How rising heat is reshaping motherhood in Kilifi
By Willow Health, July 9, 2026As temperatures rise, so do the risks of preeclampsia, preterm birth and stillbirth, while fewer women attend antenatal clinics and anxiety worsens in water-scarce communities.
Amother in Kilifi wakes up at midnight to breastfeed her newborn baby in a house that is hotter inside than outside. By morning, she is exhausted, dehydrated, and preparing to walk in search of water.
For many women in Kenya’s coastal county, this is becoming an increasingly common reality. The places considered safest for mothers and newborns, including homes and health facilities, are also becoming some of the hottest. And as temperatures rise, researchers are finding that the effects begin in pregnancy and stretch far beyond childbirth.
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New research now shows that rising heat is quietly reshaping pregnancy, birth, and newborn care in Kenya’s coastal region, creating risks that have long gone understudied. Kilifi is among the counties experiencing rising temperatures and recurrent climate-related stress.
Speaking at the Aga Khan University Institute for Human Development International Conference in Nairobi, Prof Adelaide Lusambili, a medical anthropologist and climate and mental health scientist, outlined how heat affects women across the maternal journey.
“What heat does to the mother spans pregnancy, birth and the weeks after delivery,” she said.
Her research, conducted in Kilifi and supported by findings from other African countries, shows that rising temperatures are linked to higher risks of preeclampsia, preterm birth, and stillbirth. It also found that women attended fewer antenatal clinics during periods of extreme heat, while anxiety levels increased, particularly among mothers living in areas where water for hygiene and household use was scarce.
The effects intensify during labour and delivery. Studies from Kilifi have documented increased emergency Caesarean sections, preterm births, and low-birth-weight babies during hotter periods.
The risks do not end after birth, as “Extended bleeding and slower healing have been observed in Kilifi,” Lusambili noted.
Mothers breastfeed for approximately 23 fewer minutes daily during the hottest season compared to the coolest season
The research further found that breastfeeding often declines during hotter seasons, with mothers introducing supplementary feeding earlier than recommended.
Data from the Heat Exposure Impacts on Maternal and Neonatal Health (HEARTH) study in Kilifi found that breastfeeding patterns change significantly as temperatures rise. Researchers observed that mothers breastfed for approximately 23 fewer minutes daily during the hottest season compared to the coolest season. At the same time, babies appeared to demand feeding more frequently.
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“The safest places are the hottest,” Lusambili added. “Indoors is hotter than outdoors, and the heat reaches all the way into how she feeds her baby.”
Researchers found that indoor temperatures were, on average, 1.31 degrees Celsius hotter than outdoor temperatures, with some homes reaching as high as 45 degrees Celsius.
The findings reveal a difficult cycle: as temperatures rise, babies seek more comfort and feeding, while mothers become increasingly exhausted and dehydrated.
“The hotter it gets, the more her baby nurses, draining a mother already exhausted and dehydrated,” Lusambili said.
She explained that the womb is naturally warmer than the mother’s body, making unborn babies especially vulnerable to rising temperatures. Evidence from South Africa, Benin, and The Gambia links heat exposure to increased risks of stillbirth, preterm birth, and low birth weight.
“What heat does to the baby starts in the womb, continues through birth, and into feeding,” Lusambili said.
Fewer families use bed nets during hotter periods, potentially increasing exposure to malaria
Newborns have also experienced heat-related conditions including skin rashes and blisters around the mouth and skin. Feeding disruptions have been documented, while fewer families use bed nets during hotter periods, potentially increasing exposure to malaria.
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For some mothers, these conditions are now influencing decisions about where to seek care.
“Home is dangerous. The facility is dangerous. For too many, there is no longer a safe place to give birth,” Lusambili said.
The risks are not evenly distributed. Research presented by Dr Felix Oluoch from Aga Khan University’s Population Health Department shows that heat exposure in Kenya is increasingly concentrated in a stable group of highly vulnerable sub-counties, many of them in Kilifi.
His analysis identified 61 sub-counties experiencing sustained heat exposure, defined as at least 30 high-heat days annually. Together, these areas account for 96.2 per cent of the annual heat burden experienced by pregnant women and 96.8 per cent of the burden experienced by children under five.
“This concentration means targeted action can reach the locations where the most severe heat burden occurs,” Oluoch highlighted.
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The findings suggest that focusing interventions in the hardest-hit areas could significantly reduce health risks for pregnant women and newborns. For health officials in Kilifi, the evidence reflects what they are already witnessing.
Kenneth Miriti, Kilifi County’s Coordinator for Reproductive Health, said rising temperatures are becoming an urgent concern, especially during the dry season.
“We have seen increased heat in some parts of the county, and this has resulted in issues during pregnancy,” he said. “We suspect that in some cases the increased temperatures have contributed to miscarriages and pregnancy losses.”
Access to health facilities remains difficult because of distance, transport costs, and limited public resources
He added that women often bear the heaviest burden of climate-related hardship. In areas such as Magarini, Ganze, and parts of Kaloleni, many walk long distances in search of water during drought periods, adding physical strain during pregnancy.
But researchers say heat is only one part of a broader climate-health crisis. Research presented by Prof Bilal Butt on climate change, water quality, and pastoralist health in Kenya’s drylands found that health risks are often shaped by access to water, labour demands, and deeper structural barriers.
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“Pastoralists recognise that water sources are being increasingly polluted, and this affects their health,” Butt said.
His findings show that even where health facilities exist, access remains difficult because of distance, transport costs, and limited public resources.
The pattern mirrors what many climate-vulnerable communities face: as temperatures rise, safe water, reliable transport, and accessible healthcare become critical for maternal and newborn survival.
Still, researchers say the solutions are within reach. Prof Lusambili highlighted a behaviour-change intervention designed to help families adapt daily practices to protect mothers and newborns during extreme heat.
“Shifting socio-cultural practices to protect mothers and newborns is affordable and scalable,” she said.
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Other interventions focus on redesigning the environments where mothers live. Greening, shade, and cooler community spaces can lower heat exposure before a woman ever reaches a clinic. Researchers argue that climate resilience must extend beyond hospitals to include housing, water systems, transport networks, and community support structures.
Similar approaches are emerging elsewhere. In Pakistan, researchers have developed a climate-resilient maternal nutrition model tailored for pregnant women living in extreme heat. Presenting the findings, Fatima Nazir described it as “a novel, evidence-informed and culturally grounded framework for designing heat-mitigating dietary interventions during pregnancy.”
The model focuses on practical, locally available foods and hydration strategies that help regulate body temperature, maintain electrolyte balance, and support maternal health during periods of extreme heat. It integrates cultural dietary habits with scientific guidance, making it easier for communities to adopt without major lifestyle changes.
While still being studied and refined, it offers a promising approach that could be adapted for heat-vulnerable settings such as Kilifi.