Pregnancy has become vulnerable to climate change and its effects. Natural disasters, diseases, and rising heat can lead to poor health outcomes for the expectant and their babies. With our conversation with Dr. Roshani Ulak who is currently working as a

  1. Could you tell us when is the right age for Pregnancy?

We can’t pinpoint a certain age but it is indeed better to conceive between 20 to 30 years. At this age the ovarian reserve is healthy, and the quality of eggs is fertile. Now as the scenarios have changed not everyone is ready to get married at this age, most people plan to get married after their 30s due to several factors and personal reasons. The priority is to be mentally, physically, financially, and emotionally prepared to start a family of their own. But still, we can’t guarantee age between 20 to 30 is the safest because there might be other complications affecting pregnancy. When a woman crosses their 30s, they have to face multiple health issues and physical weakness which will directly or indirectly affect the pregnancy.

 

  1. What are the major factors that affect pregnancy?

Basically, the first thing to consider is the age and to know the quality of the egg reserve. Even males need to get examined and consider their sperm count and their health. It is not the sole role of the female but both partners should be capable and healthy. In females, major concerns would be diseases like weight, Diabetes, sexually transmitted infections (STIs), preexisting medical conditions, multiple pregnancies, etc. these are the major things that can affect pregnancy.

 

  1. How does climate, as an external factor affect pregnancy? And how does it affect pregnancy?

We haven’t seen such cases where a woman went through a miscarriage or it affected the health of the baby or mother due to climate change. However, some studies have shown that intense heat does affect in various ways like increased risk of preterm and early term birth, low and decreased birth weight, stillbirth, and harmful newborn stress. Multiple studies have found that preterm births increased by 16 percent during heat waves. But Nepal has a moderate climate and even though a woman from the terai, Hilly, or Himalayan regions migrates, it would be safe and won’t cause issues by climate.

 

  1. What and who is at major risk, is it the mother, the childbirth process, or the child?

Climate change which brings diseases like dengue, and covid could be the factor risking pregnancy. The emergence of the Delta variant in June of 2021 was associated with an even greater risk for severe outcomes for pregnant women, including an increase in ICU admissions, an increase in required medical interventions such as invasive ventilation and ECMO, and an increased number of deaths. A pregnant woman already infected with dengue can pass the virus to her fetus during pregnancy or around the time of birth.

Dengue has harmful effects, including the death of the fetus, low birth weight, and premature birth. May be not exactly the climate or weather but the consequences of such diseases. The Maternal stress caused during the pandemic affects the growth of the baby in the womb. Climate change can’t cause diabetes or thyroid but this disease can cause the pregnancy to induce only due to climate change none of the processes are at risk, but the impacts of changes might.

 

  1. What should a couple consider about climate before planning their pregnancy?

In the context of Nepal, we see most childbirth in the winter season because of a belief or concept that during the winter season a mother, as well as the child, will get to sunbathe and the wound will heal sooner. Additionally, it is analytically hard to celebrate events during summer like the “Ghee and Chaku” for warmth, Oil massage for the mother and child, and Postpartum Superfood, which is also called “Sutkeri Ko Masala”. So, Nepalese prefer the winter season for the maternity period but it doesn’t mean one can’t give birth in summer, any season is best till you take care of your hygiene and health.

 

  1. What a couple and the family can do to protect the mother and child from the risks in childbirth?

If a couple is planning to have a child, they should consider the age before 35. After 35, multiple factors might affect the pregnancy. For example, if the mother suffers from pressure, Thyroid then this can create complications in childbirth as well as in the health of both mother and child.

So, if they are planning on having a baby, they should consult the doctor first and if any issues are seen, they can work as the doctor prescribe. The treatment can lead to safe delivery and parents can enjoy their parenthood. But we highly suggest that couples conceive before their 30s.

 

  1. Is Nepal well-equipped to treat maternity-related complications?

There are various aspects of pregnancy from physical/ mental to the health of the child in the womb. Hence, there are various issues that come along. Even though Nepal is considered a developing country, it has always been focused on proper maternity services. There is good coverage of maternity services across most of Nepal. The Safe Motherhood Program provides essential maternity services to all women through an extensive four-tiered district health system. In addition, with the successful service of Invitro fertilization (IVF), Intrauterine insemination (IUI), and other related services in Nepal. At the sub-health posts, maternal and child health workers provide antenatal and postnatal care and assist in home delivery’s structure. The provision of maternity services in Nepal appears to be good, with adequate coverage and availability. The utilization of maternity services has also improved in the past decade.

 

 Have you faced any incident where your patient had to go through some issues due to environmental or climatic reasons?

During Covid, multiple pregnant patients had difficulty breathing but all the babies were delivered safely. Unfortunately, during dengue one of our patients had to lose their baby and had to deliver the child in the ICU due to high fever, low platelet count, and other complications. Many deliveries proceeded to ICU and were successful too.

 

  1. What do you want to tell the “to-be mother” about safe pregnancy and the environmental factors?

First thing is to be prepared physically, emotionally, mentally, and financially because the lack of one aspect creates complications. It’s not about a day or two but whole nine months. Many years ago when people would get married at 15 and have children by 16. Now, the scenario is different. Most of them wait till their 30s, take a few years to settle then plan for a child. But still, the best time is before your 30s, if not you should consult with an obstetrician or gynecologist, as there are options and medications like folic acid tablets which are taken 3 months before childbirth. Mainly both partners should get checked it’s never only about the women, but both of them and get treatment as per requirement.