Climate change is making pregnancy and childbirth more difficult in areas of the world most vulnerable to extreme heat. In Mumbai, the summer of 2022 was unbearably hot, with daytime temperatures reaching as high as 38 degrees Celsius (104 degrees Fahrenheit), causing 23-year-old Madhuri Bolke to suffer from sleep deprivation and even considered abortion at one point.
“Even with the fan on full speed, I had a hard time falling asleep,” he recalls. I often wake up in the middle of the night. Finally, he spoke to Bharti Kamble, a community health care worker in Bolkewadi. Kamble recommends returning to the villages, which are generally cooler and wetter than Mumbai. In the third week of February, Bolke returned to the village seeking respite, but the heat followed her there.
Over the next two weeks, as Bolkewadi experienced intense heat, Bolke's hemoglobin (the protein in the blood that carries oxygen throughout the body) dropped to 6 grams per deciliter, which is normal for a woman of childbearing age and well below 12-16 gram. Low hemoglobin during pregnancy can harm a pregnant woman's health and increase the risk of premature delivery or a low birth weight baby.
As the hot weather disrupted Bolk's sleep, he began to suffer from severe headaches and difficulty digesting food. After several doctor visits, it was discovered that sleep deprivation (a risk factor for low hemoglobin) was the culprit.
“As nighttime temperatures rise, it takes longer for people to fall asleep and stay rested,” said Kelton Miner, a postdoctoral research scientist at Columbia University's Data Science Institute who was not involved in Bolk's treatment. . Minor is the lead author of a 2022 study published in the journal Forest Earth that found that people living in the hottest areas, such as Colombia, Saudi Arabia and India, were living in warmer climates for every degree of increase in nighttime temperatures. People in cooler areas lost twice as much sleep. Other studies have also found that not getting enough sleep during pregnancy increases the risk of preterm birth and other problems, such as preeclampsia, low birth weight, C-sections and pregnancy diabetes. In a study published in the International Journal of Obstetrics and Gynecology, researchers found that sleep deprivation at 36 weeks of pregnancy was associated with a significant risk of postpartum depression.
As the climate continues to warm, millions of people could be affected. In India alone, there are more than 378 million women of childbearing age. Heat isn't the only form of extreme weather getting worse as climate change accelerates: Flooding is also becoming more severe in many places, making it more difficult for women to give birth during disasters.
The One Earth study found that “people actually start waking up earlier in the summer, suggesting that heat not only causes people to fall asleep later but also shortens overall sleep time,” Miner said. “This makes people more likely to sleep less at night – which poses adverse risks to mental and heart health.”
Miner's paper analyzed more than 7 million sleep records from more than 47,000 people in 68 countries around the world. Researchers looked at whether people made up for lost sleep during a week in the summer, but they found that people slept less than usual during this seven-day period.
They found that adapting to the heat didn't help: “When we additionally studied whether people adapted to the summer, we were surprised to find that people slept slightly more in late summer, even though the hot weather was now behind us.” More cognitive familiarity ,” Miner explained.
Pregnant women need seven to nine hours of sleep a day, according to the National Sleep Foundation, a U.S. non-profit organization. In the summer of 2022, however, Bolk typically slept less than six hours.
Just seven months later, she went into labor, and a doctor at a private hospital warned that he would either save Bock or the baby. Community paramedic Kamble took them to a public hospital, where doctors successfully saved the lives of mother and child.
Because she was born prematurely, surgery was very difficult. Somehow, she survived and was hospitalized for 15 days. Kamble said.
“One of the main reasons she was facing so many problems was that she wasn't getting enough rest and sleep during her pregnancy,” Kamble said. through more complex cases. “Now, with the added heat, that's going to get more complicated.”
Bolk's baby was also underweight, and he wasn't immediately vaccinated against tuberculosis, polio and hepatitis B, leaving the newborn vulnerable to those diseases. The child becomes healthy over the next 15 months.
Pregnant women suffer from insomnia Another big threat from climate change: extreme flooding. In August 2019, 26-year-old Vrushali Kamble, who lived in Ganeshwadi village in Maharashtra, was warned of impending floods two days before her child was born.
“I immediately went to the public school, which was converted into a makeshift evacuation center,” she said. Within hours, his house was flooded, taking all his belongings with it, and the water did not recede for the next 15 days.
“I couldn't sleep those two days,” she recalled. Without adequate evacuation centers, at least 30 people were crammed into a 10-by-10-foot classroom with peeling plaster and cracks in the walls.
When she started experiencing labor pains one morning, community paramedic Chhaya Kamble immediately arranged for an ambulance. Chhaya Kamble, who is not related to Bharti Kamble, said: “We crossed the state border and took her to neighboring Karnataka because all the hospitals here were closed due to Inaccessible due to flooding.
It took them an hour to reach the Kargwad village in Karnataka, where Urushari gave birth to a girl named Virat. The baby was underweight and later died from liver disease, which had nothing to do with the stress the mother experienced during pregnancy.
Creative solution of need
Chhaya Kamble, who has more than 14 years of experience in helping pregnant women, said that in the past four years, almost every pregnant woman in her village has faced insomnia. “This is due to fear of flooding, rapid changes in local weather patterns and rising nighttime temperatures preventing them from adapting,” he said.
What worries him most is how people view this serious crisis as normal. “Most family members believe it's normal for pregnant women to not get enough sleep.” Now, the first question she asks all pregnant women is whether they're getting enough sleep. At least it raises awareness of the problem, even if it doesn't solve it.
Her experience helping Bolk made Barty Kamble more cautious. She created a WhatsApp group of pregnant women from her village, where they posted information about the dangers of rising temperatures. She also went door-to-door to educate every woman and family in the village about the dangers of rising temperatures. Now, both she and Chhaya Kamble start their days by monitoring the temperature and checking the weather forecast.
Fans, cold showers and wet clothes can help pregnant women sleep, said Nick Obradovich, chief scientist for environmental mental health at the award-winning Brain Institute in Oklahoma and co-author of the article published in One Planet. Supplies can be removed. These measures are important in India, where only 13% of households have air conditioning, and even fewer in rural areas.
“Ultimately, policymakers should work to provide cooling center resources to vulnerable groups, especially the elderly, and use air conditioning and electricity where possible,” he said. “Low-carbon energy sources should also be prioritized.”
His co-author, Miner, suggested that changing roof materials could help cool buildings. “Researchers and engineers have shown that creating cool, reflective ceilings can help lower temperatures not only on the ceiling, but also in the room below.”
As temperatures begin to rise again in many parts of India, Bolke will return to her village to escape the Mumbai heat.
“Growing up, summer has been a time for vacation, but now even going out in summer has become dangerous. I didn't know that rising temperatures would completely change my life,” Bolk said. They worry about losing more sleep this year.
