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On a hot day last summer, Clarissa Lugo was inspecting and counting corn and soybean plants in the middle of a 300-acre field. Illinois When she started vomiting and gasping. His heart started beating faster, he stopped sweating, and the severe headache did not go away for hours.
The heat index – a combination of temperature and humidity – had reached 105 F (40.56 C), and Lugo, who was eight months pregnant, was suffering from heat illness.
“I remember it was difficult for me to get back to normal that day, despite drinking water and applying ice to my body,” he recalled.
Agricultural workers are already the most vulnerable to extreme heat, and pregnant workers are being put at even greater risk as temperatures rise due to climate change. There are many low-income Latino immigrants in America who toil in the scorching heat or in humid open nurseries year-round. Heat exposure has been linked to several additional risks for pregnant people, and although protections are in place, experts say they need better enforcement and more safeguards.
These risks have to be combined trump Administration’s immigration action. According to research and interviews with advocates and health care providers, many people are too afraid to seek medical and maternal care, and there is a growing fear of retaliation if they advocate for safer work environments.
associated Press Interviewed four agricultural workers who described their experiences working in extreme heat while pregnant. Three spoke on condition of anonymity because they are in the country illegally or fear retaliation from their employers.
Increase in temperature in large agricultural states
CaliforniaThe state, one of the most agriculturally productive states in the country, is expected to employ more than 893,000 agricultural workers in 2023, according to state data. According to a 2024 study, Iowa is one of the top 10 agricultural producing states, providing more than 385,000 jobs in the agriculture industry.
Since the beginning of the 20th century, California’s temperatures have risen about 3 F (1.67 C), according to state and federal data. Warming has accelerated, and by 2024 seven of the past eight years in that state were the warmest on record. Iowa has seen temperatures rise by more than 1 F (0.56 C) over the same period FloridaAnother large agricultural state, average temperatures have increased by more than 2 F (1.11 C).
Even a slight increase in temperature can make a difference when it comes to how the body reacts.
One study found that agricultural workers had more than 35 times the risk of heat-related deaths compared to other workers. But deaths are difficult to track and are likely undercounted. In the US, an estimated one-third of agricultural workers are women – their share of the agricultural workforce is growing.
Lugo and her child recovered. But others have not been so lucky.
As one nursery worker in Florida said: “I wanted to quit this job,” but “I have to fight for my children.”
Dangers of heat and exertion
One farm worker recalled working in a Florida nursery amid the intense heat in 2010. She was four months pregnant and spent hours lifting heavy pots of plants and weeding and planting indoor foliage such as monstera. One day while at work he felt painful stomach cramps. When she saw blood in the toilet she knew something was wrong.
“(At the hospital) they told me I had already lost the baby,” she said. She believes that the physical exertion combined with the heat caused her miscarriage.
Another nursery worker in Florida who worked four months during her pregnancy in 2024 vomited — sometimes after drinking water — and experienced nausea and headaches, partly due to the heat.
Her baby was born prematurely, at seven months. “(The doctor) told me that I spend too much time bent over… and I can’t even eat properly because of the heat,” she said.
The risk of overheating increases during pregnancy because the body has to work harder to cool down. Exposure to heat increases the risk of miscarriage, stillbirth, premature birth, low birth weight, and birth defects.
The combination of pregnancy and heat with physical exertion can rapidly overwhelm the body’s cooling system, increasing the likelihood of dehydration, heat illness, and heat stroke. According to the Environmental Protection Agency, even short-term exposure to heat can increase the risk of serious maternal health complications, such as high blood pressure disorders during pregnancy.
In the worst case, it can kill.
Maria Isabel Vasquez Jimenez was 17 years old and two months pregnant when she died of heatstroke after sorting grapes on a California farm in 2008. Officials said his supervisors failed to provide shade and water while he worked nearly triple the hours in the heat.
California’s outdoor heating standard, enacted in 2005, was later named in Jimenez’s honor.
It’s not clear how sporadic regulations might benefit farm workers
No federal heat protections exist in the US, although the Trump administration appears to be moving forward with a proposed rule. Some states, including California and Washington, have their own protections, while other states, such as Texas and Florida, have barred local governments from enforcing their own protections. In states with protections, advocates say they are not adequately enforced and point to widespread distrust of the reporting systems.
