Young mother, Shilpi, navigates the challenges of heatwave during pregnancy

01 October 2024

As Shilpi stirred the boiling pot of rice in the common kitchen of their house in Korail, the familiar scent of starchy steam filled the air. Her five-year-old daughter, Nusrat, peeked through the doorway, looked around and quickly ran out of sight.

"Although I cook for my family every day, my husband takes care of all the other household chores after coming back from work," said Shilpi while taking the rice off the stove.

23-year-old Shilpi lives with her husband, daughter, and mother-in-law. She is in the last trimester of her pregnancy, expecting to give birth in just two weeks. Her pregnancy had been smooth initially, thanks to her regular check-ups at the UNICEF-supported Aalo clinic near her home and guidance from Akhi Akhter, a dedicated community volunteer.

Shilpi had met Akhi during her visits to the Aalo clinic and through Akhi’s community engagement sessions. Akhi and the community volunteers from Aalo conduct door-to-door visits and sessions on key health issues topic. This year, they emphasized the heat-related illnesses.

Impact of heatwave on pregnant mothers

Bangladesh experienced an extreme heatwave in the months of April and May, with temperatures reaching up to 43 degrees Celsius in some parts of the country. As a result of climate change, heat waves are becoming longer, more intense, and more frequent. Even in September, a heat wave is sweeping parts of the country including Dhaka. With temperatures continuing to soar, marginalized communities, including pregnant women, children, and the elderly, were the most affected.

Pregnant women are particularly vulnerable to heatwaves due to physiological changes during pregnancy, which can exacerbate heat-related discomfort and health risks. Excessive heat and dehydration during pregnancy can also increase the likelihood of  babies being born too small and too soon. According to a report, women delivering on hot days were 14 per cent1more likely to have newborns with neonatal illness compared to those delivering on cooler days.

During this critical period, with support from UNICEF, Akhi and other community volunteers began sharing life-saving messages about heatwaves and heat-related illnesses. They also distributed leaflets developed by Directorate General of Health Services (DGHS) with support from UNICEF, which contain valuable instructions on coping with heat.

“Following Akhi Apa's advice, I increased my water intake and tried to stay hydrated. But the water that came through the pipeline was not clean and had to be boiled before drinking. Due to frequent gas shortages and sharing the kitchen with all the other families living on this floor, I often had to wait long hours or sometimes resort to drinking the water without boiling it,” shared Shilpi.

A health crisis

One morning , during Shilpi’s seventh month of pregnancy, she felt particularly weak and restless but tried to go about her day. Midway through cooking, Shilpi became very dizzy and returned to her room to lie down. Her condition worsened, and she could not even sit up, let alone walk to the clinic. Her mother-in-law and daughter did not know what to do.

Just then, Akhi arrived for a routine visit. Seeing Shilpi’s condition, she quickly took her to the Aalo clinic with help from Shilpi’s mother-in-law. At the clinic, Akhi turned on the fan at high speed to cool Shilpi, who was sweating profusely, and checked her blood pressure. It was alarmingly high. After giving her cold water and letting her rest for an hour  Akhi checked Shilpi’s blood pressure again and found it was close to normal.

“The heat was the main reason behind her high blood pressure. Pregnant women are particularly vulnerable to high temperatures,” Akhi explained. The relentless heat made Shilpi feel restless and dizzy, a condition exacerbated by direct sunlight on their tin-roofed home which trapped the heat inside.

After this incident, the clinic’s doctor and Akhi reiterated the important advices from the heat related illness guideline. This includes staying well-hydrated, avoiding strenuous activities, wearing loose clothing, how to identify symptoms of heat stress such as dizziness or nausea, and promptly seeking medical help if experiencing any symptom.

“The heat is getting more intense with each passing year. Consulting with doctors for personalized advice tailored to their specific health needs is essential for pregnant women to navigate extreme heat safely,” added Akhi.

Community outreach efforts in heatwave preparedness

Shilpi diligently followed this advice. To ensure she drank more water, Shilpi makes large quantities of lemonade every day to consume throughout the day. "I prepare a jug of lemonade daily and keep it stocked to drink when the stove in the common kitchen is occupied or when there is a gas shortage, so I do not have to wait long hours to always stay hydrated. Additionally, I have incorporated more vegetables into my diet and try to take short walks regularly when it is not too hot outside. I also wear comfortable clothing to stay cool. I have been feeling much better since I started taking these precautionary measures," she explained. 

The steps taken by Aalo clinic’s healthcare workers and community volunteers in coping up with intense heat is aligned with the national guideline on heat related illness, published by the Directorate General of Health Services (DGHS) with support from UNICEF in May 2024. It contains clear guidance for service providers, community volunteers and policy makers with the aim to raise awareness  and prevent heat related illnesses and empower communities by providing heat wave safety tips.

UNICEF is working to build the capacity of health care providers on management of heat related illnesses following the national guideline and implementing Risk Communication and Community Engagement (RCCE) initiatives which involve disseminating life-saving messages through various means, such as distributing leaflets, and leveraging social media platforms and national television.

“I have shared Akhi Apa’s advice with my sister-in-law and neighbors and asked them to follow it. I also make sure that my daughter and mother-in-law follow it too,” continued Shilpi as her daughter came and sat beside her, dressed in a light cotton outfit, perfect for the summer heat.

Moving forward with resilience

Shilpi has not had another health scare since then, but she remains anxious about the impending birth. The Aalo clinic does not have delivery facilities. Shilpi gave birth at home during her first pregnancy, which led to complications after the delivery.

"Both Akhi Apa and my doctor have advised me against giving birth at home. This time, I will go to a government hospital, but the thought of the long journey from my home to the hospital and the current warm weather worries me. I am also concerned about any potential health complications in my baby associated with heat exposure during my pregnancy," concluded Shilpi, her facial expression revealing a mix of anxiety and apprehension as she shared her worries.

As her due date  approaches, Shilpi stays focused on her health, taking the necessary precautions to ensure a safe delivery. Despite the challenges, she found comfort in the support system around her — her family, and Akhi Apa, all working together to help her through the final days of her pregnancy.

1 Protecting Children from Heat Stress, UNICEF, 2023 Protecting Children from Heat Stress