As we recognize National Suicide Prevention Week, it’s important to shine a light on an often-overlooked reality: Mental health deaths, which includes both suicide and unintentional overdoses, have been identified as the leading preventable cause of pregnancy-related death [1].
From the challenges of infertility, to the vulnerable postpartum period, to the hormonal shifts of perimenopause, mental health struggles can intensify throughout the reproductive lifespan in ways that are both deeply personal and profoundly connected to systemic gaps in care.
Maternal suicide rates have remained high, even as other causes of maternal death such as sepsis and hemorrhage, have declined. The perinatal period is a time of increased access to healthcare for many, which theoretically should offer increased opportunity to screen for and address the risk of suicide, and yet death by suicide still accounts for 20% of postpartum deaths [2]. Mothers who experienced perinatal depression had a three times greater risk of suicidal behavior when compaired to peers who did not experience perinatal depression, and this increased risk did not immediately resolve, it remained increased for decades [3]. One study found that most postpartum suicides occurred in the 9 to 12 month postpartum range, with the highest rates occurring in remote and rural areas [4].
Sadly, self-inflicted violence is not the only concern during the perinatal period. Homicide rates during the perinatal period are also alarming. In the US, more pregnant people die from homicide and suicide than any individual medical cause [5]. Research has also shown that Black birthing people between the ages of 18 to 24 experience death due to homicide at a rate of nearly four times the national average [5]. In 2020, perinatal women in the US experienced a 35% higher risk for homicide compared to non-pregnant/postpartum peers [6].
The weeks and months following birth are often painted as joyful, but research shows that the postpartum period carries a heightened risk of suicide. For some new parents, feelings of isolation, intrusive thoughts, or overwhelming despair can eclipse the expected “happiness” of welcoming a child. When left untreated, postpartum depression and anxiety can escalate to suicidal thoughts or actions. Recognizing these warning signs early, being vigilant for risk factors, and ensuring rapid access to compassionate mental health care can save lives.
For individuals and couples facing infertility, the emotional toll can be devastating. The longing to build a family is often accompanied by a sense of loss, extensive (and expensive!) medical interventions, financial strain, and a sense of stigma or failure. Studies show that people experiencing infertility are at increased risk for not only depression and anxiety, but also suicidal ideation [7]. These thoughts are rarely spoken about openly, yet they are more common than most realize. Support from mental health professionals, peer networks, and fertility-informed counselors is essential to validate and protect the well-being of those navigating this difficult journey.
Suicide risk does not fade after the reproductive years. During perimenopause—the years leading up to menopause—shifting hormones can trigger significant mood changes, sleep disruption, anxiety, and even the return of past trauma. Research shows that suicide rates among women often peak during midlife, a pattern linked not only to biological changes but also to social factors such as caregiving stress, relationship transitions, and cultural silence around menopause. Despite the complex psychosocial stressors of midlife, there is an established correlation between perimenopause and increased risk for suicidal thoughts [8]. Perimenopause is a critical time for screening, support, and normalizing conversations about mental health.
When we look at suicide risk across the reproductive lifespan, a clear message emerges: mental health is inseparable from reproductive health. Whether someone is struggling to conceive, adjusting to life after birth, or navigating midlife transitions, the need for comprehensive, stigma-free mental health care remains constant.
But there is hope. While research has identified dozens of risk factors for suicide, it has also unveiled countless protective factors, many of which we can capitalize on! Social support and connection to care are profoundly impactful, regardless of life stage.
Can hormone levels, such as estrogen and progesterone, cause mental health symptoms? Dr. Kristin Lasseter discusses this in an informative blog post.
Read Blog Post