Respect Equality

Pandemic saw record drug deaths among pregnant women

“Enhanced strategies supporting substance use prevention, treatment, and harm reduction efforts among pregnant and postpartum people are critical and much needed.”
Pregnant woman.
The Associated Press/ Charles Krupa

Story at a glance


  • In 2020, a record number of pregnant or postpartum women died from drug overdoses in the United States.

  • Although these rates had been steadily increasing since 2017, the COVID-19 pandemic likely exacerbated challenges women faced when seeking care.

  • Barriers to treatment and an unregulated supply of drugs contributed to the uptick seen, researchers said. 

Drug overdose deaths among pregnant and postpartum women spiked by 81 percent between 2017 and 2020 and mirrored a similar rise among women of childbearing age overall.

Data also showed overdose increases were more pronounced for both groups in 2020, coinciding with the start of the COVID-19 pandemic. 

Findings were published Tuesday in the Journal of the American Medical Association.

Rises in drug overdose deaths among the general U.S. population have been well-documented throughout the pandemic and were likely made worse by the social and economic disruptions of the crisis. 


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But pregnant women and new mothers are at an increased risk of fatal overdose. To better understand how the pandemic impacted death rates in this population, researchers assessed data from the National Vital Statistics System.

All individuals included in the analysis either passed away while pregnant or within one year of delivery.

Throughout the four years studied, 1,249 of 7,642 pregnancy-associated deaths were overdose-related, marking an overdose mortality rate of 8.35 per 100,000. 

However, that rate grew from 6.56 per 100,000 in 2017 to 11.85 per 100,000 in 2020.

For reproductive-age women in general, the rate rose from 14.37 to 19.76 per 100,000, marking a 38 percent increase.

“For both groups, increases in overdose mortality in 2020 were more pronounced than increases during any prior year,” the authors wrote in the study.

Rates of overdose involving benzodiazepines, heroin and prescription opioids among pregnant women remained relatively stable, while deaths involving fentanyl and other synthetics and psychostimulants increased.

In 2020 alone, deaths attributed to fentanyl and synthetics grew from 5.73 per 100,000 to 9.47 per 100,000 pregnant or postpartum women.

Pregnant and postpartum individuals can face barriers when attempting to access drug treatment services. Researchers hypothesize these challenges were exacerbated by pandemic-related stressors, closures of health care facilities and an unregulated drug supply.

“Enhanced strategies supporting substance use prevention, treatment, and harm reduction efforts among pregnant and postpartum people are critical and much needed,” said senior author Silvia Martins, professor of epidemiology at Columbia University Mailman School of Public Health, in a release

“We expect new and improved approaches will help address the concerning trends we are seeing,” Martins said.

CDC data show that between 2010 and 2017, opioid use among pregnant women rose by 131 percent. If left untreated, babies born to these mothers can suffer from neonatal abstinence syndrome and a low birth weight.