Maternal deaths due to suicide: A 5-year retrospective analysis in a district in South Africa

Maternal suicide is an important contributor to maternal deaths in high-income countries. However, despite the association between suicide and life stressors, there are limited data on suicide-related maternal deaths from lower- and middle-income countries, including South Africa. This study aimed to address this gap by analysing suicide-related maternal deaths in a district in South Africa.

Retrospective review of secondary data of all suicide-related maternal deaths that occurred at all health facilities, including hospitals, community health centres and primary healthcare clinics, in Ekurhuleni Health District in South Africa over a period of 5 years and 9 months (July 2014-March 2020).

In total, there were 365,556 livebirths and 489 maternal deaths, 17 (3.5 %) of which were classified as suicide. Of the suicide-related maternal deaths, none of the women had any documented illnesses, 13 (76.5 %) died undelivered, 11 (64.7 %) were aged 20-34 years, and five (29.4 %) were adolescents. Organophosphate poisoning was the most common (n = 8, 47.1 %) mode of suicide. Avoidable factors, such as delay in initiating initial resuscitation and failure to implement adequate management thereafter, were found in four (23.5 %) cases.

Suicide-related maternal deaths are increasing in the study district, mainly affecting young women with no history of psychiatric disorders. Universal screening for suicide risk during each antenatal clinic visit, and maintenance of a suicide register in all maternity units, are recommended.