Giving birth can bring such profound physical, mental and emotional changes that a woman may have no idea how well, or not, she is coping six weeks later. Yet, this is when she is routinely discharged from maternal healthcare by a GP.
Between 10 and 15 per cent of women experience some level of postnatal depression, which may not develop until long after six weeks. Suicide, which is at the extreme end of mental health risks associated with early motherhood, is the leading cause of “late” maternal deaths (ie between 42 days and one year after the end of pregnancy) in Ireland. The numbers are very small, but each one is a tragedy with far-reaching consequences.
Of the 19 late maternal deaths reported to the Maternal Death Enquiry Ireland from 2020-2022, eight were by suicide, making up the majority of the 10 fatalities attributed directly to having been pregnant; the other two direct deaths were due to pulmonary embolism – a blood clot in an artery to the lung. (Of the remaining nine deaths, five were linked to various indirect causes and another four considered coincidental.) The latest triennial figures represent a statistically significant increase on those for the previous decade.
It is nearly 10 years since the National Maternity Strategy identified poor-quality and inconsistent postnatal care, support and advice as one of the weaknesses of the Irish maternity system. Measures introduced since have included expansion of perinatal mental health services within maternity units, and the opening of five community postnatal hubs, with eight more planned.
However, the strategy’s recommendation that the next review of the Maternity and Infant Care Scheme should look at providing an extra GP check-up for mothers at between three and four months, to address any ongo...
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