Births Affected By Opioids Continue To Rise Among Rural Women

“More than 60% of rural moms with opioid use disorder give birth locally. These rural hospitals may have more limited capacity to care for them and their babies.”

The opioid epidemic has meant that more rural moms and babies are affected by drug abuse, often requiring specialized care at hospitals that are located far from home, according to a new study. 

The study, published in the Journal of Rural Health, found that the numbers of mothers with opioid use disorder giving birth and infants with neonatal abstinence syndrome increased in rural hospitals, urban non-teaching hospitals and urban teaching hospitals. 

Mothers who abuse opioids are at increased risks of complications during pregnancy and childbirth, including pre-term labor. At the same time, infants who are born dependent on opioids often have health issues that require a stay in the neonatal intensive care unit.

This is significant because as the rates of maternal opioid abuse and neonatal abstinence syndrome increase, rural hospitals with fewer resources can be overwhelmed, and urban teaching hospitals—often with the best resources—see more patients from far away. 

“Some of these rural moms, especially those with clinical complications, give birth in urban, teaching hospitals, often far from home,” said Katy Kozhimannil, associate professor in the University of Minnesota School of Public Health and director of the University of Minnesota Rural Health Research Center. “Yet, our study findings show that more than 60% of rural moms with opioid use disorder give birth locally. These rural hospitals may have more limited capacity to care for them and their babies.”

The study found that many expectant moms with opioid use disorder are sent to urban teaching hospitals, suggesting that healthcare providers in rural settings have become adept at identifying patients with this condition and referring them to the appropriate level of care.

In fact, rural women who gave birth in urban teaching hospitals had the highest rate of maternal opioid use disorder, at 8.9 per 1,000 deliveries, since high-risk patients are often referred to this setting. 

However, since many women still have high-risk opioid-affected births at rural hospitals, Kozhimannil says more resources need to be made available in that setting. At rural hospitals, the rate of moms with opioid use disorder is 4.3 per 1,000 deliveries.

“Recent policy and clinical efforts to address opioid-affected births have frequently focused on specialized capacity building within tertiary care settings, often urban teaching hospitals,” said Kozhimannil. “Yet, these results show that resources are also needed in rural hospitals that are caring for more and more opioid-affected moms and babies each year.”

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