ICM Member Association, the New Zealand College of Midwives (the College) is a leader in climate initiatives for a more green midwifery workforce.
The College hosts a dedicated section about climate change on their web page, which includes information about climate sustainability and ways to take action. The web page also posts links to significant documents and articles about climate change and identifies actions midwives can take to reduce their carbon footprint personally and professionally. Topics also include how midwives can support women and parents to learn more about climate change issues, sustainability and parenting.
The College is a member of Ora Taiao (NZ Climate Change and Health Council), and a signatory to the Ora Taiao joint call for action, which calls for urgent action to reduce the contribution of the health sector to climate change and highlights the health gains that are possible through strong health-centred climate action. The College has responded to government consultations and made a number of submissions related to climate change response and the NZ Zero Carbon Bill.
The College also publishes a quarterly magazine for members, Midwife Aotearoa NZ, which includes a regular article with a climate change focus. For example, editions have had articles about the environmental impacts of nitrous oxide, global warming hazards for women and babies, and sustainability initiatives in NZ hospitals, and how the pressure to enable significant change needs to be political and urgent.
We sat down with the College CEO, Alison Eddy, to discuss the College’s shift toward climate change awareness.
ICM: How did the College become involved in climate change initiatives?
A.E.: The College first supported midwifery colleague Dr Lorna Davies when she presented an impact of climate change proposal to ICM. This was adopted as a position statement at the Prague ICM meeting in 2014, and reviewed at a council meeting in 2021.
NZ Midwives have contributed numerous chapters to two books about sustainability, midwifery and birth co-edited by Dr Lorna Davies, another NZ midwifery colleague and principal lecturer Mary Kensington, and NZ senior midwifery lecturer and sociologist Dr Rea Daellenbach. As outlined in a description of the first edition of this book, Sustainability, Midwifery and Birth identifies existing models of sustainable midwifery practice, such as the continuity of care model, and highlights the potential for midwifery as a role model for ecologically sound health care provision.”
NZ Midwife Ruth Martis contributed a chapter entitled good housekeeping in midwifery practice which we think describes the approach the College is aiming to follow with our climate change focus. NZ Midwife and College Policy Analyst Carol Bartle’s chapter discussed breastfeeding and sustainability and looked at the significance of infant feeding decisions to climate damage. The second edition of this book is described as outlining how “sustainability can be incorporated into midwifery practice, education and research”.
The College is grateful to Lorna for her very important work which has provided leadership and a solid platform for further work to support meaningful action by midwives. These experiences represent the beginning for the College of an increased awareness of the impact of climate change, and the potential contribution of practices and actions related to midwifery, pregnancy, birth and infant feeding that could support some mitigation of climate change damage. The College recognises the potential for midwifery to develop a model of excellence for climate action and sustainability.
We do recognise, however, that a focus on individual behaviour change promotion as a panacea to solve public health challenges is insufficient, and the most significant issue is the inadequate response by governments.
ICM: Why did the New Zealand College of Midwives decide to prioritise climate action?
A.E.: We think that midwives can play an essential role in influencing and advocating for social change in relation to sustainability and healthy environments. We continue to be gravely concerned about the increasing number of extreme weather events, and regular threats to safe drinking water and nutritious sustainable food sources. The number of natural and human induced climate disasters are increasing and affecting the lives of millions of people. Pregnant women, infants and young children are among the most vulnerable of populations and women already suffer from inequity, poverty and marginalisation in many environments.
ICM: To you, what does “health-centred climate action” really mean?
A.E.: Climate change is a public health issue and health-protecting policies, both global and national, are critical, overdue and urgent. Midwives engage in public health practice and play an essential role as primary and secondary health care providers. Health centred climate action means focusing not only on how the health system can take action and pay attention to sustainable health care practices, but it’s also about the promotion of including health in climate policy development as a top priority focus because the ability of health systems to deliver care will be disrupted and public health gains will be undermined due to climate change. The health and economic benefits from cleaner air, healthier diets, and more active communities are clear but these benefits are not yet being embraced in many climate policies.
The climate crisis will affect the health of Indigenous peoples due to a range of factors already recognised, and which include their relationship with the natural environment, socioeconomic deprivation, issues with access to quality health care and political marginalisation.
Anthropogenic climate change is intimately connected to the ideologies, systems and practices of colonialism, and climate emergency impacts could be described as an intensification of the colonisation process. In a 2021 submission to government the College supported the NZ Climate Change Commission’s comments about placing Māori tikanga values at the forefront of the transition to ensure inclusivity and equity to improve the wellbeing of all those living in Aotearoa – now and in the future.
