As heat gets more extreme, pregnant farmworkers are increasingly at risk
[October 24, 2025]
By DORANY PINEDA, MELINA WALLING and ANNIKA HAMMERSCHLAG
One hot day last summer, Clarisa Lugo was inspecting and counting corn
and soybean plants in the middle of a 300-acre farm field in Illinois
when she started throwing up and panting. Her heart raced, she stopped
sweating and a pounding headache didn’t go away for hours.
The heat index — a blend of temperature and humidity — had hit 105 F
(40.56 C), and Lugo, who was eight months pregnant, was suffering from
heat illness.
“I remember that that day it was hard for me to go back to normal”
despite drinking water and putting ice on her body, she recalled.
Agricultural workers are already among the most vulnerable to extreme
heat, and pregnant workers are coming under greater risk as temperatures
rise because of climate change. Many in the U.S. are low-income Latino
immigrants who toil under the sizzling sun or in humid nurseries open
year round. Heat exposure has been linked to many extra risks for
pregnant people, and while protections exist, experts say they need
better enforcement and more safeguards are needed.
Compounding these risks is the Trump administration's immigration
crackdown. Many people are too afraid to seek medical and maternal care,
according to research and interviews with advocates and health care
providers, and are increasingly fearful of retribution if they advocate
for safe work environments.
The Associated Press interviewed four agricultural workers who recounted
experiences of working in extreme heat while pregnant. Three spoke under
the condition of anonymity because they’re in the country illegally or
fear reprisals from their employers.
Temperature rise in big agricultural states
California, one of the nation's most agriculturally productive states,
employed more than 893,000 agricultural workers in 2023, according to
state data. Iowa, also among the top 10 agriculture-producing states,
provides more than 385,000 jobs in the agriculture industry, according
to a 2024 study.
Since the start of the 20th century, California temperatures have
increased almost 3 F (1.67 C), according to state and federal data.
Warming has accelerated, and seven of the past eight years in that state
through 2024 were the warmest on record. Iowa has seen temperatures
increase by more than 1 F (0.56 C) during the same period while in
Florida, another big agriculture state, average temperatures have
increased by more than 2 F (1.11 C).
When it comes to how the body reacts, even small temperature increases
can make a difference.
One study found that agricultural workers had more than 35 times the
risk of heat-related deaths than other workers. But deaths are hard to
track and are likely undercounted. In the U.S., an estimated one-third
of farmworkers are women — an increasing share of the farm workforce.
Lugo and her baby ended up fine. But others haven’t been so lucky.
As one nursery worker in Florida put it: “I’ve wanted to leave this
work,” but “I have to fight for my children.”
Dangers of heat and exertion
An agricultural worker recalled working in a Florida nursery in 2010
amid intense heat. She was four months pregnant and would spend hours
carrying heavy pots of plants and bent over weeding and planting indoor
foliage such as monsteras. At work one day, she felt painful abdominal
cramping. She knew something was wrong when she saw blood in the toilet.
“(At the hospital) they told me that I had already lost the baby,” she
said. She believes the physical work combined with heat caused her
miscarriage.
Another nursery worker in Florida worked four months into her pregnancy
in 2024, vomiting — sometimes after drinking water — and feeling nausea
and headaches in part because of the heat.
Her baby was born prematurely, at seven months. “(The doctor) told me
that I spent too much time bent over ... and I wasn’t eating well for
the same reason, because of the heat," she said.
Pregnancy increases the risks of extreme heat because the body has to
work harder to cool down. Heat exposure has been linked to increased
risk of miscarriages, stillbirths, preterm births, low birth weight and
birth defects.
Combining pregnancy and heat with physical labor can more quickly
overwhelm the body's cooling system, increasing the likelihood of
dehydration, heat illness and heat stroke. Even short-term exposure to
heat can increase the risk of severe maternal health complications, such
as high blood pressure disorders of pregnancy, according to the
Environmental Protection Agency.
In the worst cases, it can kill.
Maria Isabel Vasquez Jimenez was 17 and two months pregnant when she
died in 2008 from heatstroke after pruning grapes in a California farm.
Her supervisors failed to provide shade and water while she worked for
hours in nearly triple-digit heat, authorities said.
California’s outdoor heat standard, enacted in 2005, was later named in
Jimenez's honor.
Unclear how sporadic regulations may benefit farmworkers
No federal heat protections exist in the U.S., although the Trump
administration appears to be moving forward with a proposed rule. Some
states, including California and Washington, have their own protections,
while others, like Texas and Florida, have barred local governments from
implementing their own. In states with protections, advocates say
they’re not adequately enforced and pointed to a widespread distrust of
reporting systems.
