In shocking news coming out of Utah this past month, new and expecting mothers have been found to be some of the most vulnerable to opioid misuse and death from overdoses. Utah has been struggling with a massive and deadly opioid crisis, that has steadily gotten worse over the past decade. According to the National Institute on Drug Abuse, there were 456 opioid-related overdose deaths in 2017 in Utah, a rate of 15.5 deaths per 100,000 people. Nearly 70 percent of these deaths were caused by prescription opioids. Unfortunately, new and expectant mothers are increasingly likely to become part of this statistic, and as of recently, a study done by the University of Utah Health found that opioids are the leading cause of deaths among new Utah moms.
What are Pregnancy-associated deaths?
According to a study in the medical journal Obstetrics & Gynecology, “Pregnancy-associated deaths are defined as the death of a woman during pregnancy or within one year from the end of the pregnancy.” This means that many of these deaths may also involve the death of the fetus or infant as well. From 2005 to 2014, author of the paper Marcela Smid, M.D., M.S., M.A., an assistant professor of maternal and fetal medicine at U of U Health, compared the characteristics of women who experienced pregnancy-associated deaths. Her findings pointed to a sinister issue bubbling in the Utah community: drug-induced deaths were the leading cause of pregnant or new mothers due to drug overdose, more than ¾ of these deaths having been related to opioid abuse. Eighty-nine percent of deaths of pregnant or new mothers due to drug overdose occurred in the late postpartum period, which is the time period between 43 days to a year after the baby is born.
What causes pregnancy-associated, opioid-related deaths?
Over half of the recorded deaths from drug use were said to be accidental. This comes as no surprise, as many Utah moms with previous addictions to opioids may stop using them upon discovering they are pregnant. Though a good thing for the baby, this now opens the mother up to a greater risk of overdosing, as the body has lost its tolerance for the drug that it had when the user was at the peak of their addiction. This means that in the event of a relapse, it is more likely for a new mother to overdose. 26 percent of these deaths were intentional, and in the remaining 20 percent, the circumstances could not be determined. Relapses and suicides may both stem from the same set of issues, which are typically related to stress during and/or after childbirth.
Postpartum Depression and Mental Health Issues
Pregnant women or new moms are especially vulnerable to mental health issues.
Postpartum depression is extremely common, yet not often discussed. New moms may feel pressure to view their pregnancy and the birth of their child as a positive, happy experience. So when it’s not, they can feel like something is wrong with them. This causes them to avoid seeking treatment for fear of judgment or feeling as if getting help is admitting that they do not love their child as much as they should.
Following childbirth, the levels of the hormones estrogen and progesterone quickly plummet in a woman’s body. This sudden drop leads to chemical changes in the brain, which can bring about or aggravate pre-existing mental health issues. One of the most common in new mothers is Postpartum Depression. Postpartum depression is classified as a mood disorder, affecting women after childbirth. This disorder can cause feelings of intense sadness, anxiety, and overwhelming exhaustion and fatigue. These symptoms are typically exacerbated by the slew of new responsibilities that come along with motherhood, and can leave new moms feeling overworked and drained. Sleep deprivation is another commonly occurring issue in new parents, which only serves to strengthen these awful symptoms.
The National Institute of Mental Health outlines some of the most common symptoms of postpartum depression:
- Feeling sad, hopeless, empty, or overwhelmed
- Crying more often than usual or for no apparent reason
- Worrying or feeling overly anxious
- Feeling moody, irritable, or restless
- Oversleeping, or being unable to sleep even when her baby is asleep
- Having trouble concentrating, remembering details, and making decisions
- Experiencing anger or rage
- Losing interest in activities that are usually enjoyable
- Suffering from physical aches and pains, including frequent headaches, stomach problems, and muscle pain
- Eating too little or too much
- Withdrawing from or avoiding friends and family
- Having trouble bonding or forming an emotional attachment with her baby
- Persistently doubting her ability to care for her baby
- Thinking about harming herself or her baby.
As you can probably guess, not many women want to admit that they are having trouble bonding with their baby, and they especially do not want to say that they are thinking about harming themselves or the baby. But these intrusive thoughts are much more common than most people realize, and when not properly addressed with treatment and therapy, they can lead to things like a lifelong addiction, or even death of the mother and/or baby.
Turning to opioids to cope
As we know, when one is suffering from the symptoms of a mental illness, they will often turn to illicit substances in an attempt to numb the pain. And unfortunately, pregnant women are often prescribed prescription painkillers for various labor-related pains. In fact, 42 percent of pregnant Utah women insured by Medicaid are prescribed opioids! The study stated: “The most common reasons for opioid prescriptions during pregnancy are back pain, abdominal pain, headache or migraine, joint pain or other pain diagnosis.” Coupled with stress, depression, anxiety, and sleep deprivation, access to these pharmaceuticals is extremely dangerous and irresponsible on the part of many doctors and healthcare providers.
Lack of care and little resources
There is a startling lack of support for pregnant women and new moms in Utah when it comes to substance abuse, particularly with prescription medication. Fewer than half of the women in the study received mental health services, despite the majority of them dealing with a mental health condition. Not only this, but 1 in 5 of the women had a previous suicide attempt in their past. None of the women had been screened for drug use during prenatal, delivery, or postpartum care either, and none of them received therapy or treatment for their opioid use disorder.
The problem doesn’t discriminate
The study did not find any correlation between age, race, ethnicity, or socioeconomic status. This issue is one that can affect any woman, and does not discriminate based on demographics or characteristics. This is what makes the issue so dangerous, because every single expectant or new mom (and every person, in general) is susceptible to becoming dependent on opioids. This also means they are highly susceptible to facing opioid-related death. And while this article specifically points to the opioid crisis among new and expectant mothers in Utah, this problem is rampant everywhere in the United States.
What can be done?
The first step in combating any widespread issue, is to raise awareness and attempt to erase the stigma attached to it. Substance abuse alone is still very much stigmatized in our society, and new and expectant mothers can be even more harshly judged because there is an innocent life involved. Refer to the helpful list of symptoms within this article and speak up if you believe that you or a loved one is struggling. Often times they are too afraid to do it themselves, so do not be afraid to ask if they are okay.
As we saw in the study, the majority of pregnant women weren’t even screened for drugs at all, let alone receiving help for their addiction or disorder. Medical and healthcare professionals must be more vigilant in looking for the signs of addiction. They must also be held accountable for the liberal prescribing of potentially dangerous medication such as opioids.
Finally, if you are or feel as if you may be dealing with postpartum depression, a substance abuse disorder, or any symptoms that are causing you pain or grief, please do not hesitate to reach out to a loved one. There are also plenty of treatment options available, and many people have found success with 12-step programs and individual therapy. At Scottsdale Recovery Center, we offer a variety of treatment programs that will be customized to fit your needs, in a compassionate environment with the goal of lifetime sobriety.