Homicide and suicide during the perinatal period: findings from the national violent death reporting system

It is research worthy of the obstetric community's (and society's) attention, indicating that the U.S. maternal mortality rate from suicide is greater than that from preeclampsia. Given the prevalence of depression in pregnancy and postpartum, we were perplexed by the American College of Obstetricians and Gynecologists Committee Opinion conclusion that there is “insufficient evidence” to support universal depression screening during pregnancy or postpartum. Certainly, performing a randomized trial to determine screenings' effect on the end result of suicide is problematic. Therefore, given increasing time constraints in rendering prenatal care, the potential for suicide prevention with appropriate depression screening and intervention, and the marked prevalence of suicide (and homicide) as a cause of maternal mortality, it seems reasonable to call for universal prenatal and postnatal depression screening, despite the “lack of evidence.” A simple screen is time-efficient and can be accomplished without significant financial burden to the health care system. We would be most interested in the author's opinion regarding the role of universal depression screening in pregnancy and postpartum and how the obstetric provider can best identify patients for whom interventions might lead to a reduction in suicide and intimate partner violence. Language: en