By PPH Foundation
Climate change is changing more than temperatures and rainfall patterns. It is also influencing the conditions in which infectious diseases spread. Flooding, warmer temperatures and changing rainfall can create favourable conditions for disease-carrying mosquitoes, contaminate water sources and increase people's exposure to infections. For pregnant women, these changes can introduce additional health challenges before, during and after childbirth, with possible implications for maternal health and the prevention and management of postpartum haemorrhage.
Across sub-Saharan Africa, changing environmental conditions are affecting the spread and distribution of infectious diseases. Warmer temperatures can favour the survival and spread of mosquitoes that transmit malaria and other infections, while heavy rainfall and flooding can contaminate water sources and increase exposure to diseases such as cholera, dysentery and diarrhoeal infections. A 2026 scoping review by Fadeyi et al. examined climate change and maternal and child health across the region. The review identified links between rising temperatures, rainfall changes, flooding and the spread of infectious diseases, including malaria and waterborne infections (Fadeyi et al., 2026).
These changes matter during pregnancy because infections can affect a woman's health in several ways. Some infections contribute to anaemia, a condition in which the body has fewer healthy red blood cells to carry oxygen. This can reduce a woman's ability to withstand significant blood loss during childbirth. Malaria in pregnancy is one example. A 2025 systematic review and meta-analysis involving 93,809 women across 23 sub-Saharan African countries found that placental malaria was associated with higher odds of maternal anaemia (Alemayehu et al., 2025). This is important because women who are already anaemic may be less able to cope with the effects of postpartum haemorrhage.
The relationship between climate-linked infections and postpartum haemorrhage, however, needs to be understood carefully. Not every infection causes excessive bleeding after childbirth, and climate change is not a direct cause of every case of postpartum haemorrhage. The concern is that changing environmental conditions may increase exposure to certain infections, while the resulting illness and complications can leave some women more vulnerable during pregnancy and childbirth. Severe infections can also affect the body's normal functions, including blood clotting, in certain circumstances. Preventing infections, identifying them early and providing appropriate treatment are therefore important aspects of protecting maternal health.
The risks do not end when a woman gives birth. Poor sanitation and unsafe water can increase exposure to infections in homes and communities. During floods and other extreme weather events, access to clean water, medicines and healthcare services may also become difficult. Health facilities may face additional pressure when disease outbreaks occur alongside disruptions to routine services. For women recovering from childbirth, particularly those who have experienced severe bleeding or undergone emergency procedures, these conditions can make access to appropriate follow-up care more challenging.
Prof Julius Ogeng’o, Co-Lead of the End Postpartum Haemorrhage Initiative, has highlighted the importance of addressing the wider factors that influence maternal health. In his article, Social Determinants of Postpartum Haemorrhage and Their Implications, published in PPH Insights, he identifies environmental and climate change factors among the determinants associated with postpartum haemorrhage. He argues that “combatting PPH must take a multi-sectoral approach”, bringing together professionals beyond the health sector, including environmentalists, climatologists, nutritionists, sociologists and policymakers (Ogeng’o, 2026).
This perspective is important because protecting mothers requires action both within and beyond health facilities. Public health authorities need to strengthen disease surveillance, improve access to safe water and sanitation, and ensure that pregnant women can access preventive services, testing and treatment for infections. Antenatal care also provides an opportunity to identify and manage conditions such as malaria and anaemia before childbirth. Communities need reliable information on infection prevention and should be able to access health services when symptoms develop.
Health facilities must also remain prepared to manage obstetric emergencies during disease outbreaks and extreme weather events. This includes maintaining essential medicines, adequate blood supplies, trained personnel and reliable referral systems. Cooperation between health departments, environmental agencies, water and sanitation services and community organisations can help identify emerging risks and ensure that maternal healthcare continues even when environmental conditions become difficult.
Climate change is increasingly becoming a public health concern, with consequences that extend beyond the environment. For maternal health, it highlights the importance of looking at the conditions in which women live, the infections they may be exposed to and their ability to access timely healthcare. Addressing these challenges through stronger prevention, surveillance and coordinated action is part of the wider effort to protect mothers and reduce preventable deaths associated with postpartum haemorrhage.
References
Alemayehu, A., Kiya, G. T., Berhanu, S., Zeynudin, A., Beyene, J., & Yewhalaw, D. (2025). Prevalence, predictors and adverse perinatal outcomes of placental malaria in sub-Saharan Africa: A systematic review and meta-analysis. Archives of Public Health, 83, Article 295. https://doi.org/10.1186/s13690-025-01772-4
Fadeyi, O., Igbokwe, U., Sampson, I., Raheem, O., Ezeogu, E., Omidiran, Y., Adetunde, O., & Aigbogun, E., Jr. (2026). The impact of climate change on maternal and child health outcomes in sub-Saharan Africa: A five-year (2020–2024) scoping review. The Journal of Climate Change and Health, 31, 100723. https://doi.org/10.1016/j.joclim.2026.100723
Ogeng’o, J. (2026). Social determinants of postpartum haemorrhage and their implications. PPH Insights, Issue 007. PPH Foundation. https://endpphfoundation.org/assets/media/newsletter-docs/1779186254960649.pdf
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