Breathing for two, in unsuitable air

This article is authored by Angela Chaudhuri, chief catalyst, Swasti.

A recent study by AIIMS researchers drew sharp attention to how air pollution, specifically sulphur dioxide (SO2), harms pregnant women. SO2 hampers the development of the placenta, the organ that nourishes a baby in the womb. Prolonged exposure can trigger early pregnancy loss. However, the link between air pollution and reproductive health is one that has been largely overlooked—with grim consequences for women.

Pollution

Rekha is a 27-year-old bricklayer working on the outskirts of Faridabad. Two kilometres from her worksite sits a coal depot and a cluster of diesel generator units that run nearly around the clock. On windy afternoons, the air quality sensors in the area record SO₂ levels nearly six times the WHO's safe threshold. Rekha has had two miscarriages. Her doctors have attributed them to stress and anaemia. No one made the connection with the polluted air, because until recently, our science wasn’t looking.

Emerging research is making an alarming case: besides respiratory hazards, these gases are reproductive disruptors, and their harmful effects are compounded by rising heat.

Ambient heat, embodied in air, water, and ground, can trap pollutants close to the surface on still days, and spike local concentrations. Women, especially those working outdoors at construction sites, farms, and landfills, breathe in greater volumes of polluted air per hour. With India's cities routinely breaching 44°C in May, these women end up inhaling hotter air laced with higher levels of these gases. Their unborn children are the first casualties.

Artificial Intelligence (AI) is beginning to map associations between air pollution and maternal health that health systems have overlooked. Researchers are training machine learning models that cross-reference satellite-derived data on SO₂ and NO₂ with district-level maternal health indicators from the ministry of health and family welfare’s NFHS-5 survey.

Early findings suggest that these associations are concentrated along the industrial corridors of the Indo-Gangetic Plain. The region, home to over 400 million people, has some of India's most emissions-intensive industries. While the full picture is still being assembled, the outline is already hard to ignore.

However, these data and correlations have not yet been converted into policy tools. Therefore, the need of the hour is a district-level Reproductive Air Quality Index that is integrated with the existing AQI infrastructure. Such an index could flag high-risk zones for targeted maternal health interventions, prenatal screening, and occupational protections for women workers. Some researchers are pushing further, proposing that AI-driven early warning systems could alert ASHA workers and ANMs in real time when pollution spikes coincide with the first trimester windows of registered pregnancies in specified localities.

However, India's pollution monitoring framework remains gender-blind. Health impact assessments for industrial clearances do not require sex-disaggregated reproductive risk analysis. The National Action Plan on Climate Change excludes women's reproductive health. These are not technical oversights but choices made by systems that have historically treated the female body as a footnote in environmental governance.

The conversation must shift to the human terrain —of millions of Indian women who live and work in the shadow of our industrial ambitions.

Including them would mean mandating sex-disaggregated health impact assessments for all new thermal and industrial projects. It would mean integrating reproductive health metrics into the air quality monitoring dashboards. It would mean investing in the AI-driven maternal risk tools, and putting them into the hands of the frontline health workers who serve women like Rekha.

(The views expressed are personal)

This article is authored by Angela Chaudhuri, chief catalyst, Swasti.