by Louise Perry
Wednesday, 23
November 2022
Spotted
10:00

Suicide: the new leading cause of maternal mortality

A recent report highlights a grim trend
by Louise Perry
Credit: Getty

Early analysis had initially suggested that, contrary to widespread fears, the pandemic — and the lockdowns — did not lead to a rise in suicide in the UK in 2020. And, in general, that may have been true. But when it comes to perinatal suicide specifically, a new report indicates cause for concern. 

MBRRACE-UK, an organisation that monitors maternal and infant mortality, has recently released two reports that are attracting attention from health authorities.

The first is on infant mortality and contains good news: extended perinatal mortality has reduced by 20% from 2013 to 2020, equivalent to approximately 820 fewer infant deaths in 2020.

But the findings contained in the second report on maternal mortality are not good at all. The long-term data reveals a centuries-long drop in maternal mortality that ends in 2013, after which we see a levelling off, and then an enormous 24% uptick in 2018-2020. Lockdowns may have played a role, but this is an uptick that is not entirely accounted for by Covid-19 itself, which took the lives of nine pregnant or postpartum women between March and December 2020: excluding their deaths from the data still shows a 19% jump in maternal mortality from 2017-2019 to 2020. 

It’s worth pointing out that the same larger pattern has been observed in deprived parts of the UK, where life expectancy stopped increasing from about 2013 onwards, long before the pandemic struck. Once again, we have centuries of improvement, followed by a plateau, and then a decline. For the first time in living memory, life expectancy is going downwards among the poor. 

There are at least a couple of ways of explaining this development. It could be that grim trends in both life expectancy and maternal mortality are linked to the cuts to public services that were initiated by the Conservatives in 2010. It could also be that the so-called ‘lifestyle diseases’ are taking their toll, the result of the historically unprecedented availability of high-calorie processed foods. Both factors are likely to be playing some role here. 

But the rise in maternal mortality from 2018-20 is sharp enough to suggest that something else may be going on. 

There are two distinct groups of women which are at particular risk during the perinatal period (which includes pregnancy and the 12 months following birth). The first group contains women who are at risk of dying from physical health conditions, most often cardiovascular. These women are disproportionately likely to be poor, older, obese, black or South Asian, and to have suffered from at least one pre-existing health problem before they became pregnant. 

The second group shares only one risk factor with the first: poverty. Otherwise, they are quite different: young, disproportionately white British, often victims of domestic and child abuse, and frequently affected by substance abuse and severe mental illness. 

It is in this latter group that we mostly see the recent sharp rise in deaths, since they are at risk from what is now the leading cause of mortality among pregnant and postpartum women: suicide. In 2018-20, deaths from mental health-related causes as a whole (suicide and substance abuse) account for nearly 40% of deaths that occurred within a year of the end of pregnancy. 

Mercifully, we are dealing with relatively small numbers here, which means that marginal changes in the absolute figures can look like huge changes proportionally. Twenty-eight women died by suicide during 2020 in the UK and Ireland during pregnancy or up to one year after the end of pregnancy. But, as the MBRRACE-UK report details, this represents a significant increase on previous years: 

There has been a statistically significant increase in the rate of suicide during pregnancy and up to six weeks after pregnancy in the UK, comparing 2017-19 with 2020. 10 women died out of 2,173,810 women giving birth in 2017-19 (0.46 per 100,000) compared with 10 out of 674,377 in 2020 (1.48 per 100,000). 
- MBRRACE-UK

In other words, in 2020 women were over three times more likely to die by suicide during or up to six weeks after the end of pregnancy, compared to 2017-19. 

We can’t know for certain whether or not these deaths were linked to the pandemic. We do know that perinatal mental health service providers reported a huge rise in demand during 2020, and that they were limited in the amount of face-to-face and outreach care they could provide. 

This new report makes the raw numbers tragically clear: in 2020, suicide claimed the lives of more pregnant and postpartum women than did the Covid-19 virus itself. This is a crisis that demands our attention.

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Sue Sims
Sue Sims
7 days ago

What was the proportion of married women among those perinatal suicides?

Caroline Watson
Caroline Watson
3 days ago
Reply to  Sue Sims

I’ve no idea, but I know that if I had been trapped in marriage by a baby, I would have been suicidal. Fortunately I wasn’t, escaped thirty years ago and have never thought about the ridiculous concept since.

Warren Trees
Warren Trees
6 days ago

Are we to believe anything from any bureaucratic organization anymore? The entire globe seems corrupt and every organization/foundation/charity/university/government department that issues “information”/propaganda has a political bias. I don’t know what to believe anymore besides the Bible.

