In 2024, the world reached an alarming milestone: the hottest global temperatures ever recorded. Floods, heat waves, tropical storms, hurricanes, droughts, and wildfires are affecting everyone, everywhere, with devastating consequences. 

But behind the headlines of environmental catastrophe lies a quieter crisis: the health impacts of climate change on women, families and newborns, and the health providers at the forefront of this crisis.

Sexual, reproductive, maternal, newborn, and adolescent health (SRMNAH) needs don’t pause during crises. Babies are still being born, and women and girls can’t wait for care – whether it’s for contraception, treatment for a sexually transmitted infection (STI), or comprehensive abortion care. 

Midwives can provide up to 90% of essential SRMNAH services, even in the most challenging circumstances. Yet their voices are often left out of global climate discussions, and their potential as climate resilience leaders is overlooked.

Minimal infrastructure

“As the world becomes progressively more unstable over time, which it will, having care providers who can operate with minimal infrastructure to deliver care to clients will become increasingly important,” said a Canadian midwife in a new report by the International Confederation of Midwives (ICM). 

“Midwives are ideally positioned to provide flexible sexual and reproductive health and perinatal care to vulnerable populations. We are the face of climate mitigation.”

The report highlights the far-reaching health impacts of climate change and the critical role midwives are already playing in addressing them. It also showcases their vision for building climate-resilient health systems and calls on governments and policymakers to recognise midwives as integral to climate resilience.

Impact of extreme heat

Midwives are experiencing first-hand the effect of heatwaves, floods, and other disasters on their patients, with increasing risks of preterm births, stillbirths, and maternal complications like dehydration and postpartum haemorrhage.

“Extreme heat is contributing to increased stillbirth rates, postpartum haemorrhage, and stunting,” shared a midwife from Ethiopia.

Three-quarters of respondents agreed that climate change is harming the communities they serve. These challenges hit marginalised and low-income populations hardest, where access to healthcare is already limited. 

“Low-income communities are more severely affected when there are heat waves. And women are at higher risk of dehydration and preterm labour as a result,” shared one respondent.

Displacement caused by climate disasters adds another layer of inequity. 

A midwife from Ontario, Canada, noted: “Forest fires in my country have displaced Indigenous people from their land. They already face removal from their community to give birth and access care.”

Midwives are already responding

Midwives are not passive observers of the climate crisis; they are active responders. From delivering care during floods and heatwaves to educating families about health risks, midwives are already adapting to the challenges posed by climate change.

“Midwives are vital agents of change in building climate resilience in vulnerable communities. Their multifaceted contributions are critical … they tirelessly educate communities about the health risks of climate change, promote adaptation strategies, provide emergency care during disasters, and integrate sustainable practices within healthcare facilities,” said a midwife from Kenya.

Respondents often reported using their time with clients to discuss environmental health, with 39% doing so regularly. However, 31% expressed a desire to engage in these conversations but felt they lacked the necessary information to do so effectively.

This vital work often comes at a personal cost. The report revealed that 76% of midwives said the climate crisis negatively impacts their work, leading to stress, burnout, and displacement. 

As one Ugandan midwife shared, “I am not able to provide services as I want, and this has affected me psychologically.” 

A sustainable model of care

Continuity of midwife care offers a sustainable model of care that aligns with global climate goals. Unlike resource-heavy obstetric models, midwifery puts women at the centre of care, while relying on fewer interventions, producing less medical waste, and being inherently community-focused.

“As midwives, we are low tech, high touch,” said a midwife from Australia. “We should continue to advance midwifery as climate activists because [midwifery is] good for the environment.”

Midwives are resourceful in their approach. “Midwives are judicious with their use of resources and resilient and resourceful with limited equipment and facilities,” noted a midwife from Australia. 

“Midwife-attended births at home, for example, generate significantly less waste than a similar birth in a hospital setting and are therefore much better from an environmental perspective.” 

There is an extensive body of research that shows that in health systems where midwives are enabled and integrated, this type of care gives excellent outcomes.

Midwives also empower women to build their resilience. Through education and support, midwives help women make informed decisions about their health, fostering long-term stability for their families and communities.

An Ethiopian midwife noted, “Midwifery care offers a unique approach to supporting women and families in a climate-changing world. Their focus on community, resilience, and holistic care positions them as key players in ensuring healthy pregnancies and births even amidst growing instability.” 

Call to action

Midwives are key to addressing the health challenges of climate change and building sustainable, climate-resilient health systems. Yet, they remain excluded from most national climate strategies. 

Governments and policymakers must urgently integrate midwives into climate preparedness and response planning processes. This includes ensuring midwives are part of the process, and that when crisis strikes, they have the training, tools, and resources they need to address climate-related health risks and establish referral pathways and transport systems to use when needed.

The climate crisis is a public health emergency that demands immediate, coordinated action. National health strategies, especially those addressing climate resilience, cannot succeed without recognising the vital role of midwives.

The stakes couldn’t be higher. As one Canadian midwife aptly said: “It is hard to remain hopeful in a context where science demonstrates that we have a tiny window to act, but our leaders are not taking the necessary action.”

The time to act is now – for midwives, for the women and families they serve, and for a healthier, more resilient future.

Sandra Oyarzo Torrez is President of the International Confederation of Midwives

Ana Gutierrez is Communications Lead at the International Confederation of Midwives

Image Credits: International Confederation of Midwives.