Written by Innes Tounkel, MD

As concerns about climate change continue to grow, the importance of accessible contraception and reproductive health services has become increasingly evident. Climate change refers to long-term shifts in weather patterns and their deleterious consequences, including rising sea levels, melting glaciers, ecological disruptions, and the spread of vector-borne diseases.^1,2 Extreme weather events, such as wildfires and floods, result in mass displacement and the destruction of healthcare infrastructure, impeding access to essential reproductive health services, including contraception, sexually transmitted infection (STI) treatment, abortion care, and prenatal care.^2,3 Furthermore, gender-based violence tends to surge after natural disasters, increasing the demand for contraception and STI prevention.⁴ A 2021 report showed that 11.5 million people lost access to reproductive health services globally, with projections estimating this number will grow to 14 million in the coming years.⁴

These disruptions disproportionately affect marginalized populations, including people of color, women, children, disabled individuals, and those living in poverty, subsequently exacerbating pre-existing social, racial, and gender inequities.^2,3 Hurricane Sandy in 2012 highlighted these inequities when it caused one of the largest power outages in United States history, resulting in significantly higher pregnancy complications among Black and Hispanic pregnant individuals (20.9–25.9%) compared to their White counterparts (5.6%).⁵ The 2016 Zika virus epidemic similarly exposed deep inequities, as it disparately impacted resource limited communities in tropical regions, where decreased access to healthcare and reproductive health services hindered individuals’ abilities to make informed reproductive decisions.⁶

Given these impacts, it is crucial to view climate change and reproductive health through an environmental reproductive justice (ERJ) lens. ERJ is a social justice framework developed by members of the Akwesasne community to address the impact of environmental contamination secondary to climate change on their reproductive health outcomes.⁷ ERJ advocates for reproductive autonomy that is not limited by exposure to environmental harm.⁷

As reproductive healthcare providers, we are in a unique position to support ERJ and ensure that patients have the education and resources to exercise their reproductive freedom. Providing counseling on and increasing access to long-acting reversible contraceptives, STI prevention and treatment, over the counter birth control, and self-managed abortions and contraception, including IUD self-removal, can empower individuals to maintain reproductive autonomy during crises.^8,9 Healthcare providers must remain vigilant about emerging climate-related health risks, such as vector-borne diseases or pollution-linked conditions, to effectively counsel patients about harmful environmental exposures and provide evidence-based guidance that considers how these threats intersect with reproductive health.

Moreover, we can advocate for the integration of ERJ into medical education, provide testimony for equitable climate change policies, and support grassroots organizations and community health centers in underserved areas, which bear the burden of urban heat islands, poor air quality, and flooding.¹⁰ By embracing ERJ as a guiding framework, we can address the intersecting crises of climate change and health inequity, empowering individuals to make informed decisions about their reproductive health in an increasingly uncertain world.

RHAP Resources:

Your Birth Control Choices Fact Sheet

IUD Self-Removal Fact Sheet

Non-Prescription Birth Control Methods Fact Sheet

Introduction to LARC (Long-Acting Reversible Contraceptives)

Sources:

1. NASA Science. What’s the difference between climate change and global warming? Accessed November 25, 2024. https://science.nasa.gov/climate-change/faq/whats-the-difference-between-climate-change-and-global-warming.

2. Giudice LC, Llamas-Clark EF, DeNicola N, et al. Climate Change, women’s health, and the role of obstetricians and gynecologists in leadership. Int J Gynaecol Obstet. 2021;155(3):345-356. doi:10.1002/ijgo.13958.

3. van Daalen KR, Tonne C, Semanza JC, et al. The 2024 Europe report of the Lancet Countdown on health and climate change: Unprecedented warming demands unprecedented action. Lancet Public Health. 2024;9(7):e495-e522. doi:10.1016/S2468-2667(24)00055-0.

4. MSI Reproductive Choices. The Impact of the Climate Crisis on Reproductive Choice. Accessed November 25, 2024. https://msichoices.org/wp-content/uploads/2023/10/the-impact-of-the-climate-crisis-on-reproductive-choice-final.pdf.

5. Segal TR, Giudice LC. Systematic review of climate change effects on reproductive health. Fertil Steril. 2022 Aug;118(2):215-223. doi: 10.1016/j.fertnstert.2022.06.005.

6. Stein RA, Grayon A, Katz A, Chervenak FA. The Zika virus: an opportunity to revisit reproductive health needs and disparities. Germs. 2022 Dec 31;12(4):519-537. doi: 10.18683/germs.2022.1357.

7. Liddell JL, Kington SG. “Something Was Attacking Them and Their Reproductive Organs”: Environmental Reproductive Justice in an Indigenous Tribe in the United States Gulf Coast. International Journal of Environmental Research and Public Health. 2021; 18(2):666. doi:10.3390/ijerph18020666.

8. MSI United States. Climate Disruptions Impact Choice. Accessed November 25, 2024. https://msiunitedstates.org/climate-disruptions-impact-choice/.

9. Self-Care for Contraception. Family Planning: A Global Handbook for Providers. Accessed December 11, 2024. https://fphandbook.org/self-care-contraception.

10. Christensen K. A Matter of Climate Justice: Heat and Air Pollution Combine to Worsen Effects of Homelessness. Environ Health Perspect. 2024 May;132(5):54001. doi:10.1289/EHP14613.