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Care of the Suicidal Patient in Pregnancy or During the Postpartum Period

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Women's Mood Disorders

Abstract

Suicidal thoughts and behaviors are common complications in both pregnancy and the postpartum period. The effects of untreated suicidality are multifold for the mother-baby dyad and society at large. Clinicians caring for this population are best able to provide targeted interventions to address these concerns when well versed in the various presentation characteristics that can occur, including nuanced risk and protective factors. This chapter serves to provide the reader with a greater understanding of the complex nature of suicidality in the pregnant or postpartum woman and further provides recommendations in order to best evaluate for and treat suicidal ideation and behaviors.

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References

  1. O’Carroll PW, Berman AL, Maris RW, Moscicki EK, Tanney BL, Silverman MM. Beyond the tower of babel: a nomenclature for suicidology. Suicide Life Threat Behav. 1996;26(3):237–52.

    Article  PubMed  Google Scholar 

  2. World Health Organization & UNICEF. Trends in maternal mortality: 1990–2015: estimates from WHO, UNICEF, UNFPA, World Bank Group and the United Nations Population Division. 2015.

    Google Scholar 

  3. Wan JJ, Morabito DJ, Khaw L, Knudson MM, Dicker RA. Mental illness as an independent risk factor for unintentional injury and injury recidivism. J Trauma Acute Care Surg. 2006;61(6):1299–304.

    Article  Google Scholar 

  4. Seng JS, Low LMK, Sperlich M, Ronis DL, Liberzon I. Prevalence, trauma history, and risk for posttraumatic stress disorder among nulliparous women in maternity care. Obstet Gynecol. 2009;114(4):839.

    Article  PubMed  PubMed Central  Google Scholar 

  5. St Pierre A, Zaharatos J, Goodman D, Callaghan WM. Challenges and opportunities in identifying, reviewing, and preventing maternal deaths. Obstet Gynecol. 2018;131(1):138–42. https://doi.org/10.1097/AOG.0000000000002417.

    Article  PubMed  PubMed Central  Google Scholar 

  6. Davis GG, Onaka AT. Report on the 2003 revision of the U.S. Standard Certificate of Death. Am J Forensic Med Pathol. 2001;22(1):38–42. [PubMed: 11444659].

    Article  CAS  PubMed  Google Scholar 

  7. Lindahl V, Pearson JL, Colpe L. Prevalence of suicidality during pregnancy and the postpartum. Arch Womens Ment Health. 2005;8(2):77–87. https://doi.org/10.1007/s00737-005-0080-1.

    Article  CAS  PubMed  Google Scholar 

  8. World Health Organization. Maternal mental health. http://www.who.int/mental_health/maternal-child/maternal_mental_health/en/. Updated 2015.

  9. World Health Organization. Maternal mental health and child health and development in low and middle income countries: report of meeting held in Geneva, Switzerland 30 January-1 February 2008. http://www.who.int/mental_health/prevention/suicide/mmh_jan08_meeting_report.pdf. Updated 2008.

  10. Grigoriadis S, Wilton AS, Kurdyak PA, et al. Perinatal suicide in Ontario, Canada: a 15-year population-based study. CMAJ. 2017;189(34):E1085–92.

    Article  PubMed  PubMed Central  Google Scholar 

  11. Oates M. Suicide: the leading cause of maternal death. Br J Psychiatry. 2003;183:279–81. https://doi.org/10.1192/bjp.183.4.279.

    Article  PubMed  Google Scholar 

  12. Austin MP, Kildea S, Sullivan E. Maternal mortality and psychiatric morbidity in the perinatal period: challenges and opportunities for prevention in the Australian setting. Med J Aust. 2007;186(7):364–7.

    Article  PubMed  Google Scholar 

  13. Palladino CL, Singh V, Campbell J, Flynn H, Gold KJ. Homicide and suicide during the perinatal period: findings from the National Violent Death Reporting System. Obstet Gynecol. 2011;118(5):1056–63.

