Podcast
0.25 CME Credit
Beyond Blood Loss: A Shift in the Leading Causes of Maternal Death - Frankly Speaking Ep 508Guest: Mariyan L. Montaque, DNP, FNP-BC
Music Credit: Matthew Bugos
We’ve long understood cardiovascular disease, hemorrhage, hypertension, and infection as the leading killers of pregnant patients. A recent analysis challenges that, finding the leading causes are now overdose, homicide, and suicide. Join us as we unpack what this means for clinicians, explore racial and age disparities, and discuss how primary care clinicians can better protect maternal health.
Episode references and resource links:
- Azad, H. A., Goin, D., Nathan, L. M., Goffman, D., Rajan, S., Reddy, U., ... & Laraque-Arena, D. (2026). Overdose, homicide, and suicide as causes of maternal death in the United States. New England Journal of Medicine, 394(7), 722-723.
- American College of Obstetricians and Gynecologists. (2023). Screening and diagnosis of mental health conditions during pregnancy and postpartum: ACOG clinical practice guideline no. 4. Obstet Gynecol, 141(6), 1232-61.
- Chen, Y., Shiels, M. S., Uribe-Leitz, T., Molina, R. L., Lawrence, W. R., Freedman, N. D., & Abnet, C. C. (2025). Pregnancy-related deaths in the US, 2018-2022. JAMA Network Open, 8(4), e254325.
- Ganetsky, V. S., Krawczyk, N., & Kennedy-Hendricks, A. (2025). Medication for opioid use disorder and treatment retention among pregnant individuals. JAMA Network Open, 8(4), e256069.
- Han, B., Compton, W. M., Einstein, E. B., Elder, E., & Volkow, N. D. (2024). Pregnancy and postpartum drug overdose deaths in the US before and during the COVID-19 pandemic. JAMA psychiatry, 81(3), 270-283.
- Hollier, L. M., Busacker, A., Njie, F., Syverson, C., & Goodman, D. A. (2024). Pregnancy-related deaths due to hemorrhage: Pregnancy Mortality Surveillance System, 2012–2019. Obstetrics & Gynecology, 144(2), 252-255.
- Margerison, C. E., Roberts, M. H., Gemmill, A., & Goldman-Mellor, S. (2022). Pregnancy-associated deaths due to drugs, suicide, and homicide in the United States, 2010–2019. Obstetrics & Gynecology, 139(2), 172-180.
- Miller, E. S., Hoffman, M. C., Roussos-Ross, K., Byatt, N., & Simas, T. A. M. (2022). Preventing maternal morbidity and mortality through perinatal mental health care. Obstetrics & Gynecology, 10-1097.
- Miller, E., & McCaw, B. (2019). Intimate partner violence. New England Journal of Medicine, 380(9), 850-857.
- Petersen, E. E. (2019). Racial/ethnic disparities in pregnancy-related deaths—United States, 2007–2016. MMWR. Morbidity and mortality weekly report, 68.
- US Preventive Services Task Force, Barry, M. J., Nicholson, W. K., Silverstein, M., Cabana, M. D., Chelmow, D., ... & Wong, J. B. (2023). Screening for hypertensive disorders of pregnancy: US Preventive Services Task Force final recommendation statement. Jama, 330(11), 1074-1082.
- Wallace, M. E., & Jahn, J. L. (2025). Pregnancy-associated mortality due to homicide, suicide, and drug overdose. JAMA network open, 8(2), e2459342.
The views expressed in this podcast are those of Dr. Domino and his guests and do not necessarily reflect the views of Pri-Med.
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CME/CE Information
0.25 AMA PRA Category 1 Credits™
Release Date: 10/26/2026
Expiration Date: 10/26/2028
Learning Objectives
- Identify unintentional drug overdose and violence (homicide and suicide) as the leading causes of maternal death in the United States from 2018–2023, surpassing traditional obstetric complications
- Describe racial, ethnic, and age-related disparities in pregnancy-associated mortality due to overdose, homicide, and suicide
- Apply an updated, comprehensive approach to screening and counseling pregnant and postpartum patients that incorporates substance use, intimate partner violence, and mental health risk factors
Faculty
Frank J. Domino, MD
Professor, Family Medicine and Community Health,
University of Massachusetts Medical School, Worcester, MA
Mariyan L. Montaque, DNP, FNP-BC
Instructor, Department of Family Medicine & Community Health, University of Massachusetts, Worcester, MA; Term Lecturer, Family Health Practicum, MGH Institute of Health Professions, Boston, MA; Visiting Assistant Professor, Department of Business Fitchburg State University, Fitchburg, MA.
Learn MoreDisclosures
Frank J. Domino, MD: Has disclosed no relevant financial relationships.
Mariyan L. Montaque, DNP, FNP-BC: Has disclosed no relevant financial relationships.
Non-faculty contributors involved in the planning, development, editing, and review of the content have disclosed no relevant financial relationships.
CME/CE Information
AMA PRA Category 1 Credits™
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