Suicide risk in mothers extends into later postpartum years

By Rebecca Jenkins

Mothers remain at risk of death by suicide well beyond the first year postpartum, Australian research finds.

Writing in the BJOG, researchers said the early period after birth was known to be a high-risk period for suicidal behaviour for mothers, as they were more likely to experience mental health conditions. However, little was known about the risk in later postpartum years, prompting them to analyse the incidence of maternal deaths by suicide, accidental poisoning and undetermined intent within five years of childbirth.

Using linked population-level data from all women who gave birth in NSW from 2002 to 2020, the researchers found these causes accounted for more than one in every five maternal deaths in the five-year postpartum period.

Overall, there were 161 deaths due to suicide, 126 deaths due to accidental poisoning and 27 deaths due to underdetermined intent within five years postpartum.

Affected women were more likely to be younger, be born in Australia and identify as having a First Nations background compared with mothers who were alive five years postpartum. They were also more likely to be first-time mothers, live in remote areas and be in the two most socioeconomically disadvantaged population quintiles.

Nearly two-thirds of affected mothers had not accessed ambulatory care mental health services, the data showed. However, there were differences in risk factors leading to cause-specific deaths.

For example, when compared with accidental poisoning deaths, mothers who died by suicide were more likely to be first-time mothers and have presented to mental health services 12 months before they died.

‘Recognition of at-risk mothers and providing support beyond one year postpartum is imperative to reduce preventable maternal death,’ the researchers concluded.

‘Extending the period for screening and surveillance beyond one year by integrating obstetrics and primary care services ensures continuity of care and timely monitoring for mothers at risk of suicidal behaviour should be a priority,’ they wrote.

First author Dr Louise Makarious, Obstetrics and Gynaecology Registrar at Westmead Hospital, Sydney, said guidelines, policy and research efforts were largely focused on reducing maternal mortality from obstetric and medical causes.

‘There is far less teaching and infrastructure for clinicians to support women’s mental health, particularly beyond the immediate postnatal period, where many mums are navigating major life changes, social isolation and rising anxiety,’ she told Medicine Today.

Dr Makarious said the study showed a substantial proportion of maternal deaths were from the analysed causes, which have likely been under-recognised.

‘The findings highlight a critical gap in how we support women beyond the first year postpartum, particularly in addressing preventable, mental health-related deaths,’ she said. 

BJOG 2026; 0: 1-11. https://doi.org/10.1111/1471-0528.70212.