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A worker harvests pears at an orchard in Naches, Wash., Thursday,
Aug. 28, 2025. (AP Photo/Annika Hammerschlag)
 More than 30 states and cities have
laws requiring employers to provide accommodations for pregnant
workers. Most recently, 2023's federal Pregnant Workers Fairness Act
requires employers to provide “reasonable accommodations” to
pregnant workers, those who recently gave birth or have medical
conditions related to birth or pregnancy unless they will cause the
employer “undue hardship.” Other laws make it illegal to fire or
discriminate due to those factors.
Even so, there aren’t enough legal protections for
pregnant workers, said Ayana DeGaia, assistant professor of
obstetrics and gynecology at the University of Washington in
Harborview. “It’s probably one of the reasons why we have some of
the highest rates of maternal and infant mortality in high-income
countries in the world,” she said.
It’s also unclear how some of these protections benefit women
farmworkers, said Alexis Handal, an associate professor at the
University of Michigan, who led a recent study examining the
experiences of the state's women farmworkers.
In Florida, a top U.S. producer of indoor plants and tropical
foliage, the nursery industry’s mostly women workers have joined a
fight for heat protections. In California, workers have been
advocating for guaranteed compensation when they lose wages due to
heat waves and other extreme weather events, as well as extra pay
when they work during dangerous weather conditions.
Immigration enforcement compounds challenges to care
Trump’s immigration crackdown has instilled deep fear in immigrant
communities.
In California, a physician said her clinic recently had a patient
suspected of carrying a fetus with birth defects. They set her up
for specialty consultation and care about two hours from home. But
the woman couldn’t access that care during her pregnancy. Arranging
transportation and child care was difficult. The overarching reason,
however, was fear, in part of being detained, said Dr. Katherine
Gabriel-Cox, director of obstetrics, midwifery and gynecology at
Salud Para La Gente, a community health center.
She added that she hears similar stories "over and over.”
It's a growing concern nationally. Health care providers have
reported seeing fewer walk-ins, patients delaying prenatal care, and
more pregnant patients whose first doctor’s visit was for labor and
delivery, according to a brief published in April by the group
Physicians for Human Rights. Others have reported an increase in
no-shows and canceled appointments.
“I’d be concerned that people are not going to present for medical
care until it’s too late," said Katherine Peeler, medical adviser
with Physicians for Human Rights and assistant professor of
pediatrics at Harvard Medical School.
Pregnant farmworkers in rural areas already have less access to
maternity care because clinics are farther away and finding
transportation could be difficult. Other times, they can’t afford to
miss hours of work or aren't given time off. Many also don't get
employer-sponsored medical care or paid leave.
Work and home conditions can heighten risks
Farmworkers are less likely to demand employers provide adequate
shade, water or rest, or speak out when they’re feeling heat illness
for fear of being fired or having immigration enforcement officials
called on them, said Juan Declet-Barreto, senior social scientist
for climate vulnerability with the Union of Concerned Scientists.
Some workers who spoke with the AP described employers who wouldn't
provide accommodations or water, face covers or other equipment to
protect them from pesticides and heat. They continued working during
pregnancy out of necessity.
“There were times when my back and entire body hurt … but I had to
do it,” said a third nursery worker from Florida. “No one was
helping me, and so I had to keep going. If not, no one was going to
pay my bills.”
The nursery worker who had a miscarriage said she had to urinate
often during pregnancy, but the portable toilets were up to a
10-minute walk away. Another described dirty bathrooms infested with
flies. And another recalled pregnant women who were only allowed to
use the bathroom during scheduled breaks.
Yunuen Ibarra, programs director with Líderes Campesinas, a
farmworker advocacy organization, said women working in agriculture
who have been sexually assaulted at work can also be more vulnerable
to heat. They might cover their bodies with extra clothing “to not
feel exposed to a potential assault,” she said, which can raise
their body temperature.
At home, farmworkers might find little escape from extreme
temperatures because they are more likely to lack air conditioning,
be lower income or live in hotter areas, multiple studies have
shown.
As human-caused climate change continues, heat waves will only get
longer, hotter and more frequent. Without adequate protections and
enforcement, pregnant farmworkers and their unborn babies will
suffer the consequences.
“We can’t prevent temperatures from rising,” said Ibarra, “but we
can prevent farmworkers from dying or feeling sick or being disabled
due to heat-related illnesses.”
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