Suicide becomes the leading cause of death linked to pregnancy or childbirth in France, according to a study

Suicide becomes the leading cause of death linked to pregnancy or childbirth in France, according to a study

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Although they are rare, “maternal deaths” still exist in France, and suicide has become the leading cause, according to a study published Wednesday by Inserm and Public Health France, not including the period of the Covid pandemic.

Around 90 women die annually from a cause linked to pregnancy or childbirth, one every four days on average, according to the 7th edition of this work supported by monitoring by gynecologists-obstetricians, anesthetists-resuscitators, wise men. -women and epidemiologists.

“Increased confirmation of the weight of suicides”

Between 2016 and 2018, 272 maternal deaths were recorded, over the period between conception and one year after the end of the pregnancy. In the European average, the maternal mortality ratio (11.8 deaths per 100,000 live births) has not changed compared to previous surveys. But, this time, suicide – with other psychiatric causes – emerges as the leading cause of maternal mortality (17%), ahead of cardiovascular illnesses (14%).

“It was the second cause, it becomes the first: it is not a radical change in trend but an increased confirmation of the weight of suicides,” Catherine-Deneux Tharaux, research director at the Inserm.

In the 42 days after the end of pregnancy alone (reference period for international comparisons), 197 deaths occurred between 2016 and 2018, caused primarily by cardiovascular diseases.

Migrant and socially vulnerable women on the front lines

“The two leading causes of maternal deaths, suicides and cardiovascular diseases, are extra-obstetrical, and their absolute levels are increasing a little,” notes the specialist in perinatal epidemiology, inviting us to “consider women’s health globally”.

For around ten years, obstetric hemorrhages are no longer predominant, “good news”, she says. Reduced by half in 15 years, mortality due to excessive bleeding during childbirth or in the following 24 hours is now stagnating at the top of the range in European countries.

Beyond 2018, “maternal mortality will increase because of the Covid pandemic, in particular because pregnant women were more at risk of serious forms”, according to Catherine-Deneux Tharaux. For these deaths, strong territorial and socio-demographic inequalities persist. The risk is thus doubled in Overseas France, compared to mainland France – the gap was higher previously.

For migrant women, mortality is on average twice that of native French women. And socially vulnerable women are 1.5 times more represented among maternal deaths. Age also increases the risk, “markedly” after 35 years. Obesity too, with twice as many maternal deaths among obese women.

Raising awareness among the general public and involving caregivers

“Improvement is possible, because more than half of maternal deaths are considered probably or possibly preventable, and, in two thirds of cases, the care provided was not optimal,” underlines the study.

To avoid suicides, “the personal and family risk factors for perinatal depression must be known to professionals (…) and sought throughout pregnancy and postpartum monitoring,” emphasize the experts. In addition to the involvement of all caregivers to detect symptoms of mental disorders up to the year following childbirth, they recommend informing pregnant women, those around them and the general public about perinatal depression.

Worldwide, a woman dies every two minutes from complications related to pregnancy or childbirth (up to 42 days later), according to estimates by 2023 from United Nations agencies.

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