Time to pay attention: an underrecognized casualty of the opioid epidemic.

Maternal mortality and overdose deaths have both been on the rise in the USA, but the relationship between the two is unclear. Recent reports have pointed toward accidental overdoses and suicides as leading causes of maternal mortality. This short communication collected data on psychiatric-related deaths, suicide and drug overdose, from each state's Maternal Mortality Review Committee to better conceptualize the rate at which these deaths are occurring. Data was collected from each state's most recent online MMRC legislative report and met inclusion criteria if the reports included the number of deaths due to suicide and accidental overdoses during each review period, as well if the report encompassed data from 2017. Fourteen reports met inclusion criteria, cumulatively reviewing 1929 maternal deaths. Of these deaths, 603 (31.3%) were due to accidental overdose, while 111 (5.7%) were due to suicide. These findings highlight the need for increased psychiatric care in the pregnant and postpartum period, specifically for substance use disorders. Increasing screening for depression and substance use, decriminalizing substance use during pregnancy, and extending Medicaid coverage to 12 months postpartum on a national level are all interventions that could significantly reduce maternal deaths.