The data also indicate a significant uptick in overdose fatalities among pregnant or postpartum Black women, mirroring the overall spike in maternal mortality rates within this demographic. Study co-author Wilson Compton, deputy director of the National Institute on Drug Abuse, noted this alarming trend.
Experts attribute the increase in overdose deaths in this group from 2018 to 2012 to various external factors such as social isolation due to the coronavirus pandemic and a lack of adequate prenatal and postpartum care in the United States.
The majority of pregnancy-associated overdose fatalities involved opioids, particularly fentanyl. Most of these deaths occurred outside of health-care facilities, emphasizing the need for better support during and after pregnancy for individuals dealing with substance use disorders, as evidenced by the researchers’ findings. This includes education on treatment options and initiatives to encourage pregnant individuals to seek help without fearing legal repercussions.
“For many pregnant and postpartum individuals, revealing drug use may result in having their child taken away, thus there is a significant amount of stigma beyond the usual stigma associated with drug use,” said Chelsea Shover, an epidemiologist and assistant professor-in-residence at the University of California at Los Angeles School of Medicine.
Numerous laws exacerbate women’s concerns about being penalized. Certain states mandate the automatic reporting of child abuse and neglect in cases involving newborns exposed to specific substances, including opioids.
“We need to create environments where individuals dealing with substance use can disclose it and access the assistance they need,” Shover added. “However, if individuals are unaware of available treatment for opioid use disorder or are unable to access it, that becomes the primary issue.”
Current treatment for opioid use disorders in pregnancy and the postpartum period includes methadone or buprenorphine combined with behavioral therapy, as stated by the American College of Obstetricians and Gynecologists and the Substance Abuse and Mental Health Services Administration.
An analysis by the health policy group KFF in July revealed that drug overdose deaths linked to fentanyl surged during the pandemic. The report also highlighted the fact that, despite policy efforts to improve access to opioid use disorder treatments, many individuals do not receive the recommended medications.
For pregnant and postpartum individuals, the stigma surrounding drug use, combined with pregnancy and opioid use, further diminishes the likelihood of seeking help.
“I believe our country and people in general have struggled with viewing substance use as a medical condition; some still see it as a moral condition … this isn’t always a choice that women are making,” said Jessica L. Coker, an associate professor in the departments of psychiatry and obstetrics and gynecology at the University of Arkansas for Medical Sciences who specializes in suicide and substance use disorders in pregnant and postpartum women.
The Department of Health and Human Services Office on Women’s Health awarded over $3.6 million to seven organizations dedicated to helping individuals grappling with substance use disorder during pregnancy and the postpartum period. “Women who use drugs are some of the sickest patients that I have ever worked with … and it’s not a moral failing that’s caused them to use drugs,” Coker added. “I have never met a pregnant person that didn’t want to be a good mom and didn’t want to do the right thing.”
