America’s Pregnant Women at Increasing Risk for Drug Overdoses

In record numbers, pregnant and postpartum women in the U.S. are dying from drug overdoses, suggesting the American health system is not making safe and effective addiction treatment options accessible for those who need them.

New Findings Raise Alarm Regarding Overdose Risks for Pregnant/Postpartum Women

Overdose deaths for pregnant and postpartum women increased by 81% between 2017 and 2020, with 2020 recording the highest drug-related fatality rate for pregnant and postpartum women since recording began. During that same period, overdoses spiked for reproductive-age women too, but they only went up by 38%, suggesting pregnant and postpartum women experienced more than twice the overdose spike than non-pregnant and non-postpartum women in the same age group.

Between 2017 and 2020, 7,600 pregnant or postpartum women in the United States died. Of that number, 1,200 died from drug overdoses, meaning 15% of all fatalities among pregnant/postpartum women were caused by drugs. Given that drugs cause only about 3% of annual American fatalities, pregnant and postpartum women are five times more likely to die from a drug overdose than the general population.

The findings are alarming. Even as pregnant women are at significantly higher risk of drug overdose fatalities, they are also significantly more connected with the healthcare system than the average American, suggesting pregnant and postpartum women should have medical advocates who:

• a) Screen them for substance abuse
• b) Observe that substance abuse is occurring
• c) Intervene and refer them to substance abuse treatment

The fact that this is not occurring suggests a significant failure in the healthcare system’s ability to care for pregnant and postpartum women adequately.

Overdoses from Fentanyl, Methamphetamines, and Cocaine Spiked

When analyzing the types of drugs most responsible for causing overdose deaths, researchers found that deaths connected to fentanyl, methamphetamines, and cocaine soared among pregnant women from 2017 to 2020. In contrast, deaths from benzodiazepines, heroin, and prescription opioids remained stable.

Barriers to Care

In seeking an explanation for the 81% spike in overdose fatalities for pregnant and postpartum women, it’s important to touch on the challenges that pregnant and postpartum women face in accessing treatment for substance abuse. Study author Emilie Bruzelius, a doctoral student at Columbia, spoke to this point. “Pregnant and postpartum people are known to face barriers to accessing drug treatment and harm reduction services, that when compounded by pandemic-associated stressors, health care shutdowns and an increasingly volatile unregulated drug supply, may have increased fatal overdose risk. We’ve seen significant increases in fatal and nonfatal overdose in the general population during the pandemic. It now appears that pregnant and postpartum women are being affected as well.” It is also believed that social, economic, and healthcare disruptions during the pandemic likely contributed to the rise in overdose deaths among pregnant women.

Given that pregnant and postpartum women are at increased risk for overdosing on drugs, and given that they also face unique barriers to care that might not be present for the general population, public health officials, policymakers, and concerned loved ones should take additional steps to ensure pregnant and postpartum women are getting the care they need.

Further, that care must begin before pregnant/postpartum women use drugs. Preventive care should be emphasized, as it’s far easier to prevent someone from using drugs than to treat them once they’re addicted.

Change Is Needed Now

It says a lot about the healthcare system’s failures that pregnant women, who usually have lots of contact with the medical sector, are still becoming addicted and overdosing during or after their pregnancy. It’s a sign that the U.S. has lagged in its response to the addiction epidemic, attributing substance abuse more to a “moral failing” rather than the very real health crisis that it is.

Pregnant and postpartum women deserve protection from all health crises, including addiction. Medical professionals should always screen pregnant and postpartum women for substance abuse. When addiction is present, healthcare programs should offer residential addiction treatment to protect the life of the mother and her unborn or newly born child.

Sources:

• JAMA. “U.S. Trends in Drug Overdose Mortality Among Pregnant and Postpartum Persons, 2017-2020.” Journal of the American Medical Association, 2022. jamanetwork.com

• CDC. “Morbidity and Mortality Weekly Report.” Centers for Disease Control and Prevention, 2022. cdc.gov

• CDC. “Drug Overdose Deaths in the U.S. Top 100,000 Annually.” Centers for Disease Control and Prevention, 2021. cdc.gov

• USNews. “Record Number of Fatal Drug ODs for Pregnant, Postpartum Women.” U.S. News, 2022. usnews.com