Wildfires pose serious risks to pregnant people and their developing fetuses, including low birth weight and preterm birth. But public health officials are not doing nearly enough to keep these vulnerable populations safe, according to a new report.
“While we know that wildfires are continuing to intensify in the US, and we’re increasingly clear on what damages wildfires represent to maternal and newborn health, we’re still not seeing the kind of response from policymakers and public health officials that we need,” said Skye Wheeler, a researcher at Human Rights Watch and one of report’s authors.
Wheeler and researchers with the perinatal health non-profit Nurturely surveyed more than 50 doctors, midwives, doulas, lactation consultants and other community-based birth workers in Oregon, which this year has experienced its worst-ever fire season.
They said public health officials weren’t doing enough to communicate warnings and safety information to vulnerable communities, particularly the unhoused and those who speak little English, and that those populations often lacked access to vital equipment, such as air filters, that are recommended on high-risk days. Health providers said that authorities had not provided them with guidance on the specific risks wildfires posed to pregnant people – and that they typically had to rely on their own research to answer patients’ questions.
They also said the “clinical model of care, where, for example, [the state is] contracting a doctor to bill in 15-minute increments” leaves little time for healthcare workers to talk about wildfire risks with patients. Doulas, who typically spend more time with clients and provide vital information, are in low supply given their low wages.
Oregon public health officials did not immediately respond to requests for comment.
“Environmental risks like wildfire smoke and heat are increasing every day,” said Rebecca Schmidt, associate professor of epidemiology at the University of California, Davis who was not involved with the report. “Right now, I don’t think clinicians have been trained very well on those potential exposures and what they might be doing to [patients’] health.”
This year, wildfires in Oregon have burned more than 1.5m acres (607,028 hectares) statewide, surpassing previous records and causing hazardous air pollution.
Wildfire smoke contains a mixture of volatile chemicals, carbon monoxide, and PM 2.5 – fine particulate matter that can penetrate lungs and even get into the bloodstream. Growing research shows that exposure to PM 2.5 from wildfire smoke is associated with lower birth weight, harm to the developing fetus and increased risk of preterm birth, which is already on the rise in the US.
“The US is the only high-income country in the world where that’s true,” Wheeler said. “The US can’t afford more pressure on its maternal health systems, and public health officials need to do everything they can to try and reverse worsening maternal health, especially for Black and other women of color.”
Black women are three times more likely to die from pregnancy-related complications than white women, with risk spanning income and education levels. They are also disproportionately exposed to air pollution. Exposure to harmful pollutants, poor air quality, and high temperatures are associated with women of color delivering babies with lower-birth weights.
Schmidt said there are effective ways public health officials can help patients mitigate harms from wildfire smoke: “Knowing how to avoid exposure, and providing support through handing out free N95 masks, giving clean-air shelter access, and other ways of getting people to reduce their actual exposure during those events.”
Warmer, drier temperatures, caused by the climate crisis, raise the risk of extreme wildfire. The report’s authors stress that the most urgent action government can take is reducing greenhouse gas emissions.
“Ultimately, we need to turn off the tap,” said Wheeler. “We can’t just keep pouring emissions into the air, letting the climate crisis get worse, and then expect frontline community health workers to pick up the pieces.”