Climate change affects everyone. The burning of fossil fuels emits greenhouse gases which trap the sun's heat and raise temperatures. Tropical countries such as Bangladesh are more susceptible to the aftereffects of climate aggregating activities. This is why there has been more frequent extreme weathering leading to flooding, forest fires, and sea level rises in recent years (Desk, 2023). Despite these major incidents, climate change has been slowly affecting us in ways that are faint and unnoticeable but are still resulting in deadly outcomes such as degradation of ozone layer, increasing dangerous particulate matters in air, contamination of water, and the spread of infectious disease such as zika virus and dengue fever. One of the implications of climate change is air pollution. For the past two years, the air quality in Dhaka has been "unhealthy" with no signs of getting better, it is the biggest environmental risk to health (Nahian et al., 2023). Dhaka is 13.3 times above the recommended limit established by the WHO (AQI). Vulnerable groups such as the elderly, children, and pregnant women are more susceptible to the implications of rising air pollution.
Pregnant women, living in such urban areas, disproportionately suffer as air pollution negatively impacts embryonic development at genetic and epigenetic levels (Vecoli et al., 2016). Maternal exposure to such environments has been associated with premature births, low birth weight, poor lung development, mortality due to respiratory infections, and inhibited cognitive development. The mental toll this has on pregnant women is significant, knowing their children are prone to such disadvantages which are outside of their control is heart-breaking. The excessive air pollution from vehicles and industrial activities in Dhaka also weakens their own respiratory health leading to respiratory problems, difficulty breathing, and excessive coughing. Experiencing these symptoms makes pregnancy even harder and reduces their overall mobility.
To add on, air pollution has also been linked to cardiovascular diseases. Pregnant women are particularly vulnerable to these risks because they undergo cardiovascular changes during pregnancy (Samuels et al., 2022). Therefore, pregnant women are even more prone to complications such as preeclampsia and gestational hypertension, serious blood pressure conditions that can develop during pregnancy. Extreme heat is another consequence of climate change. Last summer the temperatures soared to 41 degrees Celsius, and the Bangladesh Meteorological Department has warned that there is no end in sight for these extreme heat episodes (Paul, 2023). These long and severe heat waves are worsened in enclosed bustling areas like Dhaka. This increases dehydration and heat stress in pregnant women because pregnancy increases their body's metabolic rate and heat production (Samuels et al., 2022). This puts the mother at higher risk of heat exhaustion and heat strokes as well as disrupted foetal development. Studies have shown the association between maternal heat exposure and cardiovascular abnormalities and other birth defects (Samuels et al., 2022).
The myriad of health complications that climate change leads to, has compromised the availability of medical facilities. There has been more demand for the cardiovascular and respiratory services. This means that pregnant women are unable to swiftly manage their healthcare needs during their pregnancy and such environments may deter them from seeking out medical help. Already the percentage of women taking the recommended four or more antenatal care visits declined from 46% in 2017 to 41% in 2022 so medical facilities can not be further burdened for pregnant women (National Institute of Population Research and Training & ICF, 2023).
Climate change is also leading to water quality issues. Natural disasters such as the droughts and flooding that have been taking place in Dhaka, destroy or contaminate water supplies with diseases like cholera and typhoid. Water quality is further exacerbated by rising temperatures and sea levels leading to the water being prone to dangerous pathogens (Raza and Khan., 2002). Drinking contaminated water poses serious health risks to pregnant women especially because their increased water retention and reduced stomach acidity during pregnancy increase their risk of infection with waterborne diseases (Common Pregnancy Pains and Their Causes, 2002). Water is essential to everyone, so if proper salination is not conducted then people are left with no other choice but to consume and use contaminated water.
Despite there being a lack of data measuring the link between climate issues and women's health, we can make inferences based on existing data. Key findings from the Demographic and Health Survey of 2022 highlights that the total fertility rate is lower in urban areas compared to rural areas, the former being 2.1 and the latter 2.3 (National Institute of Population Research and Training & ICF, 2023). The number of children that are born to a woman over her lifetime are reduced if the mother is based in urban areas. Furthermore, the cities with the lowest fertility rate are the cities that are the most densely populated: Dhaka, Khulna, and Rajshahi (National Institute of Population Research and Training & ICF, 2023). These findings concretely suggest the profound effect climate change is having on pregnant women in urban areas in Bangladesh. This conclusion must be taken with the caveat that women living in the urban areas may prioritise their livelihoods rather than starting a family. This is why it is important to fill the knowledge gap and study women's health and climate issues succinctly.
In conclusion, climate change has adversely affected the quality of life for pregnant women living in urban environments. The extreme heat and air pollution in the densely populated areas, coupled with the reduced quality of water, raises numerous risks for pregnant women and their unborn child; we can already observe the reduced fertility rates in urban Bangladesh environments. There must be policy intervention to combat climate change to build a healthy environment for pregnant women. If there are no interventions, then the fertility rate will continue to drop, the number of birth defects will also carry on rising, and the cognitive development of the future generation will be hindered. Let's push for an environment where women can have control of growing healthy and happy babies.
Priyanka Balamurali is a student, New York University, Abu Dhabi and an intern, Bangladesh Urban Health Network and Dr. Md. Shamim Hayder Talukder is a Member Secretary, Bangladesh Urban Health Network and Chief Executive Officer, Eminence Associates for Social Development
