Co-Director Kathryn Emerick, MD
photo: Jamie Manser
Mental health conditions are the number one underlying cause of death in pregnancy-related cases in Arizona and, nationally, suicide is one of the leading causes of maternal mortality. The highest risk time any birthing person will face in their life for suicide is six to 12 months postpartum – long after any OB follow-ups; and many times, long after friends, family and colleagues are checking in. Recognizing risk factors and red flags early is crucial for intervention and support.
A recent study found the largest risk factors for perinatal suicide include current or historical psychiatric illness, substance use, and intimate partner conflict. Other risk factors include having an unwanted or unplanned pregnancy, pregnancy complications or fetal concerns, difficulty with breastfeeding, experiencing sleep deprivation, isolation or financial instability and demographic risks of being a young mother, a first-time mom, single parent, or an older, non-Hispanic mother.
Some red flags for worsening depression or suicidality to watch for include any thoughts or statements of suicidal intent, self-harm behavior, persistent feelings of being incompetent as a mom, feeling distant from the baby or that the baby doesn’t like them, withdrawing from friends or family, feeling like they are a burden to their family, seeking access to means for self-harm (e.g., stockpiling medications, researching methods) and preparing for death, such as writing a will, giving away belongings, or unexpectedly arranging for childcare.
We can all check in on the moms that we know, work with, and care for professionally. Together, we can work towards reducing maternal mortality by intervening and getting support for moms who are struggling.
If you or someone you know is struggling, please consider the following:
- 1-800-TLC-MAMA The National Maternal Mental Health Hotline, staffed 24/7 by trained counselors who can provide support and resources directly to moms.
- 988 The National Crisis Line, staffed 24/7 to provide support and resources to anyone in distress.
If you are a professional interested in screening patients, please consider using the Edinburgh Post Partum Depression Scale (EPDS) which has a question specifically screening for thoughts of self-harm. Download the EPDS in English and Spanish.
References
Policy Center for Maternal Mental Health. (2023, September). Maternal Suicide in the U.S.: Opportunities for Improved Data Collection and Health Care System Change [Issue Brief]. https://www.2020mom.org/issue-briefs-and-papers
Orsolini L, Valchera A, Vecchiotti R, Tomasetti C, Iasevoli F, Fornaro M, De Berardis D, Perna G, Pompili M, Bellantuono C. Suicide during Perinatal Period: Epidemiology, Risk Factors, and Clinical Correlates. Front Psychiatry. 2016 Aug 12;7:138. doi: 10.3389/fpsyt.2016.00138. PMID: 27570512; PMCID: PMC4981602.
Zivin K, Zhong C, Rodríguez-Putnam A, et al. Suicide Mortality During the Perinatal Period. JAMA Netw Open. 2024;7(6):e2418887. doi:10.1001/jamanetworkopen.2024.18887