**Debra D. Joseph and Roshnie A. Doon**

**Abstract:** Maternal health concerns the well-being of women during pregnancy, childbirth, and the postpartum period. Climate change events often threaten maternal health because mothers and their offspring are more susceptible to environmental changes. In developing countries, 88% of children succumb to climate change-related deaths. The inherent vulnerability of mothers and their offspring to infections, illness, and malnourishment due to limited social services, healthcare, low household income, and dependency, are often to blame for the high mortality rate. Given that the literature on the impact of climate change events on maternal and child health in the Caribbean region is scarce, this chapter seeks to address this gap by using a secondary research approach. The impacts that climate change events in the Caribbean are likely to have on the maternal and child health of persons residing in flood-prone areas and coastal communities will be discussed. Like Nigeria, Ghana, and India, in the Caribbean, climate change events negatively impact the mortality of the mother and her child. The decline in the nutritional quality of food, amongst other health-related issues, also contributes to adverse pregnancy outcomes.

#### **1. Introduction**

Climate change represents one of the most significant global health threats of the 21st century, but more so for vulnerable populations, such as pregnant women and children. Extreme temperatures, airborne diseases, and the intensity of hurricanes with destructive high storm surges negatively impact some of the poorest countries in the Caribbean. Airborne diseases are caused by pathogenic microbes small enough to be discharged from an infected person via coughing, sneezing, laughing, close personal contact, or aerosolization of the microbe. The discharged microbes remain suspended in the air on dust particles, and respiratory and water droplets. Illness occurs when the microbe is inhaled or contacts mucus membranes or when secretions remaining on a surface are touched (Division of Disease Surveillance 2023). Some of these countries do not have the measures to either mitigate or adapt to these climate change events, leaving them at the mercy of climatic elements that accompany these natural disasters. Globally, approximately 1.3 billion people in low- and middle-income countries live below the poverty line, with 70% of these people being female (Sorensen et al. 2018). Climate change diminishes women's health, especially during pregnancy, where maternal health and nutrition are vital to the developing foetus and infant (Franco-Orozco and Franco-Orozco 2018; Sorensen et al. 2018).

Roos et al. (2021) assert that climate change impacts the maternal health of expectant mothers in many ways, such as pregnant women experiencing physiological changes that make it challenging to thermo-regulate. These changes include internal heat production due to foetal growth. When heat balance cannot be maintained, heat shock causes proteins are released, creating biological and physiological reactions with severe effects on maternal and perinatal health, including the neonatal period. Heat exposure can increase the risk of premature birth and rupture of membranes, low birth weight, and stillbirth (Chersich et al. 2020; Bekkar et al. 2020). Dehydration from increased sweating in pregnant women can cause the onset of early labour and prolong the duration of labour (Hnat et al. 2005).

The United Nations Children's Fund (UNICEF) (2015) posits that the dangers of climate change are more pronounced for children than for adults. Children are more vulnerable to vector-borne diseases than adults and face dangers from under-nutrition and diarrhoeal diseases. UNICEF adds that the physical dangers of extreme weather events can cause adverse effects on their young bodies and mind. Children will also experience these effects longer than adults. This chapter examines climate change's social impact and economic cost on maternal and children's health. Apart from the impacts, it calls attention to ways in which adaptation can help quell these impacts to enhance the standard of living for those affected.

The debate on the impact that climate change has on maternal health around the world has consistently focused on vulnerable populations in countries such as India, Indonesia, Nigeria, Ghana, and Uganda, as well as regions such as Sub-Saharan Africa and Asia. This focus is often the case because the populations of such countries and regions are prone to experiencing extreme forms of natural disasters. For example, in the case of the Asian Pacific region, there is a tendency for tsunamis, volcanic eruptions, earthquakes, and cyclones to occur, while in Asia, there is a frequent incidence of floods, landslides, mudflows, and extreme temperatures (UNICEF 2022; Burunciuc 2022).

Even though these countries have very little control over the prevalence of these climate change events, as they are indeed natural disasters, what countries can control is their response to these events through the timely implementation of mitigation and adaptation strategies. Unfortunately, many disastrous climate events tend to occur in low-income developing countries and small island developing states, where there are minimal resources and means of responding to such disasters.

Women and children are two of the most vulnerable groups negatively impacted by climate change events (Adebayo 2021). According to the World Population Prospectus by the United Nations (UN) (2022), the data for 2020–2021 reveal that within one year, both the Total Fertility Rate (TFR) and global births have fallen by 0.03 births per thousand and 1,158,000 births, while both the number of infant deaths and infant mortality rate have fallen. A similar trend is echoed in the Caribbean region where for the same timeframe, the number of births has fallen by 10,000, while the TFR has also fallen by 0.03 (UN 2022).

The same cannot be said for regions like Sub-Saharan Africa, which is prone to severe natural disasters, as there was an increase of 596,000 births between 2020 and 2021 (UN 2020). Although these population statistics on a global scale and for the Caribbean reveal a somewhat positive outcome regarding the mortality of babies and population demography, it is at the regional level that pregnant women living in places like Sub-Saharan Africa and Asia experience maternal and neonatal health problems. This situation is likely to be exacerbated by climate change.
