Perinatal Depression is one of the most common complications associated with pregnancy and childbirth (CDC, 2018). However, did you know that suicide and overdose combined are the leading cause of death for women in the first year postpartum (Davis, 2019)? Often suicide is the result of unrecognized and untreated mental health conditions. For this reason, during National Suicide Prevention Month, we would like to draw attention to the issue of maternal suicide.
The 2018 Illinois Maternal Morbidity and Mortality Report cites 21% of postpartum deaths in Illinois were a result of suicide and overdose, and 50% of these deaths occurred after 6 months postpartum. This highlights the importance of routine screening and assessment for perinatal depression, especially 6-9 months postpartum when the risk of suicide is greatest (California Pregnancy-Related Maternal Mortality Review, 2019). Pregnant women should be offered screening ideally once each trimester and during her woman’s comprehensive postpartum visits (PSI, 2021). The American Academy of Pediatrics recommends that pediatricians screen for postpartum depression at the 3, 9 and 12 month pediatric visits (Earls, 2019). Routine screening should include a suicide assessment component and occur for all women regardless of emotions or appearance in the office. Universal screening is so important because using clinical observation alone, healthcare providers miss about 50% of perinatal depression (Prevatt, 2018).
To help you, Illinois DocAssist provides information and links to free evidence-based screening tools for perinatal depression. If a woman is screening positive for suicidal ideation, the Columbia Suicide Severity Rating Scale is a tool that will guide you to assess for suicide risk and take the necessary next steps to keep your patient safe. You can access resources for perinatal women including crisis and support lines on our website. To learn more about screening, diagnosing and treating depression in the perinatal period, access our free CME eligible recorded Webinar. For guidance on screening and treatment of perinatal substance misuse, access our free online Webinar.
Illinois DocAssist provides free expert psychiatric consultation to you regarding your perinatal and pediatric patients. We’re just a phone call away to answer your questions. Call us at 866-986-2778 Monday through Friday 9am to 5pm.
California Pregnancy-Related Maternal Mortality Review. CA-PMR Report: Pregnancy-Associated Suicide, 2002-2012. 2019.
Centers for Disease Control and Prevention. Division of Reproductive Health. Depression Among Women.https://www.cdc.gov/reproductivehealth/depression/index.htm. Accessed September 13th, 2021.
Davis, Nicole L.; Smoots, Ashley N.; Goodman, David A. (2019). Pregnancy-related deaths: Data from 14 U.S. Maternal Mortality Review Committees. 2008-2017.
Earls MF; Yogman MW; Mattson G; Rafferty J, COMMITTEE ON PSYCHOSOCIAL ASPECTS OF CHILD AND FAMILY HEALTH. Incorporating Recognition and Management of Perinatal Depression Into Pediatric Practice. Pediatrics. 2019 Jan;143(1) DOI: 10.1542/peds.2018-3259.
llinois Maternal Morbidity and Mortality Report. October 2018
Postpartum Support International (PSI). “Screening Recommendations”, 13 Sept, 2021, https://www.postpartum.net/professionals/eeningscr/.
Prevatt, Betty‑Shannon & Desmarais, Sarah L. (2018), Facilitators and Barriers to Disclosure of Postpartum Mood Disorder Symptoms to a Healthcare Provider. Matern Child Health J. 22:120–129