Suicide is the leading cause of maternal death during the first year postpartum

When a woman dies during pregnancy or postpartum, we immediately think of hemorrhages, infections, thrombosis, or obstetric complications. But the records from countries with better surveillance systems have made an still uncomfortable cause of maternal death visible: suicide.The MBRRACE-UK report, an international reference in the analysis of maternal mortality in the United Kingdom, is conclusive: between six weeks and one year after pregnancy, suicide is the leading cause of maternal death. If we add deaths related to substance use, the scientific message is clear: mental health, addiction, and social vulnerability are today central determinants of survival for many mothers.In Spain, a pioneering study has published data on this reality for the first time: between 2016 and 2023, thirty women were identified who died by suicide during the first postpartum year, after a birth oran advanced gestational loss. The majority of these deaths occurred beyond the first 42 days. The quarantine is an administrative convention; a postpartum depression, a puerperal psychosis, a situation of gender-based violence, poverty, substance abuse, or lack of support do not disappear because a month and a half has passed since the birth.

There is also a reality that shakes the conscience. These deaths accumulate disproportionately in women living in situations of trauma, poverty, violence, insecure housing, little support network, and a difficult relationship with services. British data show that a significant proportion of women who died by suicide had experienced the removal of a child or were immersed in child protection processes. Protecting children is an unavoidable duty of the state, but doing so should not mean abandoning the mother. When a woman loses the care of her baby, intensive and coordinated support should be urgently activated.

For too long, women's mental health has oscillated between two equally problematic extremes: either it has been pathologized, turning social or relational problems into individual diagnoses; or it has been abandoned by a medicine that has not considered it its own. And, when attention has been paid to it, it has often been done through sexual and reproductive health services, as if women's mental health began and ended in their reproductive bodies. This fragmented view has consequences, serious mental disorders do not always find a sufficiently rapid and expert response.Maternal suicide is a family tragedy, but it is also a scientific and political indicator of the cracks in the system.