A new study shows that accidental drug overdoses, homicides, and suicides are the leading causes of death among pregnant women and women in the postpartum period in the United States.
The findings were published in the New England Journal of Medicine.
Researchers from Columbia University Irving Medical Center analyzed death certificate data for all women who were pregnant or within 42 days after childbirth and died in the United States between 2018 and 2023.
The results showed that accidental overdose was the leading cause of death in this group (5.2 deaths per 100,000 births), followed by homicide and suicide combined (3.9 per 100,000).
Overdose and suicide cases were more common among white women, whereas homicides were more prevalent among Black women; more than one-third of violent deaths involved firearms.
The analysis also found that more than half of deaths related to overdoses and violence occurred during pregnancy, while the next most common causes — cardiovascular disease, infections, hypertension, and hemorrhage — were more likely to occur in the immediate postpartum period.
The researchers note that other studies suggest that following the widespread implementation of measures to prevent and treat medical complications during pregnancy and after childbirth, deaths related to overdoses and violence have increased. However, the lack of standardized data had previously made it difficult to track these trends.
According to the study’s lead author, Hooman Azad, the findings highlight the need for more proactive screening and treatment of substance use disorders and violence among pregnant women, including a comprehensive approach involving mental health and social services throughout pregnancy — measures that could save hundreds of lives.
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