By Joy Burkhard, MBA

Background on General National Suicide Rates

Suicide is an urgent, complex public health crisis. More than 48,000 people died by suicide in the United States in 2018 (making it the 10th leading cause of death). Even more striking is that this rate has increased by one-third over the past 2 decades. Given the COVID pandemic and racial unrest, these rates are expected to rise first, before they come down.

Maternal suicide is specifically tracked through the Centers for Disease Control (CDC), through the agency’s Maternal Mortality review efforts. Here is some background about those efforts overall:

National Maternal Mortality Data - It’s Limited But Growing

CDC initiated the Pregnancy Mortality Surveillance System (PMSS) to track pregnancy-related mortality in 1986. As we reported in January of this year, the CDC for the first time since 2007, released through its Vital Signs report, data on maternal deaths using states’ enhanced death certificate coding.

As a part of a wider effort to enhance the collection of vital statistics data (data from birth and death certificates), it was suggested to states that a pregnancy checkbox be added to death certificates in 2003 in an effort to better capture pregnancy-related deaths. The checkbox was ultimately adopted and a maternal mortality rate is now reported nationally. However, the data is not perfect. Pilot validation efforts showed that the checkbox was incorrectly assigned 30% of the time.

Suicide is still not being reported through the CDC Vital Signs Report.

Prior to 2020, the CDC reported only data from those states who created maternal mortality review committees (now tracked through the CDC’s ERASE Maternal Mortality initiative, which due to the Preventing Maternal Deaths Act funded 24 states).

What Data Do We Have Regarding Maternal Suicide?
Data from 14 Maternal Mortality Review Committees

Because of the challenges with tracking pregnancy-related deaths using vital statistics alone, CDC is working with state and local Maternal Mortality Review Committees (MMRCs) to strengthen and standardize their efforts on case identification and review.

Review committees have access to multiple sources of information that provide a deeper understanding of the circumstances surrounding each death in order to develop actionable recommendations to prevent future deaths.

In 2019, CDC made 24 awards supporting 25 states, for the Enhancing Reviews and Surveillance to Eliminate Maternal Mortality (ERASE MM) Program. In 2019 the CDC reported data from the then 14 states with MMRCs.

The report showed mental health conditions as the 6th of 7 leading causes of maternal mortality.

Mental health-related deaths included deaths due to suicide, overdose/poisoning, and unintentional deaths determined by the MMRC to be related to a mental health condition.

Is Data Available by Race?

Though overall rates of maternal mortality were reported by race (with black mothers suffering the highest rates, followed by white and then Hispanic women), rates of maternal suicide were not reported by race.

Next Steps:

Further work remains to establish sustainable, fully functional review committees in every state. But, increasingly, states with established review committees are using the CDC’s standardized data system, which can bring together data across jurisdictions, improving the data not only at the state level but also throughout the country.

2020 Mom is continuing to monitor data related to maternal suicide tracking and will share new reports as they become available. We will also continue to advocate for reporting maternal suicide rates through death certificate tracking in the CDC Vital signs report.

We urge advocates in the states in the lightest shade of purple/grey below, to join Mom Congress to learn how to advocate for maternal mortality committees to be formed.