Pregnancy-associated mortality is an urgent global health concern, encompassing deaths that occur during pregnancy or within a year after childbirth. A range of factors, both medical and external, such as violence and substance use, cause these deaths. Recent research shows a troubling rise in deaths linked to these external causes, shining a light on the need for stronger preventive efforts and systemic changes to protect mothers worldwide.

Understanding the factors influencing maternal death rates is essential for developing effective strategies to combat this crisis. With increasing availability of data, researchers are uncovering more detailed insights into the trends, geographical discrepancies, and methods in which these deaths occur. This has revealed the significant role played by external factors in shaping maternal outcomes, underlining the necessity for focused intervention.

What the Data Reveals About Pregnancy-Associated Mortality

A detailed review of pregnancy-associated mortality in the United States from 2018 to 2022 provides essential insights into this evolving crisis. A staggering 10,715 deaths of pregnant women or new mothers were recorded during this period, with external causes making up a significant proportion. Homicide accounted for 837 deaths, suicide for 579, and drug overdose for 2,083.

These figures expose the magnitude of the issue and its deep societal implications. For instance, 51.4% of pregnancy-associated homicides, 31.8% of suicides, and 34.4% of overdose deaths transpired during pregnancy itself, while the remainder occurred postpartum. Such distribution elevates the need for sustained care and support both before and after childbirth.

It is also noteworthy that “women in the US are more likely to be murdered during pregnancy or soon after childbirth than to die from the three leading obstetric causes of maternal mortality” (Source: Network for Public Health Law). This startling finding highlights the growing relevance of violence as a driver of maternal deaths, requiring urgent action.

Firearms and Maternal Death Rates

The significant involvement of firearms in pregnancy-associated mortality is a serious concern. Across the five-year period, firearms accounted for 76% of pregnancy-associated homicides, making them the leading mechanism of injury. Alarmingly, they also accounted for 37% of suicides among pregnant and postpartum women, second only to methods like hanging and suffocation.

The prominence of firearms highlights the urgent need for stricter regulations to mitigate such risks. Safety measures focused on limiting violence against women, especially expectant mothers, could lead to notable improvements in maternal health outcomes.

The Role of Substance Use

Substance use also plays a critical role in pregnancy-associated mortality. Among the many challenges, drug and alcohol misuse have proven to be fatal for pregnant women and new mothers alike. According to research, “the unadjusted relative risk of maternal death is 2.7 times greater if drug or alcohol use is diagnosed” (Source: PMC). This association underscores the importance of policies aimed at reducing substance availability alongside public education campaigns to prevent misuse.

The geographic variations in maternal death rates further exacerbate the issue. For example, Mississippi recorded the highest rate of pregnancy-associated drug overdoses during a similar timeframe, pointing to broader structural and policy issues that contribute to these trends.

Prioritising Maternal Health

The rise in pregnancy-associated mortality related to external causes mirrors larger societal issues that require focused action. Preventive efforts should prioritise public education and community support, targeting underlying contributors to these deaths. Governments, healthcare providers, and communities must work together to eliminate threats such as violence and substance use, ensuring long-term changes in maternal health outcomes.

Every expectant or postpartum mother deserves the opportunity to thrive during these critical stages of life. Investing in comprehensive policies and ensuring access to care are necessary steps towards reducing maternal death rates and improving outcomes for families across the globe.

Source: JAMA Network