Climate change is no longer a distant environmental issue – it is already shaping the health and wellbeing of pregnant women and their babies. For midwifery, this presents both an urgent challenge and a clear opportunity for action. See Professor Christine Catling’s editorial on this topic in the recent special issue of Women and Birth on climate change.

Emerging evidence shows that extreme heat is linked to serious pregnancy outcomes, including preterm birth, low birthweight and stillbirth. But the impact of heat is not simply biological – it is deeply social. Women experience heat through the realities of daily life: crowded housing, limited access to cooling, work demands, and caring responsibilities. For many, especially those already facing disadvantage, staying safe in extreme temperatures is not straightforward.

At the same time, climate-related stressors such as drought and economic hardship are increasing the risk of gender-based violence. This reinforces that climate change is not just an environmental issue, but a social and equity issue that directly affects maternity care.

So, what does this mean for midwives?

First, climate awareness must become part of everyday care. Simple actions – like discussing heat safety during antenatal visits – can help, but advice must be realistic. Telling women to ‘stay cool’ is not helpful if they cannot afford air conditioning or have limited access to safe water or transport.

Second, maternity services need to be better prepared. Climate events can increase vulnerability and disrupt care, so services must ensure safe pathways for support, including for women experiencing violence. This requires planning that is both gender-responsive and culturally safe.

Third, supporting the midwifery workforce is essential. While many midwives are motivated to respond to climate-related challenges, research shows gaps in knowledge, confidence and institutional support. Training programs, such as those linking maternal health with sustainability, show promise – but must be backed by leadership, policy and resources to make a real difference. This includes integration of planetary health-informed knowledge and practice within national Midwifery Standards for Practice, as well as midwifery curricula.

Finally, progress depends on collaboration. Effective responses to climate-related risks require strong partnerships between midwives, obstetricians, public health professionals and communities. When teams work together with shared purpose and trust, they are better able to respond to complex, evolving challenges.

Ultimately, midwifery sits at the intersection of clinical care, social justice and environmental responsibility. By integrating planetary health into practice, midwives can protect women and babies today, while contributing to a more sustainable and equitable future for generations to come.