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!)
Katherine, I have been following your blog for a few months. I was officially diagnosed with PPA on New Years Eve (so 2.5 months ago). THANK YOU for all you are doing to get the word out. I am working on my story, and will be sending it to you. I am also working on creating a support group here in Maryland where I live (I will be reaching out to PSI for this). Am also part of a great support group on FaceBook for PPA support. This is an issue that deserves for attention, and needs more attention. The news yesterday about the mother in New York makes me so sad. I believe this is a bigger problem than is reported/admitted. Thank you again for all you are doing to spread the word, and I look forward to joining the crusade and helping to spread the word.
Shock is definitely not quite the word I would use. Maybe something more like “Well duh” or “Totally saw that coming” or “Um… yeah… this is news how?”, but I am admittedly snarky today…
I just read the NYT article. Thank you for linking it above. How sad for everyone who knows this mom but esp. her husband and son! His life has been saved and forever altered by a mom he will never know.
My thoughts and prayers go out to this family in the NYT article.
I wish everyone surrounding a new mom: healthcare providers, family, friends, spiritual leaders, esp. husbands/partners was knowledgeable about postpartum disorders and that they were able to take the signs seriously. 1) Avoiding answering the phone or the door? 2) Obsessing over perceived harm to her child that she felt 100% responsible for?
I look forward to hearing a story like this with a happy ending. I look forward to hearing that anyone who knows #’s 1 and 2 from above about a mom does NOT leave her alone but puts aside anything else going on in their life to get her the healthcare and safety she and her family needs.
I know from my own story and talking to others that more moms than anyone imagines at some time have the same decision process that Ms. Wachenheim did but fail to act on their thoughts. I wish something could have pulled her back from her decision also.
Thank you for what you do Katherine. I do think it is in reading and hearing personal stories that the public will become aware enough to take appropriate action. And that that awareness will prompt research and the keeping of statistics on postpartum mood disorders.
Thank you for everything this blog is and does. It saves lives.Every. Single.Day.
I’m happy to see the studies inching higher in terms of the % of women who have PPD because like you, I totally agree that it’s likely much higher than reported/understood. I just wonder how much can be done about finding out the REAL number. Nobody wants to admit it and in my experience, every attempt I’ve made to suggest to someone that they might be struggling with this causes rapid backpedalling, “What?!?! No I’m fine FINE! I was just blowing off a little steam, venting what have you. Probably made it sound worse than it is. We’re great – GREAT over here!” I imagine that same level of denial is going to keep the numbers low/under-reported in studies too.
Hi Katherine. Sadly, we had a mother who died a couple of months ago in Orlando. I was not involved with this mom but so wish that I had been and that those involved understood and were knowledgeable about PDD. This is not the first death in the Orlando area since I moved here 2 years ago. There have been a several newsworthy PDD related deaths. Orlando has one of the largest birth centers in the US and very little support for moms. I began practicing in perinatal mental health because my sister had PDD with her 2nd child. I was a seasoned therapist and didn’t know how to help her. I know I am not the only therapist out there that didn’t know about perinatal mental health. So thankfully we were able to find help and I learned how to help other moms through her experience. She is my passion for helping moms! I am trying to educate and break the stigma. So many women I come into contact say “I had that but didn’t know!” You can tell our community does not understand. So despite being so family friendly here, with theme parks etc, there are very limited resources. Sad and scary! I am thankful to be able to refer clients to your site and blog. I use you as my go to! I post your blog on FB, RT, provide to moms, during presentations, give your link to other professionals in the community and hospital based services. I continue to work to increase understanding in hopes of helping moms and preventing unnecessary loss. Thank you for being a valuable resource. I agree this is a big hairy deal!