In 2017, drug-related deaths were the leading cause of death to mothers during pregnancy or within one year afterward, which accounts for one in four of these deaths in Florida, according to a new urgent pregnancy-associated mortality review (PAMR) message to providers and hospitals.

Most (75%) of these drug-related deaths occurred after the baby is born and the mother has been discharged from the hospital.

The rate of women in Florida with Opioid Use Disorder (OUD) at delivery admission quadrupled between 1999 and 2016.

“We have got to get the message out that Opioid Use Disorder is a life-threatening, chronic condition that can be successfully managed through medication-assisted therapy, behavioral counseling and community support,” stated Dr. Bill Sappenfield, Director of the Florida Perinatal Quality Collaborative (FPQC).

A critical first step is identifying women with OUD. Stigma and bias by the public and by health care professionals can make it difficult for women to discuss substance use and get help. That is why the Pregnancy Associated Mortality Review (PAMR) Committee along with ACOG and SMFM recommend screening all pregnant women for OUD prenatally and at delivery using a validated verbal or written screening tool.

Women with OUD should be counseled in a non-judgmental way using such tools as SBIRT (Screening, Brief Intervention, Referral to Treatment). These women need to receive compassionate and complete obstetrical care or directly referred to one who will. Medication-assisted treatment (MAT) is the recommended management for pregnant women with OUD.

Providers should participate in developing a plan of safe care for pregnant women with OUD in cooperation with MAT providers and community support agencies. Naloxone counseling and a prescription should be given to pregnant women with OUD to provide life-saving treatment in the event of an overdose.

“The provision of Naloxone – both its education and use — are actually critical to help prevent many of these deaths,” said Dr. Judette Louis, FPQC Lead, President of the Society of Maternal-Fetal Medicine, and Department Chair in the Department of Obstetrics and Gynecology at the Morsani College of Medicine, USF Health.

Learn more about OUD in pregnant women and read the Urgent PAMR Message to Providers and Hospitals on the FPQC’s MORE Initiative website and in the FPQC’s Opioid Toolbox.