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Maternal, Child, and Adolescent Health Division

CA-PARC • Suicide PAMRPrevention of Pregnancy-Associated Suicide:Recommendations for Perinatal Providers & Facilities

The California Pregnancy-Associated Review Committee (CA-PARC) was established to review and report on California’s maternal deaths (HSC 123636 ). While California Department of Public Health (CDPH) provides administrative and scientific support to CA-PARC, recommendations for preventing maternal deaths are made solely by the members of CA-PARC.

Pregnancy-associated suicide is defined as suicide that occurred during pregnancy or within one year after pregnancy ended. In 2024, the federal government released bot​h the National Strategy for Suicide Prevention (PDF, 13.4 MB) and the National Strategy to Improve Maternal Mental Health Care . To support these efforts, CDPH is releasing comprehensive recommendations from CA-PARC's Pregnancy-Associated Suicide Review of deaths in 2002-2012, reviewed in 2016-2017.

CA-PARC recommendations for the prevention of pregnancy-associated suicide are relevant now because:

  • Suicide among individuals who were pregnant within the prior year has a lasting and far-reaching societal impact, so it is important to prioritize pregnancy-associated suicide prevention efforts.
  • CDC data from 1999-2022 indicate that suicide rates among women of reproductive age (15-49 years) increased from 5.0 to 7.4 deaths per 100,000 in the U.S. and from 4.7 to 5.2 deaths per 100,000 in California.
  • In California, the rate of pregnancy-associated suicide also increased from 2.3 deaths per 100,000 live births in 2009-2011 to 4.1 deaths per 100,000 live births in 2019-2021.

Key Findings:

Among the 99 pregnancy-associated suicide deaths that occurred in 2002-2012:

  • 98% of suicide deaths had at least some chance of being averted.

    Over half (51%) had a good-to-strong chance of prevention with opportunities to intervene and provide support. Nearly all suicide deaths (98%) had at least some chance of being averted.

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    83% died between six weeks and one year after pregnancy ended.

    The postpartum period is a time of heightened risk for suicide.* Most (83%) pregnancy-associated suicides happened six weeks to one year after pregnancy, reflecting the need for additional supports during this period.

    Timing of pregnancy-associated suicide

    Graph showing time frame when deaths occurred: Pregnant 9% 0-42 days after pregnancy 8% 43-180 days after pregnancy 36% 181-365 days after pregnancy 41%

    *Policy Center for Maternal Mental Health

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    87% had mental health conditions.

    Mental health conditions were highly prevalent (87%) – 62% had pre-existing mental health conditions and 25% developed mental health conditions in or after pregnancy.

    • Skip to main content 62% before becoming pregnant
    • Skip to main content 25% during or after pregnancy
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    65% had a stressful life event near the time of death.

    Nearly two-thirds (65%) had a stressful life event near the time of death (e.g., interpersonal conflict, loss of a loved one).


Substance use was identified as a precipitating factor to the suicide in 29% of individuals. Nearly one-third (32%) used illicit substances (e.g., methamphetamine, cocaine, heroin) or abused prescription opioids during or after pregnancy; heavy alcohol use was noted in 17% of individuals.

  • Skip to main content 29% substance use was a precipitating factor to the suicide
  • Skip to main content 32% used illicit substances or abused prescription opioids
  • Skip to main content 17% used alcohol heavily

Mental Health Resources:

  • Call 1-833-TLC-MAMA (1-833-852-6262). The National Maternal Mental Health Hotline provides 24/7, free, confidential support before, during, and after pregnancy.
  • Call or text “HELP” to 1-800-944-4773. The Postpartum Support International Hotline provides information, encouragement, and names of resources near you.
  • Individuals experiencing a crisis and friends/family members can call or text 988. The 988 Suicide and Crisis Lifeline provides 24/7 free, confidential support for mental health struggles, emotional distress, and alcohol or drug use concerns.
  • Visit the Zero Suicide website to view resources and information to improve suicide care.
  • Visit the Striving for Safety website as a resource for safety planning and lethal means safety.

CA-PARC Prevention Recommendations for Perinatal Providers & Facilities:

  • Individuals entering pregnancy on psychiatric medication should not be discontinued from their treatmentwithout appropriate consultation.
  • Support incentives for routine screening of pregnant and postpartum individualsfor mental health conditions by both obstetric providers and pediatricians during well-child visits.
  • For pregnant and postpartum individuals with mental health conditions, incorporate routine suicide risk assessment using a validated tool.
  • For individuals with high risk of suicide, care providers should develop a safety plan for the patient and their family that includes information on secure firearm storage and California’s Gun Violence Restraining Order, which allows for temporary removal of firearms from the home.
  • Educate all partners and family members about the spectrum of maternal mental health conditions. When indicated, include specific education on responses to verbalized distress, suicidal ideation, and restricting access to lethal mechanisms of suicide. Materials should be culturally and linguistically appropriate.
  • Reduce social isolation during and after pregnancy by increasing availability to evidence-based, culturally and linguistically relevant group prenatal care and peer-led support groups.
  • Incorporate perinatal mental health and affective disorders (including signs of and responses to suicide risk) as part of continuing medical education and maintenance of certification for the spectrum of health professionals who care for perinatal individuals
  • Improve systems of referral and ensure access to care, including substance use treatment, for people with known risk factors or mental health conditions.

The findings and recommendations in this document are those of CA-PARC and do not necessarily represent the views or opinions of the CDPH or the California Health and Human Services Agency. While California Department of Public Health (CDPH) provides administrative and scientific support to CA-PARC, recommendations for preventing maternal deaths are made solely by the members of CA-PARC.

Also see Recommendations for Agencies, Organizations & Institutions.​

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