"As climate change gets worse and worse, people are going to be experiencing multiple hazards over their lifetime, and … experiencing multiple of these hazards might affect people's choices," Meg "Bee" Brown, Research Lead at YLabs and lead author of the study, told CG.
This article is part of a series spotlighting contraceptive research and development efforts in a warming world, co-published by Climate, Gendered and CTI Exchange. Subscribe here and here to make sure you catch future installments.
Mary's efforts to reach the clinic in Kenya where she received contraceptive injections became impossible when drought forced the continual relocation of her family's grazing livestock. "That is how the pregnancy happened," the then-25-year-old told YLabs, a global design and research organization.
Aliya, with one child of her own, told researchers that it was flooding in Nigeria that was challenging her mother's access to contraception. "She could not go because the rain washed the road away," the 19-year-old said.
Aliya noted that heavy precipitation had destroyed her family's crops — a source of food and livelihood — and that her parents fought about not being able to have sex. "You know what she is trying to avoid — six of us at home and there is no food. What if she gets pregnant again?"
Mary, Aliya, and others shared their experiences with YLabs, which manages, among other projects, a digital clearinghouse for evidence at the nexus of climate change and sexual and reproductive health and rights, or SRHR. The personal stories — anonymized to protect participants' identities — reflect some of the issues highlighted in a landmark study co-authored by researchers at the organization, the University of California - Berkeley, the University of New Mexico, and Imperial College London.
Published in September 2025 in Frontiers Global Health, the study looked at how extreme temperatures and precipitation might affect "contraceptive use, fertility preferences, and contraceptive autonomy," according to a press release. Next, YLabs researchers told CG that they plan to publish further findings on how drought may come into play.
"As climate change gets worse and worse, people are going to be experiencing multiple hazards over their lifetime, and … experiencing multiple of these hazards might affect people's choices," Meg "Bee" Brown, Research Lead at the organization and lead author of the study, told CG.
Examining data reflecting 820,746 non-pregnant, reproductive-aged women across 33 low- and middle-income countries, the study appears to be among the largest on these topics, which, up until now, have largely been animated by anecdote. And while personal stories are important, they're insufficient to inform global health programs and funding decisions, especially in a warming world increasingly impacted by unpredictable and intensifying weather events.
With regard to extreme heat exposure, findings included lower odds of women using modern contraception, lower odds of wanting any or more children, and higher odds of independently making the decision to use contraception.
Meanwhile, over 41% of women using methods considered heat-sensitive — including condoms, implants, pills, injectables, and intrauterine devices — were found to live where average temperatures surpassed recommended thresholds for transportation and storage, beyond which products may be damaged and no longer work properly.
"Drought was associated with lower odds of modern contraception use, particularly under more severe drought conditions in South and Southeast Asia and West Africa," Brown told CG. "The relationship between extreme precipitation and contraception use seems to vary by precipitation intensity and by region."
Brown said her team's latest findings showed extreme precipitation to be associated with lower odds of contraceptive autonomy, "especially in the Americas, Eastern Europe and Central Asia, [the Middle East and North Africa region], and South and Southeast Asia."
Asked what she found most notable about this research, Brown pointed to "how much double exposures really amplified the trends that we were seeing individually." Those exposed to more than one type of climate hazard within a single year "had 18% lower odds of using modern contraception," according to the press release.
Spanning the extreme weather types studied, there were notable variations in contraceptive use and behaviors across countries and communities. The research found that younger women, unmarried women, and women without children, for instance, were particularly vulnerable to access and use disruptions associated with weather events.
"The economic structures in a particular place — like how people make their livelihoods, how people get their food, what are the gender norms, what are the marriage norms — all of those things also underlie these patterns that we're observing," Brown told CG.
Work unfolding around the world continues to highlight this notion.
Research from the Max Planck Institute, for example, found that "high temperatures reduce contraceptive use in [sub-Saharan Africa]," primarily impacting the use of short-acting reversible contraceptives. In the institute's study, published in late 2025, the co-authors noted that potential impacts on use might include "temperature-induced income shocks, access disruption, or reduced socioeconomic and bargaining power of women."
Work led by the Harvard Kennedy School exemplifies some of the related social and economic factors that continue to be affected by the changing climate. Researchers there identified higher rates of hysterectomy among those seeking to address menstrual and reproductive health concerns that are difficult to cope with while harvesting sugarcane in India under mounting climate pressures.
Theo Gibbs, Climate Director at YLabs and a co-author of the Frontiers publication, told CG that what most interested her about the study her organization led were the differences across countries, regions, and socioeconomic groups. "If you even think about it for 10 seconds, you're like, of course it would be super different in different countries. But I think the extent of that variation was very striking," Gibbs said.
"Some women are way more vulnerable than others," Gibbs also noted, "and I think having that nuance is super important when we're thinking about program design."
The researchers, in their publication, objected to "one-size-fits-all strategies," arguing that climate‑responsive approaches must be locally tailored and translated beyond academic journals into practical guidance for program managers, policymakers, and funders working to strengthen reproductive rights and well-being.
Some of their recommended solutions include supporting grassroots groups responding to floods and heat waves on the ground and integrating SRHR into community adaptation plans.
