Making obstetrics more environmentally sustainable during and beyond the COVID‐19 pandemic

Abstract

The climate crisis has increased the burden of obstetrical care due to the negative impact of environmental disruption on the health of pregnant women, new mothers, foetuses and neonates. During the COVID‐19 pandemic, the ecological footprint of obstetrical care has significantly increased due to the use of personal protective equipment and the provision of large‐scale testing and vaccination of pregnant women and healthcare personnel against COVID‐19. The situation calls for coordinated action to make obstetrics more resource efficient. To achieve this goal, obstetricians need to rationalise the use of electricity, water, paper and plastic, adopt green surgical practices and integrate environmental sustainability in their working culture and personal life at large. The present article discusses the main sources of environmental pollution in obstetrical care and proposes evidence‐based solutions.

The carbon footprint of different modes of birth in the UK and the Netherlands: An exploratory study using life cycle assessment

“…Eleftheriades et al 5 proposed a framework to reduce the carbon footprint of obstetrics including: reducing paper and plastic waste, minimising unnecessary PPE and informing obstetricians about toxic environmental agents so that they can perform environmental risk assessment and offer relevant clinical counselling. First, the environmental impact of N 2 O/O 2 use in maternity needs to be urgently addressed.…”

“…Birth is common (~140 M births/year worldwide) and, in many countries, a caesarean birth is the commonest major surgical procedure 3 . The environmental impact of birth and maternity care is increasingly being considered; the American College of Obstetricians and Gynecologists recognises that “climate change is an urgent women's health concern as well as a major public health challenge” and calls for ‘healthcare systems to support environmentally responsible practices in order to decrease the environmental impact and carbon footprint of medicine.’ 4 Consequently, efforts to address the environmental sustainability of maternity care have been proposed 5 . These can be viewed through the framework: Refuse, Reduce, Reuse, Recycle, Rethink and Research with opportunities for intervention at each level 6 .…”

“…4 Consequently, efforts to address the environmental sustainability of maternity care have been proposed. 5 These can be viewed through the framework: Refuse, Reduce, Reuse, Recycle, Rethink and Research with opportunities for intervention at each level. 6 Given the frequency of birth, and upward trends in caesarean rates, attention to this area could have a significant impact upon the overall 'carbon footprint' of health care.…”

Elective surgery and postoperative shower: mind the gap and push the limits

“…Similarly, a reduction in out-of-pocket expenses for postoperative monitoring will be a relief for patients dealing with post-COVID inflation and food and energy crises worldwide (9). Finally, yet importantly, harnessing postoperative showers as a leap towards environmentally sustainable surgery, is a major priority given that surgery constitutes the most energyintensive aspect of healthcare (10). Certainly, the pursuit of the above goals should respect the need for evidence-based continuous monitoring of the safety and effectiveness of early postoperative showering.…”

COVID-19, Monkeypox, climate change and surgery: A syndemic undermines the right to be operated in a clean, healthy and sustainable environment

“…A new model of surgical practice combining environmental sustainability and infection control should be designed and gradually implemented. Although the specifics of such an endeavor fall upon academic surgical institutions and surgical health bodies, some key points of consideration include reducing the use of pollution - generating anesthetic gasses such as isoflurane and using consumables based on recyclable bioplastics 16 .…”