*2.4. Food Security*

The vacillation of rainfall and temperature patterns negatively impacts crops, livestock, and fishery yields, adding to food insecurity. According to Sorensen et al. (2018; Jáuregui-Lobera 2014), women suffer higher rates of macro- and micronutrient deficiencies, and higher rates of anaemia which can impair cognitive functioning such as poor attention span, diminished capacity to remember things, emotional highs and lows, and impaired sensory perception. Malnutrition can cause negative impacts on neonatal outcomes, including intrauterine growth retardation and perinatal mortality (FAO 2002). Taking all these aspects into consideration, women are inherently sensitive to food insecurity and the resulting deficiencies due to increased needs during pregnancy and post-pregnancy, for example, in the feeding of the newborn. Often, culturally, women may prioritise food provision for children and adult males,

neglecting to ensure that they obtain a balanced or available meal. In low-income countries, women produce 60–80% of all food. As such, livelihoods, as well as nutrition, are negatively impacted during times of disaster (GDI 2017). Further, less than 10% of female farmers are landowners and barely 2% have proper paperwork for their land, exacerbating control over farmland and food security (GDI 2017).

According to FAO (1996), food insecurity is defined as inadequate access to healthy, affordable, and culturally appropriate food and this impacts more women than men, especially those of reproductive age. Food insecurity during pregnancy has great implications for the health of the mother and her baby, as this can lead to negative maternal and child health situations (Augusto et al. 2020). Pregnant women who do not have access to proper nutrition are at a higher risk for gestational diabetes and excess maternal weight gain (Laraia et al. 2010), low birth rate (Sahlu et al. 2020), maternal stress (Augusto et al. 2020), birth defects (Carmichael et al. 2007), and premature births and can struggle to breastfeed (Orr et al. 2018). Challenges with food insecurity during pregnancy can have detrimental effects on child growth and development (Augusto et al. 2020). Moafi et al. (2018) posited that food insecurity is linked to poor quality of life for pregnant women and Maynard et al. (2018) added that it is also linked to prenatal and postpartum depression. McKay et al. (2022) supported this by stating that the burdens imposed by food insecurity worsen the mental health of pregnant woman. McKay et al. added that it is important to screen very early for food insecurity in pregnancy and to identify 'at risk' women. This would benefit the provision of mental health support. Most often, food insecurity initiatives, with respect to pregnant women, do not consider income and poverty, employment status, education level, location, ethnicity, and access to food and nutrition programmes (Costa et al. 2017).

#### *2.5. Changes in Temperature, Precipitation, and Ecology Are Altering the Presence of Vector-Borne Diseases*

Exposure to mosquito-borne illnesses poses health issues to pregnant women. Dengue virus, present in the Caribbean, leads to an increased risk of caesarean delivery, eclampsia, and growth restriction (Pouliot et al. 2010). It is the most rapidly spreading mosquito-borne viral disease in the world. Sorensen et al. (2018) found that pregnant women are susceptible to mosquito-borne diseases due to their higher CO2 production and increased peripheral blood flow. Mosquitoes are attracted to CO2. Consequently, this helps them to locate their hosts quickly. Sorensen et al. explains that women spend more time around the home performing domestic tasks, which places them close to standing water with mosquito breeding sites. They add that lack of access to proper prenatal care and supported deliveries puts women at risk for postpartum haemorrhage and poor maternal outcomes.

The issues highlighted in Sections 2.1–2.5 look at the situation where pregnant women and children are affected by the social conditions that increase their vulnerability to climatic events. Pregnant women, babies, and children deserve to live and exist in a world free of the debilitating effects of climate change. As such, issues impacting these populations must be put on the agenda of Caribbean governments to safeguard maternal and children's health. Some interventions can include:

Apart from the social issues, the economic costs of climate change events on maternal and child health of low-income and single-parent households were alluded to in addition to the social perspective; these socioeconomic aspects are highlighted below.