This emphasis on real‑world application also points toward innovation, particularly in designing contraceptive products and systems that remain effective under changing environmental conditions — for example, through formulations that can hold up under extreme temperatures, protective packaging, and supply chains adapted to climate stress.
Gibbs noted that researchers don't yet have a comprehensive understanding of what heat-exposure thresholds for contraceptive products could look like, underscoring that while we may not have a big problem right now, we should take a closer look "so that we're not, governments are not investing in products that end up not working."
She emphasized that heat-related product degradation was more likely to pose issues in low- and middle-income countries, but it's possible that innovations for heat resilience could benefit users worldwide.
Still, heat resilience isn't the only product-based innovation that might help climate-impacted users contracept according to their needs and wishes.
"The elements that make up a good contraceptive product under 'normal' conditions — high efficacy, a delivery system aligned with user preferences, flexibility on duration, limited side effects — is often also what enables a product to be climate-responsive," Audrey Fratus told CG in response to a query via email.
Fratus is the Key Resources Editor at CTI Exchange, the co-publisher of this piece. She monitors contraceptives at various stages of research and development through the site's CTI Tracker database.
"User-led contraceptive design naturally lends itself to the development of methods that work in complex, changeable environments," Fratus continued.
The development of longer-lasting products that enable people to maintain their desired contraceptive coverage without having to travel long, weather-obstructed distances could fit into the framework Fratus describes. Methods that can be self-administered or that don't need to be removed could also reduce reliance on onerous, dangerous, even impossible travel to health care facilities.
"One great example is the development of 'in-situ forming implants,' or ISFIs," Fratus highlighted.
"ISFIs are injected into the arm as a gel," she said, before biodegrading after a period of months, eliminating the need for removal at a health facility.
A lot of the methods that might improve access to care amid climate shocks and strained infrastructure have not been designed with this in mind, exactly. Fratus said that's the case with ISFIs — which can be injected without the surgical equipment often difficult to obtain in crisis settings, such as following a natural disaster.
"For families navigating the stress of seasonal migration to escape extreme heat or flooding," she said, "that's a little bit of peace of mind."
IFSI prototypes, along with other emerging products, have even been designed as multipurpose prevention technologies, or MPTs, to simultaneously deliver medications that can prevent pregnancy and sexually transmitted infections. As Fratus indicated, efficiently addressing more than one health need at a time could itself be seen as climate-responsive.
Contraceptive methods that can address symptoms such as heavy menstrual bleeding — such as the hormonal intrauterine device (or hormonal IUD) as well as new methods in development — might similarly be regarded as dual-purpose and climate-smart for a range of users: from climate-impacted sugarcane harvesters juggling menstrual bleeding and economic pressures to drought- and flood-affected people facing a lack of clean water, key to safe menstrual hygiene.
Innovations in male contraception that seem to be approaching market readiness could offer another solution for couples looking to share the burden of family planning. If more than one person in a relationship can obtain that contraceptive coverage, it might increase the chances of securing it, even in the face of access-snarling storms and droughts.
Fratus and the field as a whole emphasize the importance of centering the user in contraceptive R&D to ensure not only effectiveness but also a rights-based approach to family planning. It's a mandate of historical import at the nexus of climate change and reproductive rights.
"For very good reason, the SRHR advocate community — I would say since the 1990s — has been very reluctant to talk about SRHR and climate together because of the problematic history of climate mitigation and overpopulation, or population control, being linked. And I think that makes total sense," Gibbs said.
But she also thinks "we've kind of swung the pendulum too far to just not talking about any connection to climate, even climate adaptation, resilience, and just looking at the impacts of climate change on SRHR."
Gibbs noted this "taboo" as one of the barriers that must be overcome to improve SRHR amid rising global temperatures. She and Brown identified a range of other hurdles too, including the recency of the understanding that climate might impact health and the need for experts to coordinate across a variety of sectors — including not only SRHR and climate but also disaster response, economics, and more.
The politicization of both climate and gender, Gibbs added, may also be a barrier to improving well-being, with SRHR often "left off the agenda" or seen as "too hot button to push for" in climate talks.
Communities around the world may face yet another "double exposure," then, vulnerable to compounding gendered and climate-related impacts. But in the face of this, Brown can make an ethical and a business case for advocates, researchers, policymakers, and funders to come together on these issues: "Climate change and SRH are things that affect everybody."
Emily Hoppes, Managing Editor of CTI Exchange, contributed to the editing of this article.
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"I'm excited about how accessible and practical these strategies are, and especially about their potential cumulative impact," Gregory Wellenius, Director of the Center for Climate and Health at Boston University, told CG.
"We have no choice but to transfer the costs right now to the customers," Goh Miah Kiat, Chief Executive Officer of Karex, told Reuters.
"We will keep marching on and we will continue to do our best for our communities that remain at risk," Lisa Emery, Director of the New River Health Breathing Center and Black Lung Clinic, told West Virginia Watch.
Mike Bonanza of Elevated Access told CG that the situation could "result in more referrals" to his flight-based organization, even as plane fuel is set to be impacted as well. Volunteer pilots with the nonprofit transport patients to abortion and gender-affirming care at no cost to passengers.
