By The PPH Foundation
As climate change accelerates, its effects are increasingly visible not only in the environment but also in maternity wards. High temperatures, prolonged heat waves, floods, and food insecurity are quietly reshaping maternal health risks, with postpartum haemorrhage (PPH) emerging as one of the most concerning outcomes linked to climate stress. For women in low- and middle-income countries, where health systems are already stretched, climate-related risks can mean the difference between survival and death after childbirth.
Heat stress has been identified as a direct physiological risk factor for postpartum haemorrhage. Exposure to high ambient temperatures places significant strain on the body, altering fluid balance, increasing inflammation, and affecting uterine muscle function. These changes can impair uterine contraction after delivery, increasing the likelihood of uterine atony, the leading cause of PPH. Extreme weather events also disrupt access to essential maternity supplies, skilled care, blood, and timely referrals, compounding the danger during obstetric emergencies.
Beyond heat exposure, climate change indirectly increases PPH risk through its impact on food and water security. Droughts, floods, and crop failures contribute to malnutrition and anaemia, conditions strongly associated with poor pregnancy outcomes and severe bleeding during and after childbirth. Climate-related stressors have also been linked to higher rates of pregnancy complications such as pre-eclampsia, gestational diabetes, infections, placental disorders, and premature rupture of membranes, all of which elevate the risk of haemorrhage.
In Kenya, emerging evidence from hot coastal regions has reinforced these concerns. Research conducted in Kilifi County, an area that experiences persistently high ambient temperatures, has demonstrated a link between heat exposure and prolonged postnatal bleeding. These findings highlight how climate vulnerability intersects with maternal health risks, particularly for women living in already fragile settings.
Professor Julius Ogeng’o, a leading anatomist and maternal health expert, underscores the urgency of addressing climate risks within maternal health planning. He notes that climate change is no longer a distant environmental issue but a present clinical concern. According to Prof Ogeng’o, rising temperatures and extreme weather events affect maternal physiology, increase pregnancy complications, and place women at greater risk of postpartum haemorrhage, especially in settings where adaptation measures are limited.
Encouragingly, research also points to practical mitigation strategies. Heat adaptation measures such as reducing physical exertion during late pregnancy, ensuring adequate hydration, promoting cooling behaviours, and minimizing exposure to excessive heat can help lower risk. At the health system level, integrating climate awareness into antenatal care, strengthening early detection of PPH, and ensuring readiness during extreme weather events are becoming increasingly important.
As climate change continues to reshape health risks, maternal health responses must evolve. Protecting mothers from postpartum haemorrhage now requires not only clinical excellence, but also climate-sensitive policies, preparedness, and investment in resilience. Addressing climate change is therefore not just an environmental imperative, it is a maternal survival strategy.
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References
Chersich MF et al. Climate change and maternal health outcomes, International Journal of Gynecology and Obstetrics, 2023;160(2):421–429
Dambuya S et al. Climate variability, heat stress and reproductive health outcomes, Journal of Water and Health, 2025;22(11):2113–2131
Amepkor F et al. Climate change, food insecurity and maternal nutrition, Public Health Reviews, 2025;45:1607563
Lusambili A et al. Heat exposure and postnatal bleeding in coastal Kenya, BMC Pediatrics, 2024;24:36
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