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Pathways and Barriers: Understanding Perinatal Substance Use Disorder Systems in Kansas
von Esenwein, Silke Tilden, Chris Carrillo, Patricia Cizek, Meghan
von Esenwein, Silke
Tilden, Chris
Carrillo, Patricia
Cizek, Meghan
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Abstract
Substance use disorder (SUD) during pregnancy and the postpartum period is an increasingly significant contributor to maternal and infant health challenges in Kansas. Between 2016 and 2022, the Kansas Maternal Mortality Review Committee (KMMRC) found that SUD contributed to more than one in four pregnancy-associated deaths, with all overdose deaths occurring in the postpartum period (Kansas Department of Health and Environment [KDHE], 2023). Accidental overdose was a leading cause, and substance use rarely occurred in isolation. Mental health conditions, including suicide and intimate partner violence (IPV), often overlapped, compounding the risks.
These deaths were not inevitable. Many of these pregnancy-associated deaths could have been prevented through earlier identification, treatment engagement, and stronger continuities of care. The underlying risk factors, such as untreated behavioral health conditions and fragmented postpartum services, were visible and, in many cases, addressable. Their persistence reflects missed opportunities across health, behavioral health, and child welfare systems. Kansas has made meaningful progress in shifting toward family-centered, trauma-informed care. However, significant barriers remain. Gaps in rural access, workforce capacity, harm reduction, and culturally responsive care continue to limit consistent, high-quality outcomes for pregnant and parenting people affected by SUD.
This report outlines five strategic priorities, each grounded in statewide data, lived experience, and practice-based insights: (1) Upstream identification and prevention; (2) Expand flexible, evidence-based care across the perinatal continuum; (3) Harm reduction and postpartum continuity; (4) Family-centered child welfare and court partnerships; and (5) Data-driven quality and sustainable financing. This report is designed for policymakers, health care professionals, community leaders, and advocates who influence perinatal and behavioral health systems in Kansas. It distills complex data and evidence into actionable insights, showing where early intervention, family-centered support, and cross-system coordination can make the greatest impact. Readers will find practical examples of promising practices, gaps that demand attention, and policy opportunities that can reduce preventable deaths, improve maternal and infant health, and strengthen families. Investing in high-quality perinatal care not only protects mothers and babies today, it also helps prevent childhood adversity, fosters positive early life experiences, and creates healthier, more resilient communities for generations of Kansans to come.
Description
Date
2025
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Publisher
University of Kansas Center for Public Partnerships & Research
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MAVIS Report_2025.pdf
Adobe PDF, 1.61 MB
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Keywords
Maternal mortality, Maternal and infant health, Perinatal substance use disorder, Child welfare
Citation
von Esenwein, S., Carrillo, P., Tilden, C., & Cizek, M. (2025). Pathways and barriers: Understanding perinatal substance use disorder systems in Kansas. Prepared by the University of Kansas Center for Public Partnerships and Research for the Kansas Department of Health and Environment.