Menu

California Pregnancy-Associated Mortality Review (CA-PAMR): Pregnancy-Associated Suicide from 2002 to 2012

  • Christy McCain, MPH
  • Amina Foda; Paula Krakowiak; Dan Sun; Diana Ramos; David Reynen; Christine Morton; Elliott Main; Delphina Alvarez; Sue Holtby
image: woman with hand on her head

Released by the California Department of Public Health’s Maternal, Child and Adolescent Health Division, the California Maternal Quality Care Collaborative (CMQCC) and the Public Health Institute (PHI), California Pregnancy-Associated Mortality Review (CA-PAMR): Pregnancy-Associated Suicide from 2002 to 2012 offers an in-depth review of maternal deaths offers key insights to improve care and reduce preventable maternal suicide.

Read the full report or download the executive summary below, or scroll down to watch a video overview. 

Suicide during pregnancy or within a year after pregnancy is a tragic event that has a profound impact on the children and families left behind. Maternal suicide, while rare, is a sentinel event that serves as a call to action for public health professionals and maternity care clinicians. Between 2002 and 2012, suicide accounted for 4.3% of all deaths among California women who were pregnant within the prior year.

In-depth reviews of suicide among women while pregnant or within a year after pregnancy ended revealed that suicide preventability is high, regardless of maternal mental health history.

Key findings from the report include:

  • 51% of suicide cases had a good to strong chance of preventability with missed opportunities to intervene.
  • The majority of women (83%) died in the late postpartum period, 43-365 days following the end of pregnancy: 36% died between 43 days and 6 months and 47% died more than 6 months postpartum.
  • Mental health conditions were highly prevalent: 62% of women had reported mental health conditions before becoming pregnant and 25% had new onset conditions noted during or after pregnancy. Nearly a quarter of women (23%) had a reported family history of mental health conditions.
  • Depression (54%), psychosis (24%), and bipolar disorder (17%) were the most prevalent conditions identified. Substance use, including alcohol and tobacco, was a common co-occurring condition with all mental health disorders.
  • Nearly one-third (32%) of women used illicit drugs (i.e. methamphetamine, cocaine, heroin) or abused prescription opioids during or after pregnancy; heavy alcohol use was noted in 17% of women. Substance abuse was identified as a precipitating factor to the suicide in 29% of women.
  • Approximately 85% of women had one or more psychosocial stressors documented (e.g., interpersonal conflict with partner, financial hardship, exposure to violence as a child or adult).

Read the full report.

 

Download


Work With Us

You change the world. We do the rest. Explore fiscal sponsorship at PHI.

Bring Your Work to PHI

Support Us

Together, we can accelerate our response to public health’s most critical issues.

Donate

Find Employment

Begin your career at the Public Health Institute.

See Jobs

Mural and kids' paintings hanging on a fence at a playground

Close

New Public Health Primer: Engaging Community Development for Health Equity

How can the public health and community development sectors to work together to advance health and racial equity? A new primer from PHI’s Build Healthy Places Network and partners provides a roadmap for forging upstream partnerships, with recommendations, strategies and lessons-learned from national, state and local leaders.

Explore the primer

Continue to PHI.org