By PPH Foundation

Postpartum haemorrhage, PPH, is an obstetric emergency, but protecting mothers from its consequences increasingly requires attention to what happens outside the delivery room. Climate change is altering the environmental conditions in which women experience pregnancy, seek antenatal care, give birth and access emergency treatment. As the 3rd International EndPPH Run brought communities together across 25 counties in Kenya and beyond, it also provides an opportunity to consider what safer motherhood means in a changing climate.

Recent research is strengthening the evidence behind this connection. A 2026 scoping review of climate change and maternal and child health in sub-Saharan Africa identified 51 studies and reports from the 2020–2024 period. The review found associations between climate-related exposures, including excessive rainfall, flooding, temperature fluctuations, heatwaves and drought, and maternal outcomes including postpartum haemorrhage and hypertensive disorders. It also found evidence that climate change can disrupt access to healthcare. The authors call for regional integration of climate adaptation into maternal and child health planning.

One of the clearest pathways is extreme heat. A major systematic review and meta-analysis published in Nature Medicine examined 198 studies from 66 countries and found evidence linking heat exposure with a range of adverse maternal, fetal and neonatal outcomes. The review highlights the particular vulnerability of pregnant women as temperatures rise, while also noting important differences according to location, timing of exposure and population characteristics.

For African women, the evidence is becoming increasingly local. Research published in 2025 from Kilifi, Kenya, examined a community-based intervention designed to reduce the effects of extreme heat on pregnant women, postpartum women and infants. The intervention used community discussions and digital audio-visual storytelling to improve understanding of heat risks. Participants reported greater awareness of measures such as staying hydrated, adjusting daily activities and reducing heavy workloads during periods of heat. The study also demonstrated the value of engaging spouses, mothers-in-law and community influencers in protecting women during extreme heat.

This matters because climate resilience cannot be built inside a health facility alone. It also depends on what happens in households and communities.

Research published in Burkina Faso in 2026 provides another important perspective. Interviews with pregnant and postpartum women, health providers and community members found that extreme heat affected women's use of maternal health services and influenced perceptions of the quality of care available at health facilities. Facilities without adequate cooling were viewed as less suitable, while health workers also reported challenges associated with working in hot environments. The researchers concluded that health systems need to adapt to increasingly intense, frequent and prolonged heat events.

Extreme rainfall creates another pathway of concern.

A 2026 Nature Communications study examined 256,101 births across 21 sub-Saharan African countries. The researchers found that each additional day of extreme precipitation in the three days around childbirth was associated with a reduction of approximately 10.8 facility-based births per 1,000 live births. The study estimated that extreme precipitation contributed to about 29,084 additional non-facility births in 2015. These findings are important for PPH because a woman who gives birth outside a health facility may not have immediate access to skilled birth attendance, medicines, blood or emergency obstetric care if severe bleeding occurs.

The findings are particularly relevant to Kenya. A peer-reviewed study published in PLOS Climate in March 2026 examined changing weather patterns and access to antenatal care in Western Kenya. The researchers found that altered rainfall, flooding, drought and high temperatures can disrupt infrastructure and services and create barriers to women's access to antenatal care.

These disruptions matter because PPH preparedness depends on a functioning chain of care. A mother needs to reach a facility, skilled health workers need to be available, essential medicines must be accessible, blood must be available when transfusion is required, electricity and water systems must function, and referral pathways must remain operational.

Prof Julius Ogeng'o, Co-Lead of the End Postpartum Haemorrhage Initiative, has called for climate change to be recognized as part of the maternal health conversation.

“Climate change is no longer only an environmental issue—it is a maternal health issue. Rising temperatures expose pregnant women to physiological stress that may increase the likelihood of pregnancy complications associated with postpartum haemorrhage. Protecting mothers therefore requires climate-responsive health systems that are prepared to manage the growing challenges associated with extreme weather.”

