Climate change-induced heat disproportionately affects pregnant women. Those who work outside, can’t access air conditioning, or who are Black or Hispanic are at greater risk of harm as these women tend to face long and unmitigated exposure to intense temperatures. In communities of color, heat drives high rates of premature deliveries and stillbirths. Black women are three to four times as likely to die from a pregnancy-related complication than White women. Indigenous women are twice as likely to die than White women. Racism, rather than race, is the risk factor in pregnancy complications. Coupled with climate change-induced heat, the risk of chronic disease, obesity, maternal mortality, and low birth rates increases. In California, for every 10-degree temperature increase, preterm deliveries increased by 8.6%, with a higher rate in communities of color. Pregnant women who are unable to avoid the heat may face severe cases of dehydration. Public health and environmental justice initiatives must understand these risk factors to protect communities.