Expecting Mother Nature: Uncertain Hurricane Forecasts Disrupt Prenatal Care and Impair Birth Outcomes

Abstract Early forecasts give people in a storm's path time to prepare. Less is known about the cost to society when forecasts are incorrect. We examine over 700,000 births in the path of Hurricane Irene and find exposure led to a decrease in birth weights and increase in preterm and low birth weight outcomes. Additional warning time decreased preterm birth rates for women who experienced intense storm exposures documenting a benefit of avoiding a type II forecasting error. A larger share of this at-risk population experienced a type I forecasting error where severe physical storm impacts were anticipated but not experienced. Disaster anticipation disrupted healthcare services by delaying and canceling prenatal care leading to impaired birth outcomes. Recognizing storm damages depend on human responses to predicted storm paths is critical to supporting the next generation's developmental potential with judicious forecasts that ensure public warning systems mitigate rather than exacerbate climate damages.