Pharmacists Help Address Maternal Mortality With Drug Management | ASHP Midyear 2025

In the United States, maternal mortality rates have climbed over the past decade, with many deaths deemed preventable. Behind those statistics are familiar clinical outcomes: postpartum hemorrhage, sepsis, preeclampsia and eclampsia, and a range of cardiac conditions—from stroke to cardiomyopathy—that can turn a routine pregnancy into a medical emergency. As hospitals and health systems aim to improve outcomes, pharmacists have a large role in managing these conditions with pregnancy-specific therapies.

Morgan King, PharmD, BCPPS, a clinical pharmacy specialist at Cleveland Clinic Health System, notes in this conversation as part of the American Society of Health-System Pharmacists Midyear Clinical Meeting and Exhibition 2025, most pharmacists—and even many physicians—receive minimal formal training in caring for pregnant patients. The foundational pharmacotherapy lessons are there, but pregnancy is often treated as a footnote. When a pregnant person arrives septic, clinicians know the sepsis protocols, but it could change upon seeing the patient is pregnant.

This gap in knowledge matters because pregnancy profoundly alters how drugs behave in the body. Increased plasma and blood volume change the volume of distribution. Hormonal shifts modify absorption. Decreased albumin levels and altered cytochrome P450 activity reshape metabolism. The same drug at the same dose can have a very different effect in a pregnant patient, often requiring higher or more frequent dosing to achieve therapeutic goals.

King unpacks how pharmacists can translate these physiological realities into better bedside decisions—from selecting preferred agents for preeclampsia, like intravenous labetalol and hydralazine, to knowing when, in a true emergency, the priority must be saving the mother’s life with whatever medications are necessary. Empowering pharmacists with pregnancy-specific pharmacotherapy expertise is not just an educational upgrade—it’s a critical lever for preventing maternal deaths.

"Just having a general understanding of what medications we use to treat these conditions—again, a lot of the medications we use in pregnancy are going to be ones that we use in nonpregnancy. We have our preferred medication," King said.

READ MORE: ASHP Midyear Clinical Meeting and Exhibition

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