Florida pioneers “climate doulas” program to protect pregnant women from extreme weather

When Hurricane Irma barreled toward Florida in 2017, Miami doula Esther Louis didn’t just evacuate with her own family—she escorted her nine-months-pregnant client through a harrowing 24-hour journey to Georgia. The stress-induced contractions her client experienced during the evacuation became a turning point that would reshape how birth workers approach climate emergencies.

Louis’s experience highlights a growing crisis: climate change is increasingly threatening maternal health. Research now links extreme heat, wildfire smoke, and severe weather to higher rates of stillbirths, premature births, and maternal complications like preeclampsia. Recognizing that doulas—who provide emotional and physical support during pregnancy—were already witnessing these climate impacts firsthand, Louis partnered with Dr. Cheryl Holder to create something unprecedented: the Doula C-Hot program.

This pioneering Florida initiative trains doulas to become climate educators, teaching them to assess their clients’ disaster preparedness and connect them with resources like portable air conditioners and cooling centers. The program’s 12 trained doulas now work with pregnant clients to identify flood zones, develop hurricane evacuation plans, and prepare for extreme heat—serving over 40 clients so far. They ask crucial questions: Do you have air conditioning? Emergency funds? A safe place to shelter?

The model is catching on nationwide. Oregon plans to launch a similar program focused on wildfire preparedness in 2026, while doulas in New Orleans and Philadelphia are already improvising climate-related support during disasters. As extreme weather becomes more frequent and severe, these “climate doulas” represent a vital new approach to protecting both mothers and babies from environmental threats.