Suicide prevention in expectant and new mothers

By Dr Nicole Highet, Founder and Executive Director of the Centre of Perinatal Excellence (COPE)

While many associate having a baby as a time of great happiness and joy, it’s also the time of life where a woman is most at risk of experiencing a mental illness or a relapse of a previous mental illness.

In Australia, perinatal depression and anxiety affects one in five mothers with suicide being a leading cause of maternal death.¹

The Centre of Perinatal Excellence (COPE) is a not-for-profit organisation devoted to reducing the impacts of emotional and mental health problems in the pre and postnatal periods.

In 2023, COPE released the latest revision of the Australian Perinatal Mental Health Guidelines, funded by the Commonwealth Government and approved by the National Health and Medical Research Council (NHMRC). The guidelines provide vital information to the broad range of health professionals delivering antenatal and postnatal care, to assist them in the identification, prevention and treatment of mental health conditions and mental illness.

The guidelines include detailed advice around assessing the safety of both mother and child, the management of suicide risk and the development of safety plans.

The guidelines emphasise the importance of routine universal screening for all expectant and new mothers to detect those at risk of and those experiencing mental health concerns.

The guidelines suggest women should be screened both early in pregnancy at again around 30 weeks. Mothers should be screened 6-12 weeks after having their baby and again at least once in the first year postpartum.

COPE has developed a range of tools to support training for health professionals to better identify signs of mental health concerns or suicidal thoughts and behaviours including basic training or mental health professional specific training, screening tools and psychoeducation including a national eCOPE directory
helping to link mothers and mental health staff to clinical and community services.

Advocacy

In March 2024, a Queensland coroner noted that a Logan mother, who took her own life in 2021, could still be alive if she had access to a specialist mother and baby unit (MBU). While the guidelines recommend that mothers and babies be treated together where it is safe to do so, the reality is that nationally there are not enough units, (particularly public units) and not enough beds.

COPE advocates for the provision of more publicly funded MBUs as a key aspect of suicide prevention strategy for mothers, particularly for women in regional Australia who may access difficulties in accessing appropriate mental health support services.