Substance Use, Violence, & Mental Disorders As Threatening To Pregnancy As Illness

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Substance Use, Violence, & Mental Disorders As Threatening To Pregnancy As Illness

According to a recent study by the Boston University Medical Center, pregnant women’s mortality rates have been increasing. Some is due to medical reasons, such as hemorrhage and hypertension. But there are other, less expected reasons that have nothing to do with physical illness.

While mental disorders, partner violence, and substance abuse have been found to be exacerbated by pregnancy, the current definition of the U.S. Maternal mortality does not explicitly include these causes.

The study, published in the American Journal of Public Health, reviewed cases of women who died during or within a year of pregnancy in Philadelphia from 2010-2014. Data was gathered from case summaries constructed by the office of the medical examiner. From this data researchers obtained the cause of death, any contributing factors, and known history of health care use.

What they revealed was startling. Near half, or 42 of 85 deaths related to pregnancy were caused by injuries, homicide, or suicide.

Also, the leading cause of death was found to be drug overdose, and substance use was a contributing factor in nearly half of non-overdose fatalities. More than 1/3 non-suicide women had serious mental illness history, and in 15 of 77 non-homicide deaths, partner violence was noted.

And in an eerie case for foreshadowing, in the month before their deaths nearly half the women who died were reported as having an unscheduled hospital visit. Thus, there are probably missed opportunities to intervene in cases where women are having difficulties with pregnancy due to these issues.

Pooja Mehta, M.D., M.S.H.P., assistant professor of obstetrics and gynecology at Boston University School of Medicine:

“Our analysis used a broader framework than traditional studies of death during pregnancy and found that a narrow focus on the medical causes of maternal mortality may be inadequate.”

“Even women who died from medical causes frequently had histories of substance use disorder, serious mental illness or partner violence — hidden potential contributors to maternal mortality.”

Commentary

Generally speaking, public efforts to make pregnancy safer have focused on medical factors, such as blood clots and heart disease. But these findings indicate other approaches are needed to identify pregnant women at risk and get them help before its too late.

~ G. Nathalee Serrels, M.A., Psychology

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