    Article  PubMed  PubMed Central  Google Scholar 

  14. Shadigian E, Bauer ST. Pregnancy-associated death: a qualitative systematic review of homicide and suicide. Obstet Gynecol Surv. 2005;60:183–90. [PubMed: 16570396].

    Article  PubMed  Google Scholar 

  15. World Health Organization. Prevention of suicide: guidelines for the formulation and implementation of national strategies. Geneva: WHO; 1996. [Google Scholar].

    Google Scholar 

  16. Nock MK, Borges G, Bromet EJ, Cha CB, Kessler RC, Lee S. Suicide and suicidal behavior. Epidemiol Rev. 2008;30(1):133–54. [PMC free article] [PubMed] [Google Scholar].

    Article  PubMed  Google Scholar 

  17. Nock MK, Borges G, Ono Y. Suicide: global perspectives from the WHO world mental health surveys. New York: Cambridge University Press; 2012. [Google Scholar].

    Google Scholar 

  18. Heron M. Death: leading causes for 2017. Natl Vital Stat Rep. 2019;68(6):1–77, Hyattsville, MD: National Center for Health Statistics.

    PubMed  Google Scholar 

  19. Appleby L. Suicide during pregnancy and in the first postnatal year. Br Med J. 1991;302(6769):137–40. https://doi.org/10.1136/bmj.302.6769.137.

    Article  CAS  Google Scholar 

  20. Marzuk PM, Tardiff K, Leon AC, et al. Lower risk of suicide during pregnancy. Am J Psychiatry. 1997;154(1):122–3. https://doi.org/10.1176/ajp.154.1.122.

    Article  CAS  PubMed  Google Scholar 

  21. Healey C, Morriss R, Henshaw C, et al. Self-harm in postpartum depression and referrals to a perinatal mental health team: an audit study. Arch Womens Ment Health. 2013;16(3):237–45. https://doi.org/10.1007/s00737-013-0335-1.

    Article  PubMed  PubMed Central  Google Scholar 

  22. Schiff MA, Grossman DC. Adverse perinatal outcomes and risk for postpartum suicide attempt in Washington state, 1987-2001. Pediatrics. 2006;118(3):e669–75. https://doi.org/10.1542/peds.2006-0116.

    Article  PubMed  Google Scholar 

  23. Gelaye B, Kajeepeta S, Williams MA. Suicidal ideation in pregnancy: an epidemiologic review. Arch Womens Ment Health. 2016;19(5):741–51. https://doi.org/10.1007/s00737-016-0646-0.

    Article  PubMed  PubMed Central  Google Scholar 

  24. Newport DJ, Levey LC, Pennell PB, Ragan K, Stowe ZN. Suicidal ideation in pregnancy: assessment and clinical implications. Arch Womens Ment Health. 2007;10:181–7.

    Article  CAS  PubMed  Google Scholar 

  25. Czeizel AE. Attempted suicide and pregnancy. J Inj Violence Res. 2011;3(1):45–54. https://doi.org/10.5249/jivr.v3i1.77.

    Article  PubMed  PubMed Central  Google Scholar 

  26. Frautschi S, Cerulli A, Maine D. Suicide during pregnancy and its neglects as a component of maternal mortality. Int J Gynaecol Obstet. 1994;47(3):275–84. [PubMed] [Google Scholar].

    Article  CAS  PubMed  Google Scholar 

  27. Gentile S. Suicidal mothers. J Inj Violence Res. 2011;3:90–7. [PubMed: 21498972].

    Article  PubMed  PubMed Central  Google Scholar 

  28. Thornton C, Schmied V, Dennis CL, et al. Maternal deaths in NSW (2000–2006) from nonmedical causes (suicide and trauma) in the first year following birth. Biomed Res Int. 2013;2013:623743.

    Article  PubMed  PubMed Central  Google Scholar 

  29. Khalifeh H, Hunt IM, Appleby L, et al. Suicide in perinatal and non-perinatal women in contact with psychiatric services: 15 year findings from a UK national inquiry. Lancet Psychiatry. 2016;3:233–42.

