In a recent Science Daily report, 'Homicide, suicide outpace traditional causes of death in pregnant, postpartum women', caught my attention. Outpace traditional causes of death in pregnancy and postpartum? What about all of our concern regarding mortality rates as a result of C-section? I bought the study.

According to Palladino, C. L., Singh, V., Campbell, J., Flynn, H., & Gold, K. J. (2011), in the November issue of Obstetrics & Gynecology:

In total, we identified 233 pregnancy-associated violent deaths, yielding an overall pregnancy-associated violent death mortality rate of 4.9 per 100,000 live births; 64.8% of the pregnancy-associated violent deaths in our sample (n = 151) occurred during pregnancy (compared with the first year postpartum). The overall pregnancy-associated violent death rate was fairly stable of the study time period, ranging from 4.3 to 5.4. In addition the rates of pregnancy-associated homicide and suicide were each higher than mortality rates attributable to common obstetric causes. (Palladino, et al., 2011, p. 1059)

Mortality Rates Higher than OB Complications

The rate of death for pregnant women due to homicide, or suicide is higher than hemorrhage, eclampsia/pre-eclampsia, and amniotic fluid embolism.

Suicide:

• 45.7 percent of suicides occurred during pregnancy
• 51% of suicides occurred during postpartum
• Victims were significantly more likely to be Caucasian, or Native American, and unmarried
• Women ages 40 and over represented 17.0% of suicides
• Suicide rates between states did not differ
• 54.3 percent of suicides involved intimate partner conflict contributing to suicide

Homicide:

• 77% of homicides occurred in pregnancy (not postpartum)
• 45.3% of homicides were associated with intimate partner violence
• 53.9% of victims were under 24 years of age
• 44.6% of victims were African American
• Homicide rates did not differ between states

These findings suggest that effective prevention methods aimed at perinatal psychosocial health are imperative. Unlike some obstetric complications, violence is potentially preventable.

With continued focus on maternal violent death and a continued push toward the development of effective psychosocial interventions... we may be able to reduce the effect of this unfortunate killer on American women, their children, and their families. (Palladino, et al., 2011, p. 1062)

As birth advocates, intimately involved with the health and well-being of pregnant and postpartum women, what do we do? What is our part in addressing this unfortunate killer of American women?

Posted by: Walker Karraa, MFA, MA, CD(DONA)

References

1. Palladino, C. L., Singh, V., Campbell, J., Flynn, H., & Gold, K. J. (2011). Homicide and suicide during the perinatal period: Findings from the National Violent Death Reporting System. Obstetrics & Gynecology, 118(5). 1056-1063. doi: 10.1097/AOG.0b013e31823294da
2. Berg, C., Callaghan, W. M., Syverson, C., & Henderson, Z. (2010). Pregnancy-related mortality in the United States, 1998 to 2005. Obstetrics and Gynecology,116:1302-9.
3. Homicide, suicide outpace traditional causes of death in pregnant, postpartum women. ScienceDaily. Retrieved October 21, 2011, from http://bit.ly/qCN06m

Published: October 28, 2011

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