Last edited 6 days ago by Warren T
Allison Barrows
Allison Barrows
6 days ago
Reply to  Warren Trees

No, we are not. It’s common sense to always ask what’s the angle, and who’s paying for it.

Ethniciodo Rodenydo
Ethniciodo Rodenydo
7 days ago

“Mercifully, we are dealing with relatively small numbers here, which means that marginal changes in the absolute figures can look like huge changes proportionally”
Isn’t that the point. In the UK about 5,500 people each year commit suicide which is about 15 each day.
Apparently 150 people each year die as a result of falling coconuts

Tom Lewis
Tom Lewis
7 days ago

“Apparently 150 people each year die as a result of falling coconuts”
What, in the UK ?
Maybe we should all get together and start a petition against coconut shies at fairgrounds and summer fete’s.

Ethniciodo Rodenydo
Ethniciodo Rodenydo
6 days ago
Reply to  Tom Lewis

I should have said worldwide.
I was standing under a coconut tree with my son, sheltering from the rain, when I looked up to see a bunch of large green, heavy looking coconuts which caused m to ponder the question.
I expect that WHO will shortly demand action, presumably the pollarding of all coconut trees to below head height

Warren Trees
Warren Trees
6 days ago

Better yet, they will demand complex coconut catching devices to be installed on every coconut tree worldwide, replete with approved netting, spun from Scottish wool.

Jim R
Jim R
6 days ago
Reply to  Warren Trees

This is a public health catastrophe. We need an immediate lockdown so people cannot approach these deadly trees. Follow the model of the city of Toronto, where all cherry trees were fenced off in the Covid springs to prevent people from congregating around their (deadly) blossoms. And of course we need our benevolent pharmaceutical overlords to begin work on a new mandatory gene therapy to inoculate the population against the falling coconuts. Of course we know you can’t inoculate against such things, but that doesn’t mean you can’t cook up the numbers to make it seem to work, and censor all suggestions that they don’t work. We have the playbook for this people – time to get to work!

J. Brelner
J. Brelner
6 days ago

“10 out of 674,377 in 2020 (1.48 per 100,000).” TEN? TEN? Ten is not a crisis. How many men died by suicide in 2020? I’m sure it far more than ten. You don’t even mention male suicide. That no one is talking about male suicide – the IS a crisis.

Claire D
Claire D
6 days ago
Reply to  J. Brelner

With the caveat that 1 suicide is too many, I agree with you.
In 2020 – 2021* there were 4,129 male suicides (16.0 deaths per 100,000) and 1,454 female suicides (5.5 deaths per 100,000), therefore 10 out of 674,377 is relatively low.

*The figures are from the ONS, many 2020 suicides were not registered until 2021 due to the situation.

Paula Adams
Paula Adams
6 days ago

The real crisis is bankers controlling big pharma controlling governments controlling US!

Claire D
Claire D
7 days ago

This is very sad, but because of the circumstances during the pandemic it is possible that the “crisis” has already passed and the numbers may have reduced. We will have to wait and see at the same time as monitoring the situation carefully. I hope that is what is happening.
We certainly need more midwives and mental health nurses. If only some more women, who call themselves feminists, who claim to care about women, would step up to the line and get their hands dirty doing something practical to help them.

Last edited 6 days ago by Claire D
Daniel Lee
Daniel Lee
6 days ago

“… comparing 2017-19 with 2020. 10 women died out of 2,173,810 women giving birth in 2017-19 (0.46 per 100,000) compared with 10 out of 674,377 in 2020 (1.48 per 100,000)…”
You’re comparing either two or three years (2017-19) with one year (2020). Of course the number of deaths per 100K will appear to be higher in the one-year cohort than those spread out over the longer period.

Louise Perry
Louise Perry
6 days ago
Reply to  Daniel Lee

No because what is being compared is rates, not absolute figures

Ibn Sina
Ibn Sina
2 days ago
Reply to  Louise Perry

Absolutely. It’s a shame that people are so numerically illiterate and even proud of it. If more time were spent teaching simple arithmetic to our kids, a lot of conspiracy theories never would take hold. It would also give people like our politicians more confidence in understanding science and challenging their advisors.

Warren Trees
Warren Trees
6 days ago
Reply to  Daniel Lee

Details don’t matter. As long as someone clicked the bait and read.

Helen Moorhouse
Helen Moorhouse
6 days ago

I wonder how many of those women had terminated a previous pregnancy.

Caroline Watson
Caroline Watson
3 days ago

They should have terminated that one. Instead a child will grow up without a mother.