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Esther McCant is a Miami doula who has visited clients living in hot, un-air-conditioned apartments. She has seen clients exhausted from the heat of South Florida. One of her clients, who was well into her third-trimester, was even helped to evacuate during a hurricane in 2017.
She helped her client get to Georgia safely. Soon after, she began to consider the links between climate change and extreme weather and clients’ health.
“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 became a doula partly to help with another growing crisis.
The United States has one of the highest rates of maternal mortality among developed countries. There were nearly 24 deaths per 100,000 live-born births in 2020. Statistical data for the nation. A recent report showed that the number of maternal deaths due to the pandemic increased sharply in the first year.
McCant, a Black woman, is particularly affected by the crisis
Black women are three times more likely than white women to die in pregnancy or shortly after giving birth. They also make up 50 percent more likelyTo give birth prematurely or to have underweight babies. Pregnancies are also prohibited. More than twiceAs likely to give birth in stillbirth. Hispanic and Indigenous women also have worse outcomes in pregnancy than white women.
There are many options. There are many factors to consider that contribute to these disparities—among them, barriers to access to care, Stress levels that are higherDue to systemic racism, and DiscriminationPoorer care is a result of the medical system.
Experts are now focusing on climate-related environmental factors, which can also play a role for perpetuating the gender gap in maternal health. Preterm birth, low birth weights and other adverse outcomes are all linked to exposure to extreme heat and flooding. Researchers say that black and brown women are most affected.
“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 reportIt was found that some climate-related effects could lead to poor outcomes for pregnant women.
He said that black and brown communities are more likely than white to live in urban heat island areas, work outside, and breathe in polluted atmospheres. “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 wildfires and flooding affects Black and Brown women more than other races. DeNicola finished his residency in New Orleans after Hurricane Katrina. Now, he practices medicine in Southern California that is susceptible to wildfires. These events are associated with more pregnant women needing emergency care.
“When there’s a natural disaster—a source of extreme stress—and you have to leave a city without knowing where you’re going to next, [that] increases triage visits and these adverse outcomes, like preterm births,” he said. (The paper did find no direct link between environmental factors, maternal mortality, and other factors.
“With preterm delivery or low birth weight, we know that there are so many other issues that can develop throughout childhood and even into adulthood,” said Rupa Basu, an epidemiologist and co-author of the report. She said that these ailments include neurological and cognitive impairments as well as heart defects and respiratory problems.
Yet there’s Little federal or state guidanceHow pregnant women can prepare for climate emergencies such as extreme heat. 2020 Buzzfeed Report found that of the country’s 25 largest cities, only two—Chicago and Philadelphia—specifically included pregnant people in their online heat and safety plans. Additional cities, such as New York and Miami have added guidelines for pregnant women.
The need to consider pregnant women in climate plans is becoming a more prominent concern for policymakers. This year, the Intergovernmental Panel on Climate Change report issued guidelines for pregnant people for the first time, and the Biden administration—following the urging of advocacy groups—mentionedClimate change as a matter of gender justice.
Kelly Davis, executive director of KINSHIFT, a reproductive justice organization, says those are encouraging gestures that she’d like to see backed up by funding. “I’m really looking forward to seeing an increase in dollars related to the research around structural racism and exposure to environmental hazards during pregnancy and the postpartum period for families of color,” she said.
To that end, Representative Lauren Underwood (D–Ill.) A bill called the Protecting Moms and Babies Against Climate Change Act (D-Ill.) was cosponsored by Representative Lauren Underwood (D.Ill.). It is part a larger package of legislation aimed to reduce disparities in maternal health known as The Momnibus. The climate bill would, among other things, fund research into the effects of climate change on pregnancy, increase postpartum access to Medicaid, and expand pregnant workers’ rights.
“It really does have the potential to save lives, but it’s just the first step,” Davis said. She stated that policy-makers are only scratching the surface in understanding the effects of the environment on birthing.
McCant, a Miami doula is also a mother to four children. McCant did not experience any complications during her pregnancies and births, but she considers that she is an anomaly. “I was fortunate to have a space where the lights stayed on and the AC was running,” she said. “For some folks, it’s not that simple.”
The majority of McCant’s clients are Black, and about 60 percent are on Medicaid. She said one of the biggest reasons clients approach her is because they don’t feel heard in the doctor’s office. “There are gaps in care,” she said. “[Clients]Spend seven, eight, or fifteen minutes with their provider. That’s not enough time to provide an education on a particular issue.”
She said that her experience with clients during successive heat waves, hurricanes, and other extreme weather has taught her the importance and necessity of providing proper guidance on how best to stay safe and hydrated in these conditions. She is connecting advocacy groups to a growing network of doulas to help them train in how to coach pregnant women through extreme heat and hurricanes.
“We are the trusted messengers for these families,” she said. “We want to make sure that we’re talking about [climate] and giving them really good information.”
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