September is recognized nationally as Suicide Prevention Month, an important time to raise awareness, share resources, and take action to save lives. While we all work diligently to prevent this tragic loss of life, it is critical to highlight the urgent issue of maternal mental health, including the risks associated with Perinatal Mood and Anxiety Disorders (PMADs).
Suicide in the Perinatal Period
One of the most vulnerable times While pregnancy and the postpartum period are often imagined as joyful, that is not the reality for many. One in five birthing people experience a PMAD—such as depression, anxiety, obsessive-compulsive disorder (OCD), posttraumatic stress disorder (PTSD), or psychosis. Yet, 80% of PMADs go undiagnosed and untreated, often due to shame, stigma, or fear.
Tragically, suicide is one of the leading causes of maternal death during pregnancy and up to one year postpartum. An estimated 20% of perinatal maternal deaths are due to suicide—more common than deaths from postpartum hemorrhage or hypertensive disorders.
Risk Factors for Perinatal Suicide
According to the Policy Center on Maternal Mental Health, the most critical risk factors include:
- A personal or family history of psychiatric illness, a prior suicide attempt, or suicidal ideation.
- A prior attempt: The CDC reports that 34% of pregnancy-related suicides occurred in women with a documented prior attempt.
- Psychiatric hospitalization: Women and birthing people admitted for postpartum psychiatric care are 70 times more likely to die by suicide within the first year after giving birth.
- A history of abuse at any point in life, which significantly increases the risk of suicidality during pregnancy and postpartum.
Additional overlapping risk factors may include intimate partner violence, depression, substance use, physical health issues, bereavement, young age, family conflict, loneliness, or an unplanned pregnancy. While suicide can occur during pregnancy, most maternal suicides happen between six and twelve months postpartum.
Warning Signs
According to the 988 Suicide & Crisis Lifeline, warning signs that someone may be at risk include:
- Talking about wanting to die or kill themselves
- Searching for ways to carry out suicide
- Expressing hopelessness, feeling trapped, or being a burden to others
- Increased use of alcohol or drugs
- Agitation, anxiety, or reckless behavior
- Changes in sleep (too little or too much)
- Withdrawing from others
- Rage, revenge-seeking, or extreme mood swings
Prevention and Support
Preventing perinatal suicide requires strong family and social support, access to quality perinatal mental health care and screenings, nonjudgmental conversations about mental health, and connection to peer or survivor communities.
The National Institute of Health recommends five steps to help someone experiencing suicidal thoughts:
- Ask: “Are you thinking about suicide?” Asking directly can open the door to help.
- Be There: Listen without judgment and validate their feelings.
- Help Keep Them Safe: Reduce access to lethal means and ask about plans.
- Help Them Connect: Call or text 988, or connect with family, friends, faith leaders, or professionals.
- Follow Up: Stay in touch, as ongoing contact can reduce the risk of suicide.
A Shared Responsibility
For every life lost to suicide, thousands of mothers and birthing people silently struggle with suicidal thoughts or self-harm. With 82% of maternal deaths considered preventable, we all have the power—and responsibility—to help save lives.
If you are worried about someone, call 988 to connect with a trained counselor. If the person is in immediate danger—such as having a plan, access to lethal means, and intent to act soon—call 911 right away.
Paige Bellenbaum, LCSW, PMH-C, is licensed clinical social worker and national perinatal mental health expert. Her own lived experience with severe postpartum depression and anxiety paved the way for her commitment to ensuring other new and expecting mothers and birthing people don’t have to struggle silently as she did. She was the original founding director and Chief External Relations Officer of The Motherhood Center of New York for almost a decade and currently serves the organization as the Education and Government Relations Consultant. She works closely with New York City and State government agencies – including the Administration for Children’s Services and the Department of Health and Mental Health – in a quality improvement capacity, identifying and overseeing the implementation of evidence-based perinatal mental health initiatives.
With over two decades of experience in public policy, advocacy and clinical practice, Paige played a key role in the passage of New York State legislation mandating PMAD education and screening in birthing hospitals.
Paige is an adjunct professor at the Silberman School of Social Work at Hunter College and a frequent public speaker and media contributor. She has appeared on the Today Show and Good Morning America, and in the New York Times, The Wall Street Journal, and The Atlantic.
To contact Paige, please email [email protected].
