Maternal deaths increasingly linked to suicide

Maternal deaths increasingly linked to suicide

Although the mortality rate among new mothers in France varies little, the reasons are changing: the number of complications associated with childbirth is falling. On the other hand, postpartum depression is a big deal.

Although rare, “maternal mortality” still exists in France, and suicide has become the leading cause, according to a study published Wednesday by Inserm and Public Health France. Every year, about 90 women die from causes related to pregnancy or childbirth, on average once every four days, according to the 7th edition of this work, supported by the observation of gynecologists-obstetricians, anesthesiologists-resuscitators, wise women and epidemiologists.

Between 2016 and 2018, 272 maternal deaths were reported between conception and one year after the end of pregnancy. The maternal mortality ratio (11.8 deaths per 100,000 live births), which is within the European average, is unchanged from previous studies.

But this time, suicide, along with other psychiatric causes, is becoming the leading cause of maternal mortality (17%), ahead of cardiovascular disease (14%), in particular high blood pressure. “This was the second reason, it becomes the first: this is not a radical change in trend, but an increased confirmation of the weight of suicide”explains Catherine-Denet Taro, Research Director at Inserm.

In just 42 days after the end of pregnancy (the reference period for international comparisons), 197 deaths occurred between 2016 and 2018, mainly caused by cardiovascular diseases. “The two leading causes of maternal mortality—suicide and cardiovascular disease—are non-obstetric, and their absolute levels are increasing slightly,” notes a specialist in perinatal epidemiology, inviting “look at the health of women around the world.”

Childbirth complications are reduced

For about ten years, obstetric hemorrhages are no longer prevalent, “good news”, she says. Having halved over 15 years, mortality due to excessive bleeding during childbirth or in the next 24 hours now remains at the high end of the range in European countries.

As for the period after 2018, it has not yet been studied. “Maternal mortality will increase due to the Covid pandemic, in particular because pregnant women were at greater risk of severe forms.”according to Catherine-Denot Tarot.

Strong territorial and socio-demographic inequalities associated with the risk of maternal mortality remain. Thus, in foreign countries the figure is twice as high as in mainland France, but previously the gap was even greater. Among migrant women, the mortality rate is on average twice as high as among native French women. And among maternal deaths, socially vulnerable women are 1.5 times more represented. Age also increases the risk, “noticeably” after age 35. And obesity: obese women have twice the maternal mortality rate.


“Improvement is possible because more than half of maternal deaths are considered probable or preventable, and in two thirds of cases the care provided was not optimal.”, the study emphasizes. Prevention, screening, coordinated and multidisciplinary care are still recommended, broken down into 30 key ideas. To prevent suicides,Professionals should be aware of personal and family risk factors for perinatal depression (…) and monitor them throughout pregnancy and postpartum care. experts emphasize.

In addition to engaging all caregivers to identify symptoms of mental health disorders in the year after birth, they recommend educating pregnant women, those around them, and the general public about perinatal depression. Added to this is postpartum depression, the researcher emphasizes, noting that “Women still feel a lot of guilt about being sad, not enjoying their child, feeling like they are not a good mother, but they rarely express it in words.”

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