Importantly, climate change should not be presented as a direct cause of every case of PPH. PPH has multiple causes, with uterine atony, retained placenta, trauma and coagulation problems among the recognised causes. The climate-health concern is about the ways environmental stress and climate-related disruption can increase vulnerability, complicate pregnancy and childbirth, or make it harder for women to obtain timely care.

This distinction is important for the EndPPH agenda. Climate action does not replace proven PPH interventions. Instead, it strengthens the conditions in which those interventions can work.

For example, climate-resilient maternity facilities can help maintain essential services during heatwaves, floods and other disruptions. Reliable electricity can support blood storage and essential equipment. Adequate water supplies can support infection prevention and routine maternity care. Strong referral systems can help women reach higher-level facilities when complications occur. Community preparedness can help families recognise danger signs and seek care without delay.

The experience from Kilifi also shows why communities must be part of climate adaptation. Climate resilience is not only about infrastructure. It involves knowledge, household support, community health workers and communication that helps pregnant and postpartum women respond to environmental risks.

This is where the message of Run for Her can extend beyond the finish line. The 3rd International EndPPH Run brought people together around a common commitment to safer motherhood. That same community mobilisation can help create conversations about the broader conditions that influence whether a mother can reach care and receive it in time.

From heatwaves to floods, the climate crisis can place additional pressure on women and the health systems that serve them. Preparing for those pressures is therefore part of preparing for safer motherhood.

The Run reminded us that protecting mothers is a collective responsibility. Building resilience in a changing climate is another part of that responsibility.

No woman should die while giving life; and protecting that principle requires health systems and communities that are prepared not only for today's emergencies, but also for the environmental challenges of tomorrow.

Sources

Fadeyi O, Igbokwe U, Sampson I, Raheem O, Ezeogu E, Omidiran Y, Adetunde O, Aigbogun E. 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. 2026;31:100723. doi:10.1016/j.joclim.2026.100723. PubMed

Ba OA, Hierink F, Taylor C, Macharia PM, Beňová L, Laurent-Lucchetti J, et al. Impact of extreme precipitation events on facility-based births in 21 sub-Saharan African countries. Nature Communications. 2026;17:6196. doi:10.1038/s41467-026-72547-w. Nature

 Kouanda S, Kadio K, Sana A, Congo M, Roos N, Scorgie F, Nakstad B, Kovats S, Hess JJ, Filippi V. Heat and its effects on maternal and neonatal health care: evidence from Burkina Faso. Public Health. 2026;252:106144. doi:10.1016/j.puhe.2026.106144. PubMed

Matanda DJ, Warren CE, Okoth O, Otieno B, Nakuya Z. ‘Water is a good thing, but when it destroys it is not good’: the influence of changing weather patterns on access to antenatal care services in Western Kenya – a qualitative study. PLOS Climate. 2026. doi:10.1371/journal.pclm.0000882. PLOS

Maharani A, Le T, Miah J, Mulla Z, Blakemore A, Aluh D, Jemisenia J, Idemili-Aronu N, Ezeanolue EE, van Tongeren M, Ravindrarajah R. Ambient temperature, rainfall, and adverse maternal and child health outcomes in Nigeria: evidence from a national cross-sectional study. Frontiers in Public Health. 2026;14:1841642. doi:10.3389/fpubh.2026.1841642. Frontiers

Lusambili A, Scorgie F, Oguna M, Chersich M, Luchters S, Gon G, Filippi V, Kovats S, McCawley K, Hess J, Nakstad B. Reducing extreme heat impacts on health in pregnant women and infants: a community based intervention in Kilifi, Kenya. Health Policy and Planning. 2025;40(9):943–954. doi:10.1093/heapol/czaf028. OUP Academic

 Lakhoo DP, Brink N, Radebe L, Craig MH, Pham MD, Haghighi MM, Wise A, Solarin I, Luchters S, Maimela G, Chersich MF, Heat-Health Study Group, HIGH Horizons Study Group. A systematic review and meta-analysis of heat exposure impacts on maternal, fetal and neonatal health. Nature Medicine. 2025;31(2):684–694. doi:10.1038/s41591-024-03395-8. Nature

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