Heat exposure in pregnancy is associated with a range of adverse health and wellbeing
outcomes, yet research on the lived experience of pregnancy in high temperatures is
lacking. We conducted qualitative research in 2021 in two communities in rural Kilifi County,
Kenya, a tropical savannah area currently experiencing severe drought. Pregnant and
postpartum women, their male spouses and mothers-in-law, community health volunteers,
and local health and environment stakeholders were interviewed or participated in focus
group discussions. Pregnant women described symptoms that are classically regarded as
heat exhaustion, including dizziness, fatigue, dehydration, insomnia, and irritability. They
interpreted heat-related tachycardia as signalling hypertension and reported observing
more miscarriages and preterm births in the heat. Pregnancy is conceptualised locally as a
‘normal’ state of being, and women continue to perform physically demanding household
chores in the heat, even when pregnant. Women reported little support from family
members to reduce their workload at this time, reflecting their relative lack of autonomy
within the household, but also potentially the ‘normalisation’ of heat in these communities.
Climate change risk reduction strategies for pregnant women in low-resource settings need
to be cognisant of local household gender dynamics the constraints onthat constrain

Keywords: Pregnancy, heat exposure, health and wellbeing, gender relations, Kenya,
qualitative research, climate change

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