When we think about maternal death, we think about postpartum hemorrhage, perhaps infection or fatal blood clots. Most people would be surprised to know that suicide claims a significant number of mothers’ lives in the postpartum period. The WHO highlights suicide as a leading cause of maternal death in developed countries, and research from the UK and New Zealand identify suicide as the number one cause.
However, awareness of the prevalence of maternal suicide is still lacking. Canadian maternal mortality statistics do not mention suicide or psychiatric factors as a cause of death at all. I can only assume they are lumped into “other indirect causes” which is not helpful for public awareness or for furthering research on mental health.
It is interesting to note that in the data reported from the UK, 85% of the women who died from suicide had received a psychiatric diagnosis and treatment. The implication of this statistic is unclear. It could be that women are not being screened for symptoms of postpartum psychosis or that they were not receiving adequate follow-up or effective treatment. Separation of mother and infant during inpatient treatment was speculated to be a contributing factor, as all the women who had committed suicide had been hospitalized alone, whereas women treated in a mother and baby unit did not go on to commit suicide.
Women who have postpartum psychosis are at the highest risk for suicide, but women suffering from other perinatal mood disorders can also be affected. If you are experiencing suicidal thoughts or intentions, it is important to get help as soon as possible. In a crisis where you feel that you are risk of harming yourself or anyone else, go to the nearest emergency room. Some women experience only fleeting thoughts of suicide, but these must still be taken very seriously and addressed by your healthcare provider. Sometimes subtle thoughts such as “I wish I could sleep and never wake up” or “I just want this to be over” are not interpreted as suicidal thoughts, but they absolutely are. Mention any and all thoughts of self-harm or suicide to your care provider, rather than minimizing them.
As more awareness of perinatal mental illness builds, for women, their families, their communities, and their healthcare providers, the maternal suicide rate should drop. It can a terrifying thing to discuss, admit, or ask for help for, but dealing with suicidal thoughts or intentions is essential and you will not regret it.
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