by Leah Harris

Overdose, Suicide among Top Causes of Death for California Mothers: Could Peer Support, Trauma-Informed Care, and Advocacy Help?

A new study in the American Journal of Obstetrics and Gynecology made a troubling discovery regarding the top causes of maternal death in California. While the maternal death rate in America is rising, the rate in California is below the national average. However, “deaths of despair,” deaths by suicide or overdose, remain a particular cause for concern.

For the new report, scientists from Michigan State University and the University of California, Merced investigated more than 1 million California hospital records from 2010 to 2012 to discover the leading causes of postpartum death. The researchers found that drug overdose was the second most common cause of death among California mothers within the first year after giving birth, and suicide ranked seventh. The two causes made up nearly 20 percent of all California postpartum deaths over the time period studied. 

The study also found that nearly three quarters of the women who died by suicide or overdose between 2010-2012 had visited an emergency department or hospital between their delivery and death. Women living in towns with fewer than 50,000 people, as well as women living in poverty, were among the most heavily impacted.

While the findings of this study are dire, peer support may offer a potential life raft for mothers in distress. A randomized control trial (RCT) study matched trained peer volunteers by telephone with over 700 new mothers in Scotland. The study found that “the majority of mothers perceived their peer volunteer experience positively, lending further support to telephone-based peer support as a preventative strategy for postpartum depression.”

New motherhood may also have the potential to activate traumatic memories for some women who are survivors of childhood trauma and abuse. Or it may exacerbate the effects of intimate partner violence in a relationship. Given the undeniable links between trauma, drug use, and suicide, trauma-informed peer support workers could also provide new mothers with non-disclosure based trauma education, referrals to trauma-specific resources in the community, when available, as well as resources for survivors of intimate partner violence. 

The findings of this study also suggest the need for greater attention to the role of gendered norms and expectations in maternal deaths of despair. In a paper entitled “Speaking of suicide as a gendered problematic: Suicide attempts and recovery within women’s narratives of depression,” authors Simone Fullagar and Wendy O’Brian use qualitative research to explore how societal pressure to simultaneously fulfill a variety of roles, such as partner, caregiver, worker, and “good mother,” can contribute to a sense of failure, depression, and fuel suicide attempts in women. 

More research is needed, but gender-sensitive peer support could help women to make sense of their feelings of “failure” in a larger context, to release shame and self-blame, and to find community and connection with others who share similar life challenges.

Further advocacy is also needed to alleviate the stressful social and financial conditions facing moms and families, in areas such as paid family leave, policies like removing tax on diapers and early parenthood tax credit, as well as access to quality postpartum services and supports.

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