pregnant person’s developing fetus makes pregnancy a period that is especially sensitive to environmental factors, with implications across the life course both for the pregnant person, including the fetus, and for newborns.

“We have seen US federal and state governments begin to grapple with the fact that the climate crisis is having a significant impact on human health,” Aver Yakubu from Nurturely said. “But what we are not seeing is authorities getting resources to perinatal community health workers or doing the big scale information campaigns needed.”

For instance community doulas, nonclinical health workers who provide allyship and presence including physical support during birth are trusted health workers in their community and may be well-placed to provide individualized information about simple and affordable ways pregnant people can protect themselves from climate harms, like wildfire or heat exposure and available resources. According to national and global studies, increased access to doulas was associated with higher rates of vaginal delivery, breast- or body feeding, and improved parenting skills as well as lower rates of C-sections, premature births, low birth weight infants, newborn deaths, use of analgesics, and medical interventions.

The Inflation Reduction Act (IRA) provides over US$300 billion to help decarbonize the US economy and also provides nearly US$46 billion for environmental justice programming, a vast increase on earlier government disbursement to address environmental health inequities in the country.

Federal agencies overseeing grantmaking, including the Environmental Protection Agency should allocate some of these funds to community-based support health workers with direct access to pregnant people and communities to increase knowledge and individual and community action to protect pregnancy health.

The US government should also prioritize pregnancy and newborn health inequities both in the US and in low income countries at the United Nations Climate Change Conference (COP28) in November and December, where countries make commitments to cut carbon emissions and address some of the worst harms from the climate crisis.

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