Homicide, Suicide, and Overdose Leading Causes of Maternal Death

FRIDAY, Feb. 20, 2026 (HealthDay News) — Homicide, suicide, and drug overdose are the leading causes of maternal death, according to a study published online Feb. 11 in the New England Journal of Medicine.

Hooman A. Azad, M.D., M.P.H., from the Columbia University Irving Medical Center in New York City, and colleagues analyzed all deaths among pregnant and postpartum women in the United States from 2018 to 2023.

The researchers found that 7,901 deaths occurred during the six-year period. Unintentional drug overdose was the leading cause of maternal death (1,152 deaths; 5.2 deaths per 100,000 live births). The second most frequent cause was violence, defined as homicide or suicide by any means (866 deaths; 3.9 deaths per 100,000 live births); homicide and suicide accounted for 593 and 273 deaths, respectively (68 and 32 percent). The next most common causes of death were cardiovascular causes, hypertension, infection, and hemorrhage. Disparities in pregnancy-associated mortality were seen according to race, ethnic group, and age, with homicide occurring more frequently among non-Hispanic Black women and the highest incidence seen among those aged 15 to 24 years. Across age groups, suicide and unintentional drug overdose occurred more often in non-Hispanic White women than non-Hispanic Black women or Hispanic women. Among those aged 15 to 24 years and 35 to 44 years, Hispanic women had a lower incidence of homicide, suicide, and overdose than non-Hispanic women.

“Overdose and violence are not typically on our radar when it comes to thinking about approaches to reducing maternal morbidity and mortality, but these events are far more common among pregnant and postpartum women than we think,” Azad said in a statement. “We have an opportunity to refocus our efforts on preventing drug overdose and violence with multidisciplinary care that includes referrals to mental health care and social services throughout pregnancy — which could save hundreds of lives.”

Abstract/Full Text