    Article  PubMed  Google Scholar 

  30. Curtin SC, Warner M, Hedegaard H. Increase in suicide in the United States, 1999–2014. NCHS Data Brief No. 241. Atlanta: Centers for Disease Control and Prevention, National Center for Health Statistics; 2016. Available: https://www.cdc.gov/nchs/products/databriefs/db241.htm.

    Google Scholar 

  31. Orr ST, Miller CA. Maternal depressive symptoms and the risk of poor pregnancy outcome. Review of the literature and preliminary findings. Epidemiol Rev. 1995;17(1):165–71. [PubMed] [Google Scholar].

    Article  CAS  PubMed  Google Scholar 

  32. Stott DH. Follow-up study from birth of the effects of prenatal stresses. Dev Med Child Neurol. 1973;15(6):770–87. [PubMed] [Google Scholar].

    Article  CAS  PubMed  Google Scholar 

  33. Kurki T, Hiilesmaa V, Raitasalo R, Mattila H, Ylikorkala O. Depression and anxiety in early pregnancy and risk of preeclampsia. Obstet Gynecol. 2000;95(4):487–90. [PubMed] [Google Scholar].

    CAS  PubMed  Google Scholar 

  34. Freeman MP. Perinatal psychiatry: risk factors, treatment data, and specific challenges for clinical researchers. J Clin Psychiatry. 2008;69(4):633–4. [PubMed] [Google Scholar].

    Article  PubMed  Google Scholar 

  35. Steer RA, Scholl TO, Hediger ML, Fischer RL. Self-reported depression and negative pregnancy outcomes. J Clin Epidemiol. 1992;45(10):1093–9. [PubMed] [Google Scholar].

    Article  CAS  PubMed  Google Scholar 

  36. Hollins K. Consequences of antenatal mental health problems for child health and development. Curr Opin Obstet Gynecol. 2007;19(6):568–72. [PubMed] [Google Scholar].

    Article  PubMed  Google Scholar 

  37. Copersino ML, Jones H, Tuten M, Svikis D. Suicidal ideation among drug-dependent treatment seeking inner-city pregnant women. J Maint Addict. 2008;3:53–64. [PubMed: 21796240].

    Article  PubMed  PubMed Central  Google Scholar 

  38. Gavin AR, Tabb KM, Melville JL, Guo Y, Katon W. Prevalence and correlates of suicidal ideation during pregnancy. Arch Womens Ment Health. 2011;14:239–46. [PubMed: 21327844].

    Article  PubMed  PubMed Central  Google Scholar 

  39. Stallones L, Leff M, Canetto S, et al. Suicidal ideation among low-income women on family assistance programs. Women Health. 2007;45:65–83. [PubMed: 18032168].

    Article  PubMed  Google Scholar 

  40. Paris R, Bolton R, Weinberg M. Postpartum depression, suicidality, and mother-infant interactions. Arch Womens Ment Health. 2009;12:309–21. [PubMed: 19728036].

    Article  PubMed  Google Scholar 

  41. Gausia K, Fisher C, Ali M, et al. Antenatal depression and suicidal ideation among rural Bangladeshi women: a community-based study. Arch Womens Ment Health. 2009;12:351–8. [PubMed: 19468825].

    Article  PubMed  Google Scholar 

  42. Bowen A, Stewart N, Baetz M, et al. Antenatal depression in socially high-risk women in Canada. J Epidemiol Community Health. 2009;63:414–6. [PubMed: 19155236].

    Article  CAS  PubMed  Google Scholar 

  43. Eggleston A, Calhoun P, Svikis D, et al. Suicidality, aggression, and other treatment considerations among pregnant, substance-dependent women with posttraumatic stress disorder. Compr Psychiatry. 2009;50:415–23. [PubMed: 19683611].

