Opinion: In the conversation about pregnancy-related deaths, don’t forget to talk about suicide

Northwestern Now: Summaries

The pregnancy-related death rate in the United States has steadily increased in the past three decades. Shutterstock

When Alexis Joy D’Achille went to a physician to talk about depression after and during her pregnancy, the doctor evaluated her and remarked to her husband that “she is too pretty to kill herself.”
Soon after—and six weeks after giving birth to a daughter—Alexis took her own life in 2013. It’s a story that her husband, Steven D’Achille, told during his keynote address at November’s annual conference of the Perinatal Mental Health Society—and a story that underscores just how much work health-care providers need to do to understand postpartum depression and suicide. After all, you can’t tell how depressed someone is by looking any more than you can check blood pressure by sight.
The pregnancy-related death rate in the United States has steadily increased in the past three decades. And a survey of 2003-2007 statistics from the National Violent Death Reporting System found 94 cases of pregnancy-associated suicide, with most deaths occurring in the first year after birth. But even as there is growing awareness of maternal mortality in the United States, there’s little discussion about these fatalities.
I’ve cared for pregnant women with depression and other mental health conditions across the decades as a professor of psychiatry at Northwestern University. It’s agonizing to witness the impact of these preventable deaths on families and communities.

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Biology and a culture that does not adequately support mothering play a role in postpartum depression and suicide. After giving birth, the mother’s hormone concentrations plunge within a matter of days. This massive drop, initiation of breastfeeding, and the often-challenging adjustment to parenting contribute to the …

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