Pregnant person sits cradling their stomach.

Substance Use Disorder (SUD)/Opioid Use Disorder (OUD)

“Accidental poisonings were the leading cause of maternal deaths in 2018 and accounted for over 50% of all maternal deaths. This category includes drug-related overdose deaths. In 2013, only 19% of pregnancy-associated deaths were due to accidental poisonings. That over half of all deaths in 2018 fell into this category reflects, in part, the continuing devastating impact of Pennsylvania’s opioid epidemic on both individuals and families.” (source: PA MMRC)

Top Causes of Death for All Maternal Deaths (Excluding Philadelphia County) in 2018 (N=85)
 Cause of Death  Number of Deaths   Overall Percentage
 Accidental Poisoning  43 51% 
Other Direct Obsetric Deaths 9  11%
 Transportation Accidents  8 9%
 Assault 7 8%
Other Pregnancy Related 4 5%
  Intentional Self-Harm 4 5%

• 70-84% of pregnant women with Opioid Use Disorder (OUD) do not receive a post-partum visit in PA
Kelley, D, 2018 CMS Quality Conference

Successes

%
Hospitals engaged
As of December 2022, 90% of hospitals engaged in the PA PQC SUD initiative are using validated, self-reported screening tools for maternal substance use, up from a baseline of 53% in 2019.
%
Increase in staff-wide education
Between September and December of 2022 alone, there was a 9% increase in the percentage of hospitals providing staff-wide education on perinatal racial and ethnic disparities and root causes.

2023-2024 Goals

Increase the percentage of hospitals with trauma-informed protocols in the context of substance use from approximately 10% to 20%

Increase the percentage of hospitals with a system in place to provide naloxone to at-risk patients prior discharge from 8% to 30%

Increase the percentage of hospitals with established perinatal care pathways for SUD that coordinate services across multiple providers up to 1 year postpartum from 60% to 70%

Maintain at least 90% of pregnant individuals being screened for substance use with a validated screen

Key Interventions

Educate staff and patients about substance use disorders

Screen pregnant women for substance misuse and physical and behavioral health co-morbidities using validated screening tools

Connect women to treatment and supportive resources

Establish prenatal, intrapartum, and postpartum care pathways for women with SUD that incorporate care coordination among multiple providers