Midwife observations on the impact of hot weather on poor perinatal outcomes in central Australia: a qualitative study

Remote arid Australian towns already experience high summer temperature and are projected to have warmer future temperatures due to climatic changes. It is also home to many Indigenous women who prefer an outdoor lifestyle and have poor perinatal outcomes. Quantitative analysis of preterm birth and temperature data indicated higher risks to preterm births among Indigenous women in central Australia. This paper aims to report midwives’ observations on the effects of hot weather on poor perinatal outcomes in a central Australian town. Semi-structured interviews were conducted with 12 registered midwives providing perinatal services to families in central Australia. The interview responses were coded and classified against the major themes. None of the midwives perceived any direct relationship between heat exposure and preterm birth, but reported increased incidences of dehydration, exhaustion, discomfort and requests for induction among pregnant women which were often treated before further complications. A quarter of the respondents also mentioned that Indigenous pregnant women do not complain, even when symptoms of heat stress are evident. Quantitative analysis of perinatal and temperature data indicated increased risks to preterm births, but did not provide information on discomfort, dehydration, exhaustion or more requests to be induced. The study also shows that it is important for midwives and health practitioners to be culturally-sensitive to the fact that certain population groups tend not to complain, even if they are experiencing symptoms of heat stress. This research highlights the importance of cultural training for midwives and their role in alerting pregnant women to take precautionary measures during summer periods.