In light of the sharp increase in drug-related overdose deaths among pregnant and postpartum individuals, the American Medical Association (AMA) and Manatt Health released a new report (PDF) with recommendations for state policymakers to improve access to evidence-based care for pregnant and postpartum people. Recent data shows opioid-related overdoses are now a leading cause of death associated with pregnancy and the postpartum period, with mortality rates rising more than 80% between 2017 and 2020. The AMA urges state agencies and policymakers to carefully review and implement the recommendations contained in the report to address this mounting crisis.

Key policy recommendations in the report include:

• Supporting access to medications for opioid use disorder (MOUD) given it is the standard of care for opioid use disorder in pregnancy
• Ensuring pregnant and postpartum people are supported and not punished for receiving MOUD
• Improving data collection and state partnerships to ensure equitable access to treatment
• Requiring correctional facilities and judicially supervised diversion programs to provide all justice-involved people with access to MOUD and universal screening
• Guaranteeing Medicaid coverage and access to pre-release services for all incarcerated people

“The escalating rise of drug-related overdose deaths during and immediately after pregnancy demands that state policymakers act now to improve outcomes for these individuals, newborns, and families,” said AMA President Jesse M. Ehrenfeld, MD, MPH. “Improving evidence-based medical care during pregnancy for patients who have substance use disorders must start with compassion. Some states have started taking a nonpunitive, public health approach to address this crisis, but more needs to be done.”

Many structural barriers impede access to evidence-based care for pregnant and postpartum people with opioid use disorder. The report includes several examples of states’ forward progress to remove barriers including increasing education and training opportunities to address misconceptions about MOUD use during pregnancy, linking data sets to obtain a comprehensive analysis of racial and ethnic disparities in access to MOUD among pregnant people, and establishing community-based care teams to support pregnant and postpartum individuals coming out of incarceration.

AMA and Manatt leaders will share the report’s recommendations with front-line clinicians and policymakers during a webinar on Tuesday, March 5, at 2 p.m. Eastern.