How heat exposure is a serious pregnancy risk and India should be on high watch

Some 2.9 billion women and girls now live in countries rated highly or very highly exposed to climate change and geophysical hazards, according to the UN Women's Gender Snapshot 2026. An international survey released on October 5 shows what that exposure may look like inside a maternity ward.Commissioned by the Wellcome Trust, a global charitable foundation, and conducted by pollster Censuswide, the survey asked 1,001 healthcare professionals in pregnancy, childbirth and newborn care across India, the UK, Australia, Brazil and Zimbabwe what extreme heat is doing to their patients.Seventy-three per cent of the respondents said heat-related cases or complications among pregnant women had risen over the past five years. Seventy-six per cent reported a similar rise in foetal and newborn health problems. Nearly all, 98 per cent, said they had personally treated a pregnant woman whose health they believed had been harmed by heat.The poll records what health workers have seen and believed, not clinical case records, and its authors caution against reading it as proof of cause. Its 200 Indian respondents came from an online, English-language panel, and the results are unweighted. But the pattern it describes matches a growing body of peer-reviewed evidence. A 2020 meta-analysis by a team of researchers led by Matthew Chersich, and published in the international medical journal The BMJ, found that the odds of preterm birth rise by roughly 5 per cent for every 1°C increase in temperature, and by about 16 per cent during heatwaves.Back home, researchers at Chennai's Sri Ramachandra Institute of Higher Education and Research followed 800 pregnant women doing moderate to heavy physical work across Tamil Nadu. Women whose workplaces crossed safe heat-stress limits were more than twice as likely to miscarry as those working in cooler conditions. They were also more than twice as likely to suffer an adverse pregnancy outcome—from preterm birth and low birthweight to stillbirth.That finding matters in India where most working women hold informal jobs on farms, construction sites, brick kilns and salt pans. Their employers have no obligation to cool them, rest them or pay them when they stop working.“Extreme heat is an invisible killer, but pregnant women must not be invisible,” said Julia Gillard, chair of Wellcome and a former prime minister of Australia.The health workers surveyed say they are not equipped for what they are seeing. Ninety-two per cent want more training and resources to protect pregnant women in extreme heat while 55 per cent said clearer national or international guidance would help. More than a quarter said heat was making it harder for women to reach care at all, and 29 per cent reported more urgent or emergency presentations.The UN Women report helps explain why that guidance has been slow to arrive. Women hold just 26.3 per cent of health ministerships worldwide, 27 per cent of environment portfolios and 12 per cent of those covering energy, natural resources and mining. These are the posts that sign off on heat action plans and adaptation budgets. Women's health attracts only about 6 per cent of private healthcare investment, and development assistance for health is projected to fall by 29 per cent to 46 per cent between 2024 and 2026.“Climate finance rarely reaches women,” says Dhun Davar, deputy CEO and chief of programmes at AVPN, a network of philanthropic, public and private funders working across 43 markets in Asia. “Capital flows to large, bankable projects that have formal collateral, credit histories and established networks.”Most women dealing with climate shocks are farmers, self-help group members and small entrepreneurs who have none of these. “If finance cannot reach women where resilience is being built, it cannot build inclusive climate resilience at scale,” says Davar.Gujarat may become a test case for one response. The Self-Employed Women's Association (SEWA) plans to launch HERA Materna, billed as the first parametric insurance product designed for pregnant women, in Gujarat and Delhi in 2027, covering about 30,000 women. Parametric policies pay out automatically when a pre-set trigger—in this case a temperature threshold—is crossed.HERA Materna's payouts are designed to kick in at lower temperatures than standard heat cover. The idea is that women can stop work, find cooling or see a doctor before harm sets in. The campaign notes that women in India's salt pans, who once stopped working around the seventh month of pregnancy, increasingly work later to support their families.Ahead of the 31st United Nations Climate Change Conference (COP31) next month, researchers in the field want pregnant and postpartum women written into national adaptation plans, with funded and accountable measures. They want the WHO's first clinical guideline on heat, pregnancy and the postpartum period. And they want heat exposure built into maternal death surveillance systems.Subscribe to India Today Magazine- Ends