Climate change has unfolded as a serious global health concern and threat, with growing evidence linking environmental heat exposure to adverse reproductive outcomes. Maternal exposure to elevated temperatures has been associated with increased risks of stillbirth, low birth weight, preterm birth, and congenital anomalies. A meta-analysis by Lakhoo et al. (2024) found that each 1°C rise above average regional temperatures elevated risks for multiple maternal and neonatal outcomes. Additional data reports heightened vulnerability in underserved populations due to limited access to healthcare, cooling resources, and adaptive infrastructure. For example, structural birth defects, including spina bifida, hypospadias, and congenital heart abnormalities, have been associated with high environmental temperatures, particularly during critical windows of fetal development (Haghighi et al., 2021). The effects are worsened by related climate stressors, including air pollution, vector-borne diseases, and flooding, again, disproportionately affecting low-income and rural communities (Segal & Giudice, 2022; Kaur & Pandey, 2021). Despite this growing evidence, most public health policies and heatwave protocols do not fully address the specific needs of pregnant women. There is an urgent need for climate-informed reproductive healthcare templates, targeted policy interventions, and surveillance systems to reduce preventable birth defects and improve outcomes, especially for at-risk populations. A population-based approach is important to advance reproductive justice in the face of accelerating climate change.  

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