The Pacific Islands provides a stark example of the disproportionate burden of the impacts of climate change faced by developing nations and indigenous populations. Many ethnicities from across the Pacific nations have large communities living within New Zealand. There are many connections and touch points at individual, community, political and strategic levels between New Zealand and the Pacific. The urgent need to address the devastating effects of climate change could not be more apparent anywhere in the world than the Pacific. The need to protect these vulnerable nations who are our neighbours, provides further impetus for action.
The College considers that the commercial determinants of health need to be considered and addressed. Recognition of the influence of corporate activity on population health is well documented  and there is growing evidence that the economic power of corporations has defeated, delayed and weakened public health policies. The corporate practices that have actively worked against public health initiatives, and health advocates, are also holding back progress towards meaningful climate goals. Corporate social responsibility initiatives have been used as a strategy to “neutralise opposition” and they have the potential to ‘pacify’ opposition. Awareness and analysis of corporate tactics such as coercion, which can be explicit and visible, and appeasement, which may be more subtle, is significantly important to inform advocacy efforts.
We think that midwives and midwifery associations need to be informed about these issues and recognise conflict of interest situations.
ICM: What is the link between midwifery and climate? What about between healthcare and climate?
A.E.: The potential contribution of practices and actions related to midwifery, pregnancy, birth and infant feeding can support some mitigation of climate change damage as well as the wellbeing of mothers and babies. The ‘fingerprint of climate change’ has been described as beginning before a baby is born due to pregnant women already enduring environmental crises that their children will be exposed to after birth. Evidence indicates that exposure to a deteriorating environment, which includes the effects of air pollution, heat-related illness, malnutrition, vector-transmitted diseases, and mental health problems, have adverse effects on maternal stress, health and wellbeing. This can negatively shape the developing fetus and is associated with adverse pregnancy outcomes.
The Global Initiative, the ‘First 1,000 days’, has the stated mission of making the wellbeing of women and children in the first 1,000 days a priority. The College supports all the key indicators described in the ‘First 1,000 days’ framework which includes social investment in infants and children, and the statement which draws attention to the need to care for pregnant women and mothers. Without immediate, courageous and transformational action on climate change future generations will suffer significant harm. Sustainable health equity should be the goal of all aspects of climate action.
ICM: What are your recommendations to midwives’ associations who would like to reduce their carbon footprint? What about individual midwives?
A.E.: Continuous scrutiny of decisions in how we use resources as an organisation, and evaluation of low carbon or sustainable alternatives is daily activity. Rationalising the use of air travel or flights, using virtual connections when possible, reducing carbon footprint by limiting the use of paper based resources in lieu of virtual ones are some examples of what we are doing as an organisation.
We are at the beginning of developing more information about how midwives can reduce their carbon footprint. Resources will be progressively posted on our webpage.
ICM: Can you recommend any particular resources to midwives and midwives’ associations to educate themselves on climate-friendly care and reducing their carbon footprint?
A.E.: Our webpage already has some useful links and we will continue to develop further resources.
 Jones, R. (2019). Climate change and Indigenous health promotion. Global Health Promotion, 26(3):73-81.
 Jones, R. (2019). Climate change and indigenous health promotion. Global Health Promotion, 26(3):73-81
 Correct procedure, custom, habit, lore, method, manner, rule, way, code, meaning, plan, practice, convention, protocol – the customary system of values and practices that have developed over time and are deeply embedded in the social context. https://maoridictionary.co.nz/search?keywords=tikanga
 Maani., N., McKee, M., Petticrew, M., & Galea, S. (2020). Corporate practices and the health of populations: a research and translational agenda. The Lancet, 5:e80-e81.
 Mialon, M., Vandevijvere, S., Carriedo-Lutzenkirchen, A., Bero, L., Gomes, F., Petticrew, M., McKee, M., Stuckler, D., & Sacks, G. (2020). Mechanisms for addressing and managing the influence of corporations on public health policy, research and practice: a scoping review. BMJ Open, 10:e034082.doi:10.1136/bmjopen-2019-034082.
 Lacy-Nichols, J., & Marten, R. (2021). Power and the commercial determinants of health: ideas for a research agenda. BMJ Global Health, 6;e003850. Doi:10.1136/bmjgh-2020-003850
 Pacheco, S. (2020). Catastrophic effects of climate change on children’s health start before birth. The Journal of Clinical Investigation, 130(2):562-564.
 The First 1,000 Days. An urgent opportunity: a healthy first 1,000 days for mothers and children everywhere. https://thousanddays.org/the-issues/