The Latest Data on Maternal Suicide from United Health Foundation and Health Affairs
Shalini Wickramatilake, MHS
By Shalini Wickramatilake, MHS; Cindy Herrick, MA, CPSS, MHFA
According to a recent report from the United Health Foundation, maternal mortality increased by 16% between 2018 and 2019. Mental health and substance use issues continue to be major drivers of maternal mortality. The same report found that 18.1% of women ages 18-44 reported their mental health was “not good” 14 or more days in the past 30 days — equivalent to roughly 10.2 million women. Additionally, drug-related deaths in women increased by 24% in 2017-2019, compared to 2014-2016.
Additionally, the October 2021 edition of Health Affairs is dedicated to maternal mental health, and one of the articles, Preventing Pregnancy-Related Mental Health Deaths: Insights from 14 US Maternal Mortality Review Committees (MMRCs), further explores the impact of mental health and substance use. The study concluded that:
Mental health disorders were the underlying cause of one in nine pregnancy-related deaths.
63% of pregnancy-related mental health deaths were by suicide.
72% of those who died of a pregnancy-related mental health cause of death had a history of depression.
67% of those who died of a pregnancy-related mental health cause had a history of substance use.
Mental health and substance use disorders (SUD) were the leading cause of preventable pregnancy-related deaths.
Notably, the study’s lead author, Susanna Trost, and her colleagues found that MMRCs deemed 100% of these deaths preventable compared to 64% of other causes of pregnancy-related deaths.
Deaths Occur Most Often in the Postpartum, and in White People
Other important facts to note are that 86% of pregnancy-related mental health deaths occurred among non-Hispanic White people and that most of the deaths (63%) occur 43-365 days postpartum. This highlights the importance and necessity of continued support, care, and screening for moms well beyond the immediate postpartum period.
The top two contributing factors to pregnancy-related mental health deaths were classified at the patient or family level (51%) and at the system level (21%). The most common patient or family level factors were mental health conditions, SUD, adherence to medical recommendations, social support or isolation, and knowledge. Contributing factors at the systems level include continuity of care and access or financial factors.
Key Take Away
It is important to look upstream to systems changes and patient-centered care in order to effectively reduce pregnancy-related mental health deaths.
Considering that mental health and substance use disorders are the largest contributors to maternal mortality and that they have been found to be 100% preventable, it is crucial that moms receive effective, efficient, and equitable mental health and addiction services.