Sarcouncil Journal of Biomedical Sciences

Abstract: In the United States, pregnancy-related mortality is becoming a growing and underestimated issue, and the role of substance use disorders (SUDs) in it is becoming extremely important. The given traditional literature review is the synthesis of existing knowledge on the determinants, pathophysiology, and interventions in relation to SUD-related maternal mortality. Based on national statistics and other peer-reviewed sources, the review describes the increasing rates of overdose, suicide, and medically complex mortality during pregnancy and postpartum. The most notable ones are trauma, psychiatric comorbidities, housing instability, structural racism, and punitive legal systems, which tend to discourage care. Healthcare system gaps, including delayed diagnosis, fragmented services, and provider stigma, predispose physiological risks, such as cardiovascular stress, sepsis, and hemorrhage. Despite the growing convincing evidence of the effectiveness of medications, integrated perinatal-SUD care models, and trauma-informed approaches, the application of these strategies is not uniform among the population and geographical areas. There is an exceptionally high barrier to adolescents, Black and Indigenous women, or rural or justice-involved settings. The review determines significant gaps in research of long-term outcomes of maternal health, surveillance systems, and culturally based interventions. Multisectoral investment in the form of Medicaid expansion, supportive state legislation, workforce training, and non-criminalizing care models is urgently required to minimize the number of deaths that can be avoided. Addressing SUD in pregnancy must become a public health and equity priority, requiring compassionate, evidence-based strategies that respond to the lived realities of at-risk birthing people.