(Washington, DC) – Extreme heat exposure affects pregnancy and newborn health where higher temperatures are associated with increased rates of preterm birth and stillbirth as well as greater rates of hypertension in pregnant women, said Human Rights Watch today. Emerging research suggests care work, such as mothering newborns, is also negatively affected.
“In Sierra Leone we already have high rates of preterm birth, stillbirth, and hypertension in pregnancy, all of which are worsened by extreme heat, which is increasingly a problem in our country,” said Dr. Fatu Forna, an obstetrician-gynecologist and Executive Director of The Mama-Pikin Foundation.
Heat waves and extreme temperatures are becoming more frequent and intense due to human-induced climate change, primarily driven by the burning of fossil fuels. These elevated temperatures can trigger physiological stress responses in pregnant women, including altered blood flow to the placenta, dehydration, and inflammatory responses that can compromise maternal-fetal health outcomes.
Record breaking temperatures in recent years have contributed to the deaths of hundreds of thousands of people, and have adversely affected the health of many more, leaving vast numbers of people without adequate cooling solutions at serious health risk.
A recent study by the non-profit Climate Central found that between 2020 and 2024, Sierra Leone had an average of 33 more days than normal that were dangerously hot for pregnancy.
Research in Sierra Leone done by The Mama-Pikin Foundation and Human Rights Watch included group discussions with pregnant women and interviews with 20 providers, mostly midwives and doctors. Women interviewed reported being weakened by the heat, and heat rashes in babies.
They said they had to continue doing arduous work in extreme heat because of care responsibilities, subsistence agriculture, and the need to earn family income. Much of this work is unpaid and considered “women’s work.” Women also reported that unbearable heat at nights stopped them from sleeping under bed nets, crucial protection from malaria, which is especially deadly for pregnant people.
Health workers facing large workloads with minimal resources said that the heat provided added pressure, leaving them exhausted, overwhelmed, and irritable, affecting their care for patients.
Ongoing research in South Africa and Zimbabwe by the HIGH Horizons Project is finding ways to cool health facilities. The projects include research to better understand not only how pregnant women are harmed by heat but also how health workers’ wellbeing and capacity are corroded as temperatures rise. Extreme heat undermines health workers’ ability to provide attentive, respectful care, often resulting in shorter consultations and reduced patience, which compromises quality of care.
The HIGH Horizons Project is also developing an app, MotherHeatAlert, to help provide climate health information. The HAPI project, also carried out in South Africa and Zimbabwe, is investigating the acceptability and effectiveness of heat adaptation interventions for pregnant women and their children and showcases how heat exacerbates the suffering of women during labor.
“If you are in pain and it’s hot, it’s like it’s double pain,” one patient said.
HAPI has co-designed and is testing multilevel interventions at the individual, household, community, facility, and policy level. The Mama-Pikin Foundation has developed a climate literacy tool for pregnant and postpartum women in Sierra Leone and in Miami, work is ongoing to develop tailored advice for pregnant woman by doulas. Researchers at the University of California, Berkeley are working to understand how pregnant women in Bangladesh are harmed by heat and how low-cost residential cooling might help to mitigate these impacts.
“Organizations, communities, public health experts, and scientists are working together to find ways to offset damage from extreme heat and other climate impacts on maternal health and the next generation,” said Skye Wheeler, senior women’s rights researcher at Human Rights Watch. “But it’s unfair that pregnant women, their newborns, and those who care for them keep fighting harder and harder for survival as emissions continue to rise.”
