The Unpleasant Topic of Maternal Suicide
No one wants to talk about maternal suicide, but we need to. The idea of mothers, the creators of life, dying by suicide is a concept that is confusing and unpleasant. It’s like the untying of the ultimate primal engagement of birth and dragging it back into the darkness of nonexistence. Why would anyone want to talk about that? It’s not a great topic for dinner conversation.
The National Institute of Health (NIH) reports that “death by suicide is a leading cause of maternal mortality and accounts for about 20% of postpartum deaths.” This is why we should talk about it. Because mothers are dying by suicide, and we need to look out for each other. We need to know how to talk about it, what to watch out for, and how to ask for help. According to the NIH, “Maternal deaths are an indicator of the overall public health of a country.” We are the canaries in the coal mine, and it’s getting hard to breathe.
How do we talk about it? First, we acknowledge it.
The Policy Center for Maternal Mental Health reports that “It is estimated that up to 20% of maternal deaths are due to suicide, making maternal suicide deaths more common than deaths caused by postpartum hemorrhage or hypertensive disorders.” Burying our heads in the sand and pretending it isn’t happening isn’t helpful. Distracting ourselves because we don’t want to think about it isn’t helpful. Being unprepared to have an open, honest, and vulnerable conversation with a mother in your life who needs support isn’t helpful.
However, being willing to have hard conversations can help normalize a struggling mother’s experience, creating a judgment-free space where women can openly discuss challenges. This is helpful. Reach out and check on each other. Motherhood can be incredibly isolating, and we are just trying to survive in a society that tells us we should be perfectly fine, and motherhood is the best thing that could ever happen to us.
Now that we’re talking about it, what do we need to watch out for?
We need to watch out for moms who are quietly asking for help. We must check on the moms we haven’t seen in a few days. We can make eye contact with the mom at the grocery store with the screaming toddler in the shopping cart and the crying baby on her hip and ask her if she needs help. Maybe we can reach that box of cereal for her. Perhaps we can tell her she’s doing a great job and that we also just heard about this new Mother’s Day out program in town with great reviews. Maybe we can tell her we understand how hard it is, and then maybe she won’t feel alone. Perhaps we can let her know that there is help available.
The NIH reports that “The postpartum period appears to be a higher risk period than pregnancy for suicide as two-thirds to three-quarters of all maternal deaths by suicide occur between 6 weeks and one year postpartum.” The first year of the postpartum period is when most maternal suicides occur. While maternal suicides are not limited to that first postpartum year, heightened awareness during this time is wise.
There are additional risk factors that can come into play as well. The NIH further reports that “Risk factors for perinatal suicide and suicidal behavior are similar to risk factors in the general population. In the general population, risk factors include younger age, limited education, being unmarried, history of childhood abuse, intimate partner violence, and psychiatric comorbidity. In perinatal populations, younger age, being unmarried, and marital dissatisfaction are risk factors, while social support and cohabitation with a partner are associated with reduced odds of suicidality.” Being a mother is hard. It can be even harder when there are some pre-existing challenges.
How do we ask for help? Or know when help is needed?
Open and vulnerable communication is the doorway to understanding. Check on the moms in your life and ask the hard questions. Are they sleeping? Are they eating? Is the baby sleeping? How often do they worry? How do they feel about the baby? And then just listen. Just hold space for whatever feelings are shared with you. Let that mother know that she is not alone. Hold her, so that she can hold her baby. We all do better with community, and we cannot care for a child without caring for its mother first.
How do you ask for help if you are a mom? Scream it from the rooftops. But if you can’t do that, tell someone. Tell anyone. Tell your child’s pediatrician. Tell your OB or lactation consultant. Tell a friend or family member. If you are worried that you feel differently than you thought you would or are having intrusive thoughts that are causing you great anxiety, please tell someone. If you are worried that you don’t love your baby or that you’re not attaching the way you thought you would, you are not alone. There are other mothers who experience the same feelings, and there is help available.
Therapy can be a valuable tool for a variety of life stages, particularly the perinatal period. Mamaya Health was conceived for exactly this purpose: to create a lifeline for mothers in need of mental health services. Because moms matter, too. To learn more about Mamaya Health, please see our website at www.mamayahealth.com for resources, meet our team of specially trained therapists, and learn how to schedule an appointment.