Human Rights Watch and Nurturely released a report last month that shows how pregnant people are affected by wildfires. It also suggests that officials and agencies should place an emphasis on reproductive justice when providing support and information around disasters. Additionally, it recommends better education for health workers on environmental determinants of health. We learn more about the report from Skye Wheeler, senior researcher with Human Rights Watch, and Aver Yakubu, program director for Nurturely, which is based in Oregon.
The following transcript was created by a computer and edited by a volunteer:
Dave Miller: This is Think OutLoud on OPB. I’m Dave Miller. We end today with a new report that focused on the impacts of recent wildfires on maternal and newborn health in Oregon. It was put out by Human Rights Watch and Nurturely. That’s an Oregon based nonprofit focused on equity and perinatal wellness. The study’s authors talk to community health workers and maternal health providers. They say that the federal and local governments need to do more to address the growing threats that wildfires pose to maternal and newborn health, especially in marginalized communities. Skye Wheeler is a Senior Researcher with Human Rights Watch. Aver Yakubu is Program Director for Nurturely. They both join us now. It’s great to have both of you on Think Out Loud.
Skye Wheeler: Thank you for having us.
Miller: Ave, why did you decide to focus on this issue?
Aver Yakubu: At Nurturely we focus on a couple of different areas related to the well being of families in the perinatal period. And one of those areas is climate/environmental justice related issues. Wildfires are a growing issue in the state of Oregon and they have major implications for everyone throughout their life course. But there’s also a particular issue and an area of concern for the perinatal period. Because infants or those that haven’t even been born yet, are a reflection of how your future society will be.
So even for the person who is pregnant, their experiences during pregnancy have implications then on their birthing experience and the health of the infant. At least that’s a contributing factor. And then, as I just said, that does have potential implications on growth and development and health and well being.
Miller: Skye, how is this an issue for a human rights organization? What’s the connection?
Wheeler: We all have a right to health and the U.S. government, the State government in Oregon have an obligation to make sure that they’re doing everything they can to improve the health of their constituents. And that includes making sure that preparations and resilience is being built for emerging health problems such as the wildfire crisis.
We know the best science in the U.S. has told us that we’re going to see increasing wildfires, more intense wildfires, at least until the mid of this century. That’s going to mean more stress, more toxic smoke, which is going to impact the health of everyone. But an especially vulnerable population is pregnant people. And we need to see more put in place to protect them from this growing health threat.
Miller: Aver, this was less an epidemiological study and more a qualitative one, based on a lot of interviews with a lot of people. And we can hear about some of the important questions that you all asked. But how much do we know about the physical health effects of wildfires or wildfire smoke on pregnant people and their babies?
Yakubu: There have been some research studies, particularly from researchers who are based in regions that are affected by wildfire. So quite a few researchers in California, for example, have begun publishing studies, assessing the impacts of different components related to wildfires, like exposure to particulate matter or other toxins that enter the air and how those affect birth outcomes.
So I would say there is growing data, especially quantitative data. Some of it has been highlighted in the Report, but then less information from those actually serving families or developing policies and what their perspectives are. So that’s where the qualitative piece comes in.
Miller: Skye, the health professionals that you all talked to included community health workers, doctors, doulas, midwives, nurses. What do you see as the most important questions that you asked them?
Wheeler: Do you feel prepared? Do you have what you need to be able to support pregnant people and families, to protect their health as much as possible? And in general, they’d say no. There is some public health advice, but the problem is [that] some of the most at-risk pregnant people, for example, farm workers or people who are unhoused currently or who live in low quality housing and don’t have a lot of money.
These groups are less likely to be able to take on the advice and put it into practice, do things like stay at home, stay in a room with an air purifier during the most smoky days. That’s the kind of advice that is out there, but it’s not really practical or actionable for many people.
We also heard a lot about mental health stresses from wildfires as well, especially maternal anxiety and depression. And for people who may have pre-existing mental health conditions, wildfires really exacerbate those. So we’d like to just see a much broader and wider approach to wildfires and much more engagement with communities, pregnant people, and those that serve them.
Miller: Aver, what did you hear about the way that air quality measures are communicated to the public?
Yakubu: As far as air quality measures, there are specific websites and other and specific agencies that do have a way of providing notifications on specific air quality, especially in regions that do have wildfires ,like in Oregon. But there is variance in how much the general public is aware and/or notified of different air quality scales, and also how to assess that information. There are a lot of different ways that the information may be available through different avenues. But how is that information being shared out to the public, especially for specific vulnerable communities?
Miller: Skye, let’s go back to what you were talking about and just to focus on the very tangible issue of indoor air quality. What would you like to see for low income families or people who can’t afford air filters or say, whose landlords won’t put them in?
Wheeler: We would like air filters and indeed also cooling AC units to be available on Medicaid, and for all pregnant people, even if they’re low income, to be able to afford them, either for them to be free or to be subsidized. We’re also really interested in clean air spaces. They’re being used in some parts of the U.S. as well. So even if you can’t afford to have clean air at home, you can go to one of these spaces and at least give your body a break from breathing unhealthy air. Then also,better standards for housing and subsidized things like being able to get your windows sealed and other parts of your house sealed so that if you do close your windows and try to use that as a way to improve your air quality at home during a wildfire event, it actually works.
Miller: Smoke is one thing but an evacuation, either a get-set or a true go-now order. It’s even more life altering. Abe, how do you think about an order like that ,in the context of a pregnancy?
Yakubu: That’s a great question. And that ties into why we stress that this period in the life course, during pregnancy or immediately after, is such a critical period because there are multiple factors to take into account. So we know that with certain types of environmental events or disasters, maybe evacuations are inevitable. They have to happen. Everyone is affected but this is where the systemic piece of access to resources and different types of supports vary, based on maybe economic status, et cetera.
So even when I think about someone being pregnant and needing to evacuate, I think about how they will get access to the proper nutrients or food that they need to maintain a healthy pregnancy. How are their stress levels being managed, because stress during pregnancy is not a good thing. What implications on the body, in terms of this chronic stress, will that have in terms of potential adverse outcomes, preterm birth, et cetera.
So when I think about when evacuations have to happen, it’s best to have a structure in place for preparation to, at least, reduce the potential stress that the experience can cause.
Miller: Skye, just in a minute or so that we have left, one of the broadest recommendations is that leaders or lawmakers use a reproductive justice approach to these issues. What does that mean?
Wheeler: That means looking at pregnant people as people and as rights holders. So what do pregnant people need? What are the circumstances? What is the environment that those pregnant people find themselves in? You know, it’s all very well telling pregnant people to do this or to do that, to protect themselves. But what about all the extenuating circumstances around that? What are all the intersecting issues [such as] where they work? Can they ask their boss for time off? What’s their housing like?
It’s [about] looking at the person as a whole and looking at all the different justice issues that impact that person. And it’s really putting that person and their rights in the center. It’s a really important approach. It was developed by Black reproductive justice or reproductive rights experts in the U.S. who really felt that the focus, on access to contraception and safe abortion rights, while really important, missed out on the many other issues that especially poor racialized communities that have been marginalized, through government policies over the decades were facing in their lives, which is far more complex and intersectional and not just about access to those important healthcare issues.
Miller: Skye and Aver, thanks very much.
Yakubu: Thank you.
Wheeler: Thank you.
Miller: Skye Wheeler is a Senior Researcher with Human Rights Watch. Aver Yakubu is Program Director at Nurturely. I should say that we’ve got a lot more information about wildfires, air quality and other resources at opb.org/wildfires.
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