Where does suicide rank in terms of maternal mortality? How prevalent is postpartum depression, really?

The media always said 1 in 10 moms got postpartum depression. Then in the last couple of years we convinced them to switch to 1 in 8. Now, a new study published in JAMA Psychiatry says 1 of every 7 mothers will get PPD, or 14% of all new moms.

So much media coverage this week has called the 1 in 7 news “surprising.” I’m sure this makes all of you snicker, given that it’s not surprising AT ALL (yes, I’m yelling) to anyone who has spent any time either suffering from postpartum depression or working with moms who do.

I still think it’s closer to 20%.  Australia, which found 1 in 5 moms gets PPD, agrees with me.

In the Science Daily article on this study, a particular sentence stood out to me: “Suicide accounts for about 20 percent of postpartum deaths and is the second most common cause of mortality in postpartum women.” The second most common cause of death in the postpartum period is suicide. Wow.

With so much attention given by the World Health Organization, other women’s health groups and the media, it has always bugged me that the focus has been primarily (and often, only) on postpartum hemorrhage. It’s not that hemorrhage isn’t an important topic, because certainly it is and it’s important to eradicate those preventable deaths. But if suicide is the second leading cause of mortality in the first year postpartum, that’s a huge deal. That’s something we need to fix. It cannot be ignored, and as hard as I looked, I was never able to find suicide mentioned in the World Health Organization’s maternal death materials, nor in the CDC’s maternal mortality material.  As I explained in a story I wrote last year, “I recently reached out to both the CDC and the National Institute of Mental Health to find out how many women die of suicide in the first year postpartum in the US, and where suicide ranks among the leading causes of maternal death here. And you know what? No one had any idea, because they haven’t tracked it.” Why??

I rushed to get a full copy of the new JAMA study so I could find out where its maternal mortality data came from.  As it turns out, it’s the same study everyone cites, from Lindahl in 2005. Thank God for Lindahl, but I hope we can get more research done on this topic, because women are still dying needlessly. A mother named Cynthia Wachenheim jumped to her death this week in New York, and it’s very possible her suicide was due to severe PPD or psychosis. We can’t let this keep happening.

I could kiss Dr. Katherine Wisner on the mouth for doing this new study, which is large and garnering lots of attention, and for what she has said about it in the media. Here’s her quote at Science Daily:

“In the U.S., the vast majority of postpartum women with depression are not identified or treated even though they are at higher risk for psychiatric disorders,” said Northwestern Medicine lead study author Katherine L. Wisner, M.D. “It’s a huge public health problem. A woman’s mental health has a profound effect on fetal development as well as her child’s physical and emotional development.”

Yes. YES. YESSSSSSSS!!!!!!!!!!!!!!!! Please take note, people of the world. This is a big, hairy deal. Postpartum depression is a huge freaking problem. Enormous. And yet there’s this small, ragtag band of wonderful people working their fingers to the bone on it with very little help from the business community, the healthcare community, foundations and others with money that could make a difference. We need help. We can fix this, but we need help.

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Other things you should read from this week:

NPR: Postpartum Depression Affects 1 in 7 Mothers

New York Times: Mother Called Her Final Act “Evil” (trigger warning)

Psychology Today: Too Many Mothers Are Dying (Amen Karen!)