The Intergovernmental Panel on Climate Change Report and the Obstetrician: A Perspective and a Call to Action1Jordan Emont, MD MPH ScM1Department of Obstetrics and GynecologyColumbia University Irving Medical Center622 West 168th Street, PH 16New York, NY 10032 [email protected] Title: The IPCC Report and the ObstetricianWord Count: 491The newest report from the Intergovernmental Panel on Climate Change (IPCC) released this month confirmed everything we know about climate change: it is happening, all experts agree, and while things will get worse there is still a chance for us to make things better (IPCC 2021).Healthcare professionals are aware of the health risks of climate change but often face barriers to advocating for and educating patients about these risks (Kotcher et al. 2021). In the field of obstetrics, these barriers can be manifold including limited time and lack of provider education about the climate risks to pregnancy. As the world continues to warm, weather will become increasingly unpredictable and extreme. Healthcare professionals will again be on the front line of another pandemic, that of climate-induced disease. Pregnant patients will look to their obstetricians for guidance on preventing deleterious outcomes. There are simple actions we can take to step into this role.First, we must educate ourselves about these risks in order to help guide our patients appropriately. Anyone who has worked in an obstetric triage on a hot day knows that heat can be very uncomfortable and can cause preterm contractions for pregnant patients. Excess heat exposure has been demonstrated to be associated with preterm birth and low birth weight, two of the leading causes of infant morbidity and mortality (Bekkar et al. 2020). Exposure to particulate matter, for example from air pollution and wildfires, has a similar association (Bekkar et al. 2020). New precipitation and heat patterns will change distributions of mosquito vectors that can carry teratogenic infections such as Malaria and Zika (Rocklöv and Dubrow 2020). Finally, climate disasters such as floods and hurricanes limit access to adequate pregnancy care thus leading to poor maternal/fetal outcomes.Second, we must educate patients about how to avoid such risks. While time is often a barrier for obstetricians to provide thorough education, reminding patients about the value of adequate hydration and cooling on a hot day take seconds of a prenatal visit. Furthermore, clinics can create educational materials and utilize support staff for patient education. For example, a project in El Paso, TX on maternal heat safety utilized pamphlets and community health workers to empower patients to monitor their own climate health (Monteblanco et. al 2021).Third, healthcare professionals have a responsibility to not only be on the front lines of clinical care for the climate affected mother but also to advocate on local, national, and international platforms. The siren of climate change has rung since at least the 1970s with minimal initiative worldwide. It is now the health of people, specifically mothers and children, that will need to lead the argument for climate action. The new IPCC report identifies that immediate international curbs to greenhouse gas emissions can limit the very worst predictions for the future of the world.The IPCC report is a reminder of the challenges we face for pregnant women worldwide in the era of climate change. With education and advocacy, obstetricians can help prevent poor outcomes associated with climate change for our patients now and in the future.Acknowledgements: NoneDisclosure of Interest: NoneContributions to Authorship: The manuscript was conceived, written, and edited by J EmontEthics Approval: Not requiredReferences:IPCC, 2021: Climate Change 2021: The Physical Science Basis. Contribution of Working Group I to the Sixth Assessment Report of the Intergovernmental Panel on Climate Change [Masson-Delmotte, V., P. Zhai, A. Pirani, S. L. Connors, C. Péan, S. Berger, N. Caud, Y. Chen, L. Goldfarb, M. I. Gomis, M. Huang, K. Leitzell, E. Lonnoy, J. B. R. Matthews, T. K. Maycock, T. Waterfield, O. Yelekçi, R. Yu and B. Zhou (eds.)]. Cambridge University Press. In Press.Kotcher, John, Edward Maibach, Jeni Miller, Eryn Campbell, Lujain Alqodmani, Marina Maiero, and Arthur Wyns. “Views of Health Professionals on Climate Change and Health: A Multinational Survey Study.” The Lancet Planetary Health  5, no. 5 (2021). https://doi.org/10.1016/s2542-5196(21)00053-x.Bekkar, Bruce, Susan Pacheco, Rupa Basu, and Nathaniel DeNicola. “Association of Air Pollution and Heat Exposure WITH Preterm Birth, Low Birth Weight, and Stillbirth in the US.” JAMA Network Open  3, no. 6 (2020). https://doi.org/10.1001/jamanetworkopen.2020.8243.Rocklöv, Joacim, and Robert Dubrow. “Climate Change: An Enduring Challenge for Vector-Borne Disease Prevention and Control.” Nature Immunology  21, no. 5 (2020): 479–83. https://doi.org/10.1038/s41590-020-0648-y.Monteblanco, Adelle Dora, Jennifer K Vanos, Sarah LeRoy, Patricia M Juarez, and Gregg M Garfin. “An Evaluation of a Maternal Health and Extreme Heat Exposure Training.” Journal of Social, Behavioral, and Health Sciences  15, no. 1 (2021). https://doi.org/10.5590/jsbhs.2021.15.1.02.