INDIANA — A stark new report from the Indiana Maternal Mortality Review Commission reveals that substance use is now the leading cause of death for women in the year following childbirth. The data suggests that for many Hoosier mothers, the joy of a new arrival is overshadowed by a deadly “relapsing illness” that pregnancy alone cannot cure.
According to the commission’s most recent analysis, overdoses contribute to approximately one-third of all deaths among women during pregnancy and up to one year postpartum. Experts emphasize that these are largely accidental overdoses, occurring at a time when medical support for mothers often drops off.
The “Deadly” Postpartum Gap
While the risk of overdose often decreases during pregnancy as mothers focus on prenatal care, it spikes dramatically after delivery.
According to Dr. Camila Arnuado, a member of the mortality review committee in the postpartum period, the risk of having an overdose is higher than if you had never been pregnant – it’s a deadly time for people.
The report highlights a significant disparity in care:
- Prenatal Care: Mothers typically attend 6 to 20 appointments.
- Postpartum Care: Most mothers receive only one follow-up appointment, usually six weeks after birth.
For women struggling with addiction or undiagnosed mental health disorders—estimated to be present in 80-90% of substance use cases—this lack of follow-up can be fatal. Practical barriers like childcare, transportation, and a fear of judgment often keep the most vulnerable mothers from seeking help.
Child Services: A Red Flag for Intervention
A recurring pattern found by the commission is the high rate of interaction between deceased mothers and the Department of Child Services (DCS). Data shows that two out of three maternal deaths involved a mother who had a DCS history, either as a child or an adult.
Statewide data from 2024 indicates that over 7,100 children were removed from their homes, with 57% of those cases tied to parental drug or alcohol abuse.
| Location | % of Child Removals Due to Substance Use |
| Indiana (Statewide) | 57% |
| Monroe County | 74% |
| Lawrence County | 68%* |
*Based on recent regional trends in Southern Indiana, local officials note that substance use remains the primary driver of foster care placements in Lawrence County.
The commission is calling for increased funding and specialized recovery programs that allow mothers and children to stay together during treatment. Currently, Indiana faces a shortage of OB-GYNs and midwives, further complicating access to care.
Advocates point to harm reduction tools like Naloxone (Narcan) and fentanyl testing strips as essential immediate resources. However, experts like Dr. Mary Abernathy, chair of the mortality committee, argue that the long-term solution requires a fundamental shift in how the community views addiction.
According to Dr. Abernathy, substance use disorder is a chronic, sometimes lifelong condition. She believes the state needs to capitalize on the association between DCS and health care to flag and support high-risk mothers before it’s too late.
For those seeking help with addiction in Indiana, resources are available through the CHOICE program or by calling 2-1-1.
