The fight against climate change is being held back by midwives. There aren't enough of them to begin with. According to the United Nations, there is a shortage of nearly one million midwives. The US has worse maternal mortality rates than other high-income countries because of the lack of midwives.

There are multiple insurance-related hurdles between patients wanting to work with a midwives and getting to do so. Black, Indigenous, and Latinx people are more likely to live in states with more barriers to access the midwife. Integrating midwives into the American health care system positively affects equity and health outcomes.

There is a line between the racist campaign to undermine midwives in favor of the medicalization of childbirth and the rise of white male OBs and gynecologists. The doctors criminalized and discredited the work of Black midwives in the early 1900s. Joseph DeLee, one of the earliest obstetricians, called the midwives a "relic of barbarism." Many Americans think of midwives as unsafe or don't think about it at all because of this history. It's amazing to me how little the average person knows about professional midwives and what they can do.

It's necessary to connect patients to the birth workers who can provide climate-focused care, to the people who will ask their patients if they have air conditioning, and to the people who know how to apply for an electricity stipend.

Maternal care workers are being asked by Wheeler and her colleagues at the National Birth Equity Collaborative what they already do to address climate impacts and what more they want to do. The results can help develop training between birth workers and other professionals. She believes that the climate crisis is teaching us how to approach health. This type of collaboration has taken place before. In El Paso, Texas, researchers hosted a training on heat exposure and maternal health in the community room. The attending doulas and midwives said they spoke to their clients more about heat risks after the pilot project.

There is room for growth. There is a need to makesustainability literacy a core component in every midwifery curriculum. Her work on the subject has already made a difference in her country. The New Zealand College of Midwives was inspired by Davies' research to consider how to serve as a climate solution.

There is a responsibility to educate and lead midwives to become climate change champion in their work, to think and act critically in how they use resources in their practice, and to consider their role in advocacy to hold governments, hospitals, and politicians accountable. The College has advocated for the recognition of the special needs of pregnant people and infants in New Zealand.

In the US, there is some movement toward investing in midwives because of their connection to improved health outcomes. Women are particularly vulnerable to the effects of climate change and there needs to be a similar effort.

There is a lot of discussion about what we need to give up. There is a rare example of something we can get.