Climate protest sign that reads "no nature no future."

Climate Change and Pregnancy: Policies for Impact

By Cydney Murray

The ongoing, worsening environmental crisis is exacerbating negative pregnancy outcomes associated with climate change.

Exposure to air pollutants, such as smog (ozone) and PM2.5 (another type of air pollution), is linked to impaired fetal growth, increased likelihood of cancer, autism spectrum disorder, stillbirth, and low birth weight. These health consequences have the potential to impact children’s overall quality of life by affecting their brain development, and their susceptibility to disease.

Climate change is worsening this established association, particularly for those living in urban environments with high air pollutant exposure. This disproportionately affects women of color, since they are more likely to live in more highly polluted areas, and already suffer a higher risk of negative pregnancy outcomes.

And as climate change increases temperatures in communities across the country, this also poses a risk to pregnant people. Research reflects a correlation between extreme heat exposure and an increased risk of negative pregnancy outcomes, particularly among women of color and women with low incomes. An increase in cardiovascular output is a common mechanism the human body utilizes to cool itself down, but it is especially risky for pregnant women, since pregnancy already puts a strain on the cardiovascular system. Further, exposure to extreme heat can damage a pregnant woman’s placenta and developing cells.

Despite evidence of the association between climate change, air pollution, and extreme heat, researchers find that the general public is not well-apprised of this public health concern.

And the potential to make an impact through policy work seems dubious. Previous governmental bans on the use of certain toxic chemicals have, ironically, led to the substitution of equally, if not more, harmful chemicals. Also, while the Environmental Protection Agency (EPA) established National Ambient Air Quality Standards, which regulate air pollutants such as PM2.5, it is difficult to ascertain the efficacy of such regulations, since a threshold for safe exposure to PM2.5 has not been established. Further, an objective of the Clean Air Act is to prevent and reduce harm experienced by sensitive groups, yet the EPA does not provide protection directly for pregnant women. Finally, women aren’t categorized as vulnerable to extreme heat by the health and emergency departments in 25 of our nation’s most populated cities, nor by the Centers for Disease Control and Prevention (CDC). Similarly, they are not identified as a vulnerable population by the CDC’s webpages on Ozone and Your Health and Particle Pollution.

Laws and policies advocating for patient rights, and working to address the causes of climate-related dangers, are needed, and some have begun answering that call.

The International Federation of Gynecology and Obstetrics (FIGO) issued a policy statement in 2015 advocating for policies that reduce air pollution emissions, divest from fossil fuels, and reduce exposure to toxins. Domestically, the 100% Clean Economy Act of 2019 was introduced with the goal of achieving an economy with zero climate pollution by 2050, and the very similar Clean Economy Act of 2020 was introduced shortly thereafter. Currently, the CDC notes that particle pollution is associated with low birth weight and other negative birth outcomes and recommends consultation of public reports based on the EPA’s Air Quality Index (AQI). The EPA similarly recommends that pregnant women consult its Air Quality Index (AQI) prior to engaging in outdoor activities.

As attention on this public health concern increases, advocates such as Catherine Garcia Flowers are pointing to the government’s failure to adequately regulate air pollution as a form of systemic racism, as Black mothers are at a greater risk of experiencing these negative health consequences. More work must be done to address the systemic causes of issue and to mitigate its harmful effects.


Cydney Murray is an intern for the Temple University Center for Public Health Law Research. She is a student at the Temple University Beasley School of Law.

Temple University Center for Public Health Law Research

Based at the Temple University Beasley School of Law, the Center for Public Health Law Research supports the widespread adoption of scientific tools and methods for mapping and evaluating the impact of law on health. It works by developing and teaching public health law research and legal epidemiology methods (including legal mapping and policy surveillance); researching laws and policies that improve health, increase access to care, and create or remove barriers to health (e.g., laws or policies that create or remove inequity); and communicating and disseminating evidence to facilitate innovation.

Leave a Reply

This site uses Akismet to reduce spam. Learn how your comment data is processed.