Suicidal Ideation and Depression Among Racial and Ethnic Minority Women in the Immediate Post-Partum Period

Background: Suicidal ideation and postpartum depressive symptoms during the perinatal period is a major health concern representing a risk for maternal mortality and further compromise the well-being of infants. More than 400,000 infants are born to mothers with depression every year and one in seven women suffers from frequent postpartum depressive symptoms in the United States. CDC estimated around 12.8% of women in the U.S. reported experiencing postpartum depression with a recent live birth in 2018. Few studies examine the prevalence of suicidal ideation and mental health of racial/ ethnic minority women.  Elevated depressive symptoms can indicate risks for complications and adverse birth outcomes for mothers and infants in the first few weeks after delivery. The aim of this study is to identify the prevalence of suicidal ideation and depression among a sample of racially and ethnically diverse women in the immediate post-partum period (within 3 days of delivery). 

Methods: Between 2012 and 2016 a sample of 10,450 immediate postpartum women, who gave birth between 0-3 days prior to completing an Edinburgh Postnatal Depression Screens in the maternity unit prior to discharge as part of standard postpartum care in a large regional delivery hospital. All depression screens were collected along with risk factors from electronic medical records and collected as a depression registry. Logistic regression models were used to measure the association among suicidal ideation, depression and race/ethnicity. 

Results: Of the 10,401 participants, 7.7% mothers had elevated symptoms of depression and 61.3% had suicidal thoughts. Black women had the highest rate of elevated depressive symptoms at 11.1%. The overall prevalence of immediate postpartum suicidal ideation in this sample was 2.2%. Among racial and ethnic groups, the prevalence of postpartum suicidal ideation was as low as 1.29% for White women, 3.48% for Black women, and as high as 8.25% for Asian American women. After adjusting for age and clinical risk factors, Black and Asian American women remained 2.82 and 7.61 times as likely to report suicidal ideation compared to their White counterparts. 

Conclusion and Implications: Results suggests the prevalence of elevated depressive symptoms is common in the immediate postpartum period and minority women had a higher risk of having suicidal ideation and depression than white women. Further research is needed to explore the factors that expose women of minorities to risk of having suicidal ideation. Women's mental health during the perinatal period is critically important and early identification to target mothers at risk to facilitate early treatment will aid hospitals to address mental health needs of mothers prior to discharge. Future studies should investigate how to appropriately tailor screening and interventions to the mental health needs of different racial groups within healthcare settings.