EUROPEAN ASSOCIATION OF PERINATAL MEDICINE Position statement: environmental sustainability in obstetric healthcare.

Climate change is one of the biggest threats to global health in the 21st century and is responsible for many health complaints and diseases worldwide. The healthcare community is an important contributor to environmental pollution, and the latter has an adverse effect on maternal and fetal health. This paradox needs to be addressed, and healthcare professionals need to take the responsibility for change. The current position statement outlines what is already known about environmental sustainability in obstetric healthcare, and provides recommendations on how to address the problem, based on existing evidence and real-life experiences. To start the transition to a more environmentally sustainable obstetrical healthcare, it is important to establish local dedicated teams, working in collaboration with national or international institutions. Institutional and individual energy-saving behaviours need to be encouraged. Public transportation needs to be promoted, and travel movements reduced, by moving to video appointments, telephone appointments, and telemonitoring, when appropriate. The pharmaceutical impact on the climate also needs to be addressed: inhalation anaesthetics should be avoided, shorter prescriptions should be made, and patients should be educated on how to deal with pharmaceutical waste. It is also important to reconsider the way that certain hospital products are used: surgical trays can be optimised, sterile gowns, gloves and drapes do not always need to be used, and reusable products should be preferred. Finally, the overuse or inadequate use of healthcare services needs to be addressed.