Study Finds Life-Saving Treatment Opportunities in Pregnancy-Associated Overdose Deaths

The United States experiences high rates of maternal mortality. A major cause of death is linked to opioid overdoses. Yet treatment rates among this population remain low, and the factors contributing to care gaps are not well understood. Recent research led by the Rollins School of Public Health and published in Obstetrics & Gynecology Open has identified some of the obstacles preventing pregnant women from receiving the life-saving interventions and treatments they needed. These include  lack of care coordination, insurance gaps, and limited provider knowledge of substance use treatment.

"At a critical time in the United States when maternal mortality rates have increased due to substance use and mental health conditions, this investigation provides methodically innovative strategies for addressing structural, financial, and cognitive barriers to health care for pregnant and postpartum women," says the study’s lead author, Sarah Blake, director of the Maternal and Child Health Center of Excellence at Rollins. "It also provides potential strategies for preventing pregnancy-associated overdose deaths and ensuring that women receive the care they need during the perinatal period and beyond."

Blake's team used Maternal Mortality Review Committee (MMRC) data from six states representing 104 individuals who died of a pregnancy-associated overdose to identify which barriers to care appeared most frequently and where prevention opportunities existed.

What They Found 

• 90% of individuals had evidence of substance use during the perinatal period, most notably opioids
• Fewer than 50% received treatment
• 75% experienced barriers to health care, including financial and geographic barriers
• 11% of those who died during the postpartum period had a documented postpartum doctor’s visit
• Continuity of care or care coordination were cited as contributing factors in more than half (52%) of deaths.