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Maternal exposure to air pollution during pregnancy has significant health consequences for both mothers and offspring, particularly by affecting foetal development during critical gestational phases. This paper estimates the causal impact of air pollution on maternal health in India by combining satellite-derived PM2.5 data with geocoded Demographic and Health Survey (DHS) data from 2019–2021. To address endogeneity concerns arising from household economic behaviours such as reliance on biomass fuels or crop residue burning, which are unobserved in survey data, I use an instrumental variable approach leveraging biomass burning events in neighbouring areas as an exogenous source of variation in local pollution levels. I find that increased maternal exposure to air pollution during the first trimester significantly increases the risk of adverse pregnancy outcomes, including a higher incidence of low birth weight among newborns. My findings are robust to a variety of controls, specifications, and identification approaches My study contribute to the growing literature on pollution and health in the developing world, offering new insights by addressing the endogeneity of local pollution through a context-specific instrument.