The climate crisis has increased the burden of obstetrical care due to the negative impact of environmental disruption on the health of pregnant women, new mothers, foetuses and neonates. During the COVID-19 pandemic, the ecological footprint of obstetrical care has significantly increased due to the use of personal protective equipment and the provision of large-scale testing and vaccination of pregnant women and healthcare personnel against COVID-19. The situation calls for coordinated action to make obstetrics more resource efficient. To achieve this goal, obstetricians need to rationalise the use of electricity, water, paper and plastic, adopt green surgical practices and integrate environmental sustainability in their working culture and personal life at large. The present article discusses the main sources of environmental pollution in obstetrical care and proposes evidence-based solutions.