In this summer, Pakistan becomes one of the hottest places on earth. Temperatures often climb to 40 degrees Celsius, and on some days it can feel as hot as 50 degrees.
For most people, this kind of heat is very uncomfortable, but for pregnant women living in poor neighborhoods, it can be truly life-threatening.
A recent trial led by researchers at Pakistan’s Aga Khan University has shown that simple and cheap tools can make a real difference.
Things like canvas canopies, hand fans, damp cloths, and solar reflective paint were able to lower indoor temperatures by 3 to 4 degrees Celsius.
These may not sound like medical solutions, but in some of Pakistan’s hottest and most crowded neighborhoods, they can save lives.
Why Common Solutions Do Not Work Here
The reason these low-tech tools matter so much is that most of the commonly recommended solutions for dealing with heat simply do not work for poor women in countries like Pakistan.
Gregory Wellenius, director of the Center for Climate and Health at Boston University, explained that many commonly recommended heat interventions assume reliable electricity, formal workplaces, and universal phone access, making them impractical for many women in low-income countries.
Air conditioning is out of reach for most families because of both cost and unreliable electricity supply.
Even electric fans are often not available for the same reason. This means that when a heatwave hits, millions of pregnant women have almost nothing to protect themselves or their unborn babies from extreme temperatures.
Climate change is making this problem much worse every year. According to World Weather Attribution, a network of scientists who study extreme weather, heatwaves in Pakistan are now 30 times more likely to happen because of climate change.
The city of Karachi, Pakistan’s largest city, is expected to become an additional 2 to 7 degrees Celsius hotter than the rest of the world due to the urban heat island effect, where densely built city areas trap heat and raise temperatures even further.
One woman who knows this struggle very well is Asiya, a pregnant mother living in Lyari, one of the most densely populated neighborhoods in Karachi. She is expecting her third child and described the experience of being pregnant in such extreme heat.
She said, “The heat exhausts me. My body feels like lead.” During her last pregnancy two years ago, she had to take three cold showers a day just to cool down because she could feel her baby kicking in distress.
But for Asiya, cooling down is not as simple as opening a window or stepping outside. Her husband does not allow her to stand by the window because of cultural and religious conventions.
This is a reality that many women in Pakistan face, and it makes the problem of heat exposure even more difficult to solve.
Designing Solutions That Respect Culture
This is one of the reasons why the cooling solutions being tested are designed with social and cultural realities in mind.
Canvas canopies and bamboo pole structures, for example, create outdoor spaces where women from conservative families can sit outside to cool down while still observing purdah, which is the practice of remaining covered in front of unrelated men.
By designing solutions that respect these values, researchers hope more women will actually be able to use them.
On the other hand, the health risks of heat during pregnancy are serious and well-documented. Neha Mankani, a midwife who runs a clinic on Karachi’s Baba Island, has been watching the effects of extreme heat on her patients for years.
She said that she has seen rising rates of second-trimester pregnancy losses and estimated that at least half of her patients now face some kind of heat-related complication, including high blood pressure, respiratory illnesses, and neurological problems in newborns.
A 2026 study conducted across Pakistan found that between 9 and 13 percent of all low birth weight cases were linked to heat exposure during pregnancy. Low birth weight is a serious condition that puts babies at a much higher risk of illness and death in their early months of life.
Pakistan’s neonatal mortality rate is already more than double that of neighboring countries like India and Bangladesh, according to data from the World Health Organization, and heat is one of the factors making this worse.
A Midwife Taking Matters Into Her Own Hands
Mankani has responded to this crisis by distributing care packages to her patients to help them manage the heat.
Each package contains cotton clothes to replace heat-trapping polyester clothing, spray bottles for misting water on the skin, rehydration salts to replace fluids lost through sweating, washcloths that can be dampened and applied to the body, and hand fans.
These items cost very little, but they can make a meaningful difference for a woman struggling through a hot pregnancy with no electricity and no other options.
What makes all of this so important is that the women most affected by extreme heat are also the ones with the least power to protect themselves.
They are poor, they live in overcrowded neighborhoods, they often cannot leave their homes freely, and they have almost no access to modern cooling technology. The solutions being developed by researchers and midwives like Mankani are not perfect, but they are practical, affordable, and designed for the real lives of the women who need them most.
As climate change continues to push temperatures higher every year, the need for these kinds of solutions will only grow.
Researchers hope that the results of the Aga Khan University trial will encourage governments and health organizations to take low-tech cooling tools more seriously as part of public health policy. If these simple and affordable solutions can be scaled up and distributed widely, many more lives could be saved during future heatwaves.
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