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Drug overdose and suicide are leading causes of death among California mothers within the first year after delivery, a recent study shows.
Professor Sidra Goldman-Mellor of UC Merced and Professor Claire Margerison of Michigan State University found that drug overdoses were the second-leading cause of postpartum death and suicide was the seventh in California. Both constitute around 20% of all California postpartum deaths from 2010-2012. The first was obstetric-related, or physical, causes.
Over the past few decades, pregnancy-related deaths have been steadily increasing across the U.S. Most research and preventive measures have focused on physical causes of death, such as blood clots and postpartum hemorrhage. However, deaths related to drugs and suicide have rarely been part of the conversation, the researchers said.
“Many official statistics of postpartum mortality don’t consider these to be causes of death that people should pay attention to,” Margerison said.
With increasing deaths due to drug overdoses and suicide nationwide, Goldman-Mellor and Margerison anticipated that mental health was also an important factor in postpartum deaths. However, they were still surprised at the magnitude of the results.
One possible explanation is that mothers are not able to attain drug use disorder treatment after giving birth due to lack of time or access to health care, they said. Or perhaps these results could reflect the fact that drugs and suicide are among the leading causes of death for people of reproductive age.
The study also found that two-thirds of maternal deaths happen six to 12 months after delivery, calling attention to the period after birth, rather than just during the pregnancy. This sparked interest in both researchers to find out whether women were coming into the emergency room between the time of delivery and their death.
“Now we are focused on: How can we find those women? Why are they falling through the cracks?” Margerison said.
California has a Mother and Baby Substance Exposure Initiative, which addresses treatment and prevention of drug abuse during and after pregnancy. It will be funded through September 2020.
Still, Goldman-Mellor and Margerison see a need for increased research and public health initiatives that directly address maternal deaths related to drugs and suicide, with special attention to the later stages of giving birth.
One possible policy direction is to ensure that women are able to stay insured and have access to health care for the first year after birth, the researchers said. Another is to require all state Maternal Mortality Review Committees to keep a record of deaths related to drugs and suicide.