Patients

What you should know:

• Montana is getting more days over 90°F (source). Pregnancy makes you more sensitive to temperature extremes. Heat waves can stress your body and mind, causing health problems for both you and your baby (source, source).
• Montana is getting more wildfires and more smoke (source). Exposure to wildfire smoke raises your risk of gestational diabetes and high blood pressure, as well as the risk of your child being born pre-term, underweight, and with birth abnormalities (source). Wildfires can stress your mental health and also affect your child's developing brain (source).

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What you can do:

• During wildfires, keep a close eye on the air quality. Avoid going outside if the air is "unhealthy for sensitive populations" (orange) on the AirNow.gov website. Phone apps can give you up-to-the-minute data. If you can smell or see smoke, that's a good sign to get inside. Keep your windows closed. You can make a DIY box fan air filter or purchase an air filter. If you can't avoid being outside, an N95 mask will help filter out small particles.
  
• Avoid outside activities if the temperature is over 85°F. Drink plenty of water and run errands when the sun is low.
  
• On hot days, get to a building with A/C (such as a library or mall) if you don't have air conditioning at home. Remember that pregnancy makes you more sensitive to heat, and take it easy.
• Be aware that gas ranges, wood stoves, and smokers in your home all increase indoor air pollution.
• Ask your elected leaders to vote for clean air protection policies!

Providers

What you should know:

HEAT

Montana is predicted to have 5-35 more days of extreme heat (over 90°F) by 2050 (Whitlock et al, 2017). This will also cause further flooding and droughts, decreasing the availability of clean water and food security.

• Exposure to extreme heat in utero increases risk for heart defects (Zhang et al, 2019), congenital cataracts (Zutphen et al, 2012),  premature birth (Basu et al, 2010), and low birth weight, especially in the early stages of pregancy and among disadvantaged groups (Chersich et al, 2020).

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AIR POLLUTION

Due to increasing wildfire smoke, tillage during drought, and inversion layers condensing wood stove use in winter, particulate matter is seasonally elevated in Montana (Whitlock et al, 2017; to look up your county see American Lung Association's State of the Air 2023). The pollutant of particular concern is particulate matter 2.5, or PM 2.5, tiny particles 2.5 microns or smaller in width. These particles can travel deep into the lungs.

• Wildfire smoke exposure increases the risk of gestational diabetes mellitus and gestational hypertension (Evans et al, 2022).
• Maternal exposure to air pollution is also related to low birth weight, preterm labor, and stillbirth (Bekkar et al, 2020), abnormal brain development (Payne-Sturges et al, 2019), and childhood hypertension (Zhang M et al, 2018).

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NATURAL DISASTERS

Rapid spring floods, extreme wildfires, and other natural disasters are increasing in Montana (Whitlock et al, 2017).

• This causes displacement, interrupting prenatal and postpartum care (Rassmussen, 2022).
• Postpartum parents are at risk for severe stress and other mental health issues when exposed to natural disasters (Payne-Sturges et al, 2019).
  
• Floods correlate with increase in maternal stress, anemia, eclampsia, and miscarriages (Crimmins, 2016).
  
• Flooding creates a risk of unsafe drinking water and bacteria diseases (Adams et al, 2021).
  

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What you can do:

• Share community emergency response planning with patients to prepare for evacuation in the case of flood or fire.
• Teach patients to avoid outdoor activity if the Air Quality Monitor is orange, meaning "unsafe for sensitive populations."
  
• PM 2.5 increases even indoors during smoky days, so encourage patients to use an air filter and close windows when possible (Walker et al, 2023). We have instructions for a low-cost DIY filter here.
• Ensure all patients have access to their electronic records to support transfer of care if natural disasters occur.
  
• Schedule prenatal appointments in the early morning and late afternoon to avoid high-temperature times of day.
  
• Encourage patients to evaluate sources of indoor air pollution such as gas ranges, wood stoves, and secondhand smoke.
  
• Encourage local clinical and community-based research on climate change and maternal-fetal health.
  
• Ask your healthcare center to support environmentally sustainable methods.
  

We've designed a patient education poster for your clinic! Dowload it below:

Administrators

Please excuse our mess! This page is under construction. Contact us with any questions you have about the effects of climate change on pregnancy and maternal health.

Many thanks to our generous partner, the Rocky Mountain Pediatric Environmental Health Specialty Unit!

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