More than 30 states and cities have laws that require employers to provide accommodations for pregnant workers. Most recently, the federal Pregnant Worker Fairness Act of 2023 requires employers to provide “reasonable accommodations” to pregnant workers who have recently given birth or who have medical conditions related to birth or pregnancy, unless they would cause the employer an “undue hardship.” Other laws make it illegal to fire or discriminate because of those factors.
Still, there aren’t enough legal protections for pregnant workers, said Ayana Degaiah, an assistant professor of obstetrics and gynecology at the University of Washington in Harborview. “This is perhaps one reason why we have the highest maternal and child mortality rates among high-income countries in the world,” he said.
It’s also unclear how some of these protections benefit female farmworkers, said Alexis Handel, an associate professor at the University of Michigan who led a recent study examining the experiences of the state’s female farmworkers.
In Florida, the top U.S. producer of indoor plants and tropical foliage, the nursery industry’s mostly female workers have joined the fight to beat the heat. In California, workers are advocating for guaranteed compensation for lost wages due to heat waves and other extreme weather events, as well as additional pay if worked during dangerous weather conditions.
Immigration enforcement involves challenges of care
Trump’s immigration actions have stoked deep fear in immigrant communities.
In California, a doctor said his clinic recently had a patient who was suspected of carrying a fetus with a birth defect. They set him up for specialized counseling and care about two hours away from home. But the woman could not get that care during her pregnancy. It was difficult to arrange transportation and child care. However, the main reason for detention was fear, said Dr. Catherine Gabriel-Cox, director of obstetrics, midwifery and gynecology at the community health center Salud para la Gente.
She said she hears similar stories “over and over again.”
This is a matter of increasing concern at the national level. Health care providers reported fewer walk-ins, patients delaying prenatal care and seeing more pregnant patients whose first doctor visit was for labor and delivery, according to a brief published in April by the group Physicians for Human Rights. Others have reported an increase in no-shows and canceled appointments.
“I would be concerned that people won’t present for medical care until it’s too late,” said Katherine Peeler, medical adviser to Physicians for Human Rights and assistant professor of pediatrics at Harvard Medical School.
Pregnant agricultural workers in rural areas already have less access to maternity care because clinics are far away and transportation can be difficult to find. Other times, they cannot afford to miss work hours or are not given time off. Many do not even receive employer-sponsored medical care or paid leave.
Work and home conditions may increase risk
Juan Decelet-Barreto, senior social scientist for climate vulnerability at the Union of Concerned Scientists, said farmworkers are less likely to demand adequate shade, water or rest from employers, or to speak out for fear of being fired or summoned by immigration enforcement officers if they feel heat ill.
Some workers who spoke to the AP described employers who did not provide them with housing or water, face coverings or other equipment to protect them from pesticides and the heat. She continued to work under compulsion even during pregnancy.
A third nursery worker from Florida said, “Many times my back and my whole body ached… but I had to do it.” “No one was helping me, and so I had to keep going. If not, no one would pay my bills.”
The nursery worker who had an abortion said she had to urinate frequently during her pregnancy, but portable toilets were a 10-minute walk away. Another described dirty bathrooms full of flies. And another recalled pregnant women who were only allowed to use the bathroom during scheduled breaks.
Women working in agriculture who have been sexually harassed on the job may also be more sensitive to the heat, said Yunuen Ibarra, program director of Lidares Campesinas, a farmworker advocacy organization. They may cover their bodies with extra clothing “to avoid being exposed to a potential attack,” which could increase their body temperature, he said.
Several studies have shown that at home, farmworkers may have little respite from extreme temperatures because they are more likely to lack air conditioning, have lower incomes, or live in hotter areas.
As human-caused climate change continues, heat waves will become longer, hotter and more frequent. Without adequate protections and enforcement, pregnant farmworkers and their unborn children will suffer the consequences.
“We can’t stop temperatures from rising, but we can stop farm workers from dying or feeling sick or becoming disabled due to heat-related illnesses,” Ibarra said.
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The Associated Press receives support from the Walton Family Foundation for water and environmental policy coverage. AP is solely responsible for all content. For AP’s complete climate coverage, visit https://apnews.com/hub/climate-and-environment.