Sumathy was one of many first recruits.

Her child was additionally one of many first within the research to die.

“I used to feel so exhausted being pregnant and working in the heat,” she says.

One day, as Sumathy was dropping off her husband’s lunch, she abruptly began feeling very unwell. That night, she went to see a health care provider who instructed her she had suffered a miscarriage 12 weeks into her being pregnant.

“My husband would lay me down on his lap and console me. I don’t know what I would have done without him,” she says.

Sumathy talks about her husband with a lot love however has needed to study to reside with out him. He not too long ago died, and he or she is now the principle breadwinner for the household.

Sumathy won’t ever know for certain if working within the warmth throughout her being pregnant had something to do together with her shedding her first baby.

But general, the research discovered that girls who labored in related circumstances as her have been twice as more likely to undergo a stillbirth or miscarriage than these working in cooler environments.

The pregnant girls within the research in India actually are “at the forefront of experiencing climate change,” says Prof Hirst, who’s a UK-based guide obstetrician, and Professor of Global Women’s Health at medical analysis organisation The George Institute.

Earth’s common temperature is projected to rise by practically three levels by the top of the century, in contrast with pre-industrial instances, and the World Health Organization (WHO) is warning of “an existential threat to all of us” with pregnant girls dealing with “some of the gravest consequences”.

Previous studies have proven a few 15% rise within the threat of untimely start and stillbirth throughout heatwaves, however these have usually been carried out in high-income international locations such because the US and Australia.

The newest findings from India are notably stark and worrying, says Prof Hirst, and have wider implications.

“The UK is getting hotter summers, and while it’s not as hot as India, these adverse effects [on pregnancies] can be seen at much lower temperatures in more temperate climates, such as the UK.”

However, she provides, they do have to be “kept in perspective”. Even with a doubling of threat, experiencing child loss continues to be going to be a “rare event for most women”.

There is at the moment no official worldwide recommendation for pregnant working girls within the warmth.

The important steering that does exist for hot-weather working, is predicated on research involving a person within the US navy within the Sixties and 70s, weighing 70-75kg and with 20% physique fats.

Prof Hirst hopes this research, and further research, will change that. In the meantime, Prof Vidhya Venugopal, from the Faculty of Public Health at SRIHER, who led the analysis on India, says pregnant girls working within the warmth can shield themselves by:

For this research – funded by the Indian authorities – researchers used what is known as the wet-bulb-globe-temperature (WBGT), which measures the consequences of temperature, humidity, wind pace and radiant warmth on human our bodies.

WBGT readings are sometimes decrease than the temperatures you may see forecast on the TV or a climate app.

India is predicted to grow to be one of many first international locations on this planet the place temperatures will high the protected restrict for wholesome people who find themselves merely resting within the shade, in response to a recent study from the University of Cambridge.

In the sugarcane fields of Tiruvannamalai, Rekha Shanmugam, a former nurse and one of many SRIHER research’s researchers, is measuring the daytime warmth.

Around us, a few dozen employees – about half of them girls – hack down thick stems of cane with small machetes.

“These women often have no choice but to work out in the sun – they need the money,” says Ms Shanmugam.

She pours water right into a gauge and presses varied buttons. It reveals a WBGT temperature of 29.5C – that is above the protected threshold for doing this sort of bodily demanding work within the warmth.

“If the workers continue for prolonged periods in this level of heat, they are more prone to heat-related illnesses, and it’s especially concerning for pregnant women,” she tells me.

Sandhiya, 28, tells me she has no selection however to do this sort of back-breaking work for which she will get paid about 600 rupees, slightly below £6 a day.

She has two younger kids and an prolonged household to feed.

Sandhiya additionally took half within the research – and misplaced her first baby six months into her being pregnant.

She needed to take a number of months off work to get well and says she continues to be paying off the money owed she racked up throughout that point.

“All my desires centre around my children,” Sandhiya tells me. “I want them to study well and get good jobs. They shouldn’t end up toiling here in the fields like me.”

The mechanisms round how and why warmth impacts pregnant girls and their rising infants on this troubling manner should not properly understood.

One principle is that when the mom will get too sizzling, blood might be diverted away from the foetus, to assist cool the mom down.

Ms Shanmugam thinks a scarcity of bogs can also be taking part in an element.

She says a previous study discovered many ladies did not need to squat in an open discipline to alleviate themselves and so would keep away from consuming water, creating urinary issues in consequence.

“They worry about insects and snakes in the bushes, or men peeping to look at them,” she says.

“They often don’t feel safe, so they’ll just hold it in for the whole day and then finally go to the toilet when they get home.”

India has made enormous enhancements to maternal and child well being in recent times, however the stillbirth fee continues to be 12.2 per 1,000 births, in response to knowledge from the World Bank Group. In the UK the speed is 2.7.

The findings of the research in Tamil Nadu are being taken very severely, says Dr TS Selbavinayagam, the state’s director for public well being.

“We already offer financial compensation to pregnant women, but maybe we need to look at options for giving alternative employment too,” he says.

The state authorities affords poorer girls 18,000 rupees (£170) after they attain 12 weeks of being pregnant, to attempt to ease a few of their monetary pressures.

However, a lot of the facility to guard these low-paid employees rests with office bosses.

On the outskirts of Chennai, Thillai Bhasker – a brick-kiln proprietor – has erected big metal roofs with particular heat-protective coatings on them, to offer his employees with much-needed shade. He’s been taking recommendation on higher defending employees from researchers at SRIHER.

“Business owners should be smart enough to know how to retain the employees,” he says. “If you take care of them, they will take care of you.”

He additionally instructed us he was planning to construct women-only bogs.

Some organisations are additionally providing training periods on the straightforward steps girls can take to higher shield themselves within the warmth. Insulated bottles are additionally being made obtainable to maintain consuming water cool.

Sumathy had no selection however to proceed to work in excessive warmth when she turned pregnant once more inside a few years of her miscarriage.

But she received particular recommendation from medical doctors and the SRIHER researchers on how you can higher shield herself. Sumathy gave start to a wholesome daughter and son.

Tonight – after her lengthy shift – she’s going to return house to them.

Exhausted, anxious, however so grateful they’re there.

If you are affected by any of the problems raised on this story, help and recommendation isobtainable by way of the BBC Action Line.