Effect of climate change on the health of puerperal mothers:A systematic review

Climate change is widely recognized as a global health threat, disproportionately impacting vulnerable populations, including postpartum women (WHO, 2021). Driven by human activities such as fossil fuel combustion and deforestation, climate change manifests through long-term alterations in temperature and weather patterns. The release of greenhouse gases traps heat in the atmosphere, resulting in a planet already 1.2°C warmer than pre-industrial times and an increased frequency of extreme weather events (IPCC, 2023). These changes create a cascade of health impacts, from heat stress and the spread of infectious diseases to food insecurity and immense strain on healthcare systems globally (WHO, 2021). The intersection of climate change and postpartum health presents a critical and growing public health concern. The postpartum period defined as the six weeks following childbirth is a time of significant physiological and psychological vulnerability, often termed a "window of vulnerability" (Rylander et al., 2013). During this period, women experience increased metabolic demands from lactation and wound healing. Climate related stressors, particularly extreme heat, can severely disrupt recovery. Elevated core body temperature and reduced thermoregulatory efficiency put postpartum women at higher risk of dehydration, heat exhaustion, and cardiovascular strain (Basu et al., 2018). Furthermore, excessive sweating from heat can lead to fluid loss, dangerously exacerbating the expected blood and fluid loss after childbirth and increasing the risk of hypovolemic shock (WHO, 2023). The risks extend beyond the physical. Prolonged heat exposure is associated with higher rates of postpartum depression, likely due to sleep disturbances and increased physical discomfort (Mullins & White, 2019). Climate change also amplifies indirect threats. Erratic rainfall, flooding, and shifting temperatures facilitate the spread of vector borne diseases like malaria, dengue, and yellow fever, to which postpartum women and their newborns are particularly susceptible (Chersich et al., 2020). These challenges are compounded by the effect of temperature on medicine potency, as improper storage conditions can render crucial pharmaceuticals less effective. These impacts are not felt equally. The burden falls heaviest on regions with weak healthcare infrastructure and limited adaptive capacity. According to the WHO, 94% of maternal deaths occur in countries highly vulnerable to climate change (WHO, 2023). Globally, the health impacts of climate change are evident through a cascade of interconnected pathways (Meherali et al. 2024). In North America, there are more intense hurricanes, wildfires and heatwaves, with agriculture being affected by extreme temperatures. Europe is experiencing hotter, drier conditions in the south and more flooding in the north, threatening water resources and agriculture. In Asia, rising temperatures, heatwaves and erratic monsoons are harming agriculture, while melting glaciers threaten water supplies and rising sea levels affect coastal regions. South America faces shrinking glaciers, droughts and deforestation in the Amazon, impacting water supplies and biodiversity. Oceania is particularly vulnerable, with rising sea levels threatening island nations and Australia facing more frequent wildfires and heatwaves. Extreme heat, changing rainfall patterns and more frequent floods and droughts exacerbate both chronic and infectious diseases, including respiratory diseases, cardiovascular conditions and vector-borne illnesses. The intersection of climate change and postpartum health presents a growing public health concern (Filippi et al., 2022). Sub-Saharan Africa, which already has the highest maternal mortality rates globally, is acutely at risk due to its pronounced vulnerability to environmental shifts and strained health systems (IPCC, 2022). Extreme weather events like floods and heatwaves disrupt access to essential healthcare services, exacerbate sanitation issues and intensify existing health disparities (Chersich et al., 2022, Dumbuya et al., 2024). Despite this dire situation, significant research gaps persist, particularly in regions like Africa and the Caribbean, highlighting a disparity in global research attention and resources (Meherali et al., 2024). This research contributes directly to the United Nations' Sustainable Development Goals (SDGs), specifically SDG 3 (Good Health and Well-being), SDG 13 (Climate Action), and SDG 15 (Life on Land). Investigating the climate postpartum health , this work supports the global call to improve health, combat climate change and ensure prosperity for all. While the broad impacts of climate change on maternal health are increasingly documented, a significant gap exists in understanding the specific effects on puerperal (postpartum) mothers. Most existing reviews focus broadly on pregnancy, neglecting the unique vulnerabilities of the postpartum period. This gap is especially pronounced in specific geographical contexts like Ghana. Ghana, a West African nation, is highly vulnerable to climate change impacts, experiencing extreme heat, erratic rainfall and flooding (Angnuureng et al., 2023). However, national awareness and research have primarily focused on climate change’s agricultural and environmental hazards, such as drought and pollution (Tetteh et al., 2022). The specific impact on the physical and mental health of puerperal mothers has not been sufficiently studied, particularly the intersection of climate induced stressors like dehydration, excessive bleeding and vector borne diseases with existing health disparities (Gyampoh et al., 2023). There is a critical lack of local health information on adaptation strategies, such as cooling centers or disaster preparedness plans, tailored for postpartum women .This systematic review aims to address this gap by assessing the existing literature on the effect of climate change on the health of puerperal mothers. Synthesizing available evidence, this study will contribute to the growing body of climate health research and provide a foundation for evidence based interventions. The findings will be crucial for informing policy decisions and shaping healthcare practices that are responsive to climate change, ultimately working to mitigate the health impacts on this highly vulnerable population in the globally context (WHO, 2023).