Obstetrics and Gynaecology (O+G)
How Will Climate Change Affect Women's Health?
There is increasing evidence that extreme heat exposure in pregnancy is associated with increased rates of preterm birth, low birthweight, foetal anomalies, hypertensive disease, and placental abruption.
Air-pollutants, such as particulate matter and nitrogen oxides, are associated with increased risks of hypertensive disorders of pregnancy, gestational diabetes, and cardiovascular events in labour.
Microplastic particles, with as yet undetermined clinical effects, have been detected within human placentae and foetal meconium.
Moreover, women and girls are more vulnerable to the indirect impacts of global heating, and for example face elevated risks of sexual violence and trafficking as a result of mass displacement events, and increased risks of child marriage driven by land-degradation and impoverishment.
How are O+G Departments Affecting Climate Change?
Entonox is a potent green-house gas. Four hours of typical use in labour is equivalent to driving 1500km in an average sized car, and as a result a vaginal delivery with Entonox use has more than 6 x the greenhouse gas emissions than a planned Caesarean section. This is not the case in the Netherlands where Entonox is rarely used .
Operating theatres: The climate impacts of the operating theatre result from inhalational anaesthetics, energy use, and the use of large amounts of both sterilised and disposable materials. The type of surgery is also important, for example, robotic hysterectomy has a larger environmental footprint compared with laparoscopic, abdominal, and vaginal approaches (which generate 69%, 37% and 35% of the emissions, respectively).
Other examples:
- Disposable nappies
- Formula milk
- Pharmaceutical contamination, e.g. contraceptives
- Single use menstrual products
Royal College of Obstetrics and Gynaecology E-Learning
RCOG free E-Learning course on climate change and women's health
Discussion Ideas with Patients and Colleagues
Patients:
"There will likely be some heatwaves this year. Have you thought about how to keep yourself and baby cool in these periods?"
"Air pollution can be harmful to your health and your baby's. You can reduce the amount of air pollution by taking public transport if possible or we can arrange your next consultation as a telephone appointment."
Colleagues
"How can we minimise the use of entonox in our department whilst ensuring analgesia for our patients"
"We produce a lot of waste from surgery. Could we adopt anything else from the Green Surgery report?"
Highest Impact Actions for O+G Departments
Minimise Entonox usage and leakage
Review the Green Surgery Report and work through its recommendations
Maximise healthcare approaches that prioritise patient empowerment and prevention of disease e.g. The OASI care bundle
Other ideas could include: promoting reusable nappies, supporting the use of reusable period products
For More Information
Visit the Royal College of Obstetrics and Gynaecology website for more resources on climate change and women's health and for ways to join communities of likeminded clinicians