Climate change is usually discussed in terms of living standards and resource availability — less in terms of public health. But a research program in Bangladesh may kickstart that conversation after revealing a possible effect of climate change on fertility: Among the women of a coastal Bangladeshi community, an elevated rate of miscarriage has been recorded, and researchers say climate change is behind the increasing pregnancy loss.

The researchers followed more than 12,000 pregnancies between 2012 and 2017, finding that women living in the district of Chakaria, near Cox’s Bazaar, Bangladesh, have a higher rate of miscarriage than women from the same community who have moved inland. More specifically, women living within 20km of the sea, and 7m above sea level, were 1.3 times more likely to have a miscarriage than the women who had moved farther inland.

Additionally, researchers say the number of miscarriages among the coastal plains communities seem to be growing.

The researchers say the difference is likely due to the amount of salt in the women’s diets. As global temperatures and atmospheric pressure rises, sea levels rise and contaminate natural aquifers — natural underground stores of fresh water. This means that people like those living in Chakaria district are drinking, cooking and bathing with increasingly saltier water, consuming up to 16g of salt per day — three times the World Health Organization’s recommended daily salt intake (5g). Excess dietary salt has been linked to a host of health problems, including miscarriage and preeclampsia.

While the increase in miscarriage is currently slight, among coastal women, without action climate change’s effect on fertility “will only get worse, as Bangladesh feels the effects of climate change more and more,” Dr Manzoor Hanifi, a scientist from the International Centre for Diarrhoeal Disease Research Bangladesh, the research institute behind the findings, told the BBC.

It may also worsen in other low-lying coastal areas outside of Bangladesh. In Kerala, devastating floods earlier this year contaminated drinking water across the state with sludge and garbage, drawing attention to infrastructure that is unable to withstand extreme weather events — which will increase as an effect of climate change. But little attention has been paid to how the rise in sea level — a much more subtle effect of climate change — may affect drinking water long term, and hence, public health, including fertility. Hopefully this study heralds more research — and more efforts to mitigate the fallout.

“A lot of money is being thrown at climate change interventions,” says Dr Hanafi, “but almost none of it goes into research – not for the public health impact anyway. Everyone is thinking about environmental disasters. No one is thinking about public health.”