    Article  PubMed  PubMed Central  Google Scholar 

  44. Chaurdon L, Klein M, Remington P, et al. Predictors, prodromes and incidence of postpartum depression. Psychosom Obstet Gynaecol. 2001;22:103–12.

    Article  Google Scholar 

  45. Brand S, Brennan P. Impact of antenatal and postpartum maternal mental illness: how are the children? Clin Obstet Gynecol. 2009;51:441–55. [PubMed: 19661760].

    Article  Google Scholar 

  46. Gandhi SG, Gilbert WM, Mcelvy SS, et al. Maternal and neonatal outcomes after attempted suicide. Obstet Gynecol. 2006;107:984–90. [PubMed: 16648400].

    Article  PubMed  Google Scholar 

  47. Mcclure CK, Patrick TE, Katz KD, Kelsey SF, Weiss HB. Birth outcomes following self-inflicted poisoning during pregnancy, California, 2000 to 2004. J Obstet Gynecol Neonatal Nurs. 2011;40:292–301.

    Article  PubMed  Google Scholar 

  48. Hodgkinson SC, Colantuoni E, Roberts D, Berg-Cross L, Belcher HME. Depressive symptoms and birth outcomes among pregnant teenagers. J Pediatr Adolesc Gynecol. 2010;23:16–22. [PubMed: 19679498].

    Article  PubMed  Google Scholar 

  49. Petik D, Czeizel B, Banhidy F, et al. A study of the risk of mental retardation among children of pregnant women who have attempted suicide by means of a drug overdose. J Inj Violence Res. 2012;4:10–9. [PMC free article] [PubMed] [Google Scholar].

    Article  PubMed  PubMed Central  Google Scholar 

  50. Gidai J, Acs N, Banhidy F, et al. Congenital abnormalities in children of 43 pregnant women who attempted suicide with large doses of nitrazepam. Pharmacoepidemiol Drug Saf. 2010;19:175–82. [PubMed] [Google Scholar].

    Article  CAS  PubMed  Google Scholar 

  51. Barker DJ. In utero programming of chronic disease. Clin Sci (Lond). 1998;95(2):115–28. Retrieved from http://www.ncbi.nlm.nih.gov/pubmed/9680492 [PubMed] [Google Scholar].

    Article  CAS  Google Scholar 

  52. DiPietro JA, Novak MF, Costigan KA, et al. Maternal psychological distress during pregnancy in relation to child development at age two. Child Dev. 2006;77:573–87.

    Article  PubMed  Google Scholar 

  53. Nock MK, Borges G, Bromet EJ, et al. Cross-national prevalence and risk factors for suicidal ideation, plans and attempts. Br J Psychiatry. 2008;192:98–105. [PubMed: 18245022].

    Article  PubMed  PubMed Central  Google Scholar 

  54. Coverdale JH, Aruffo JA. Family planning needs of female chronic psychiatric outpatients. Am J Psychiatry. 1989;146(11):1489–91. [PubMed] [Google Scholar].

    Article  CAS  PubMed  Google Scholar 

  55. Lee BH, Kim YK. Potential peripheral biological predictors of suicidal behavior in major depressive disorder. Prog Neuro-Psychopharmacol Biol Psychiatry. 2011;35:842–7. [PubMed: 20708058].

    Article  CAS  Google Scholar 

  56. Harris EC, Barraclough B. Excess mortality of mental disorder. Br J Psychiatry. 1998;173:11–53. https://doi.org/10.1192/bjp.173.1.11.

    Article  CAS  PubMed  Google Scholar 

  57. Joiner TE Jr, Rudd MD, Rouleau MR, Wagner KD. Parameters of suicidal crises vary as a function of previous suicide attempts in youth inpatients. J Am Acad Child Adolesc Psychiatry. 2000;39:876–80. [PubMed: 10892229].

    Article  PubMed  Google Scholar 

  58. Beautrais AL, Joyce PR, Mulder RT, Fergusson DM, Deavoll BJ, Nightingale SK. Prevalence and comorbidity of mental disorders in persons making serous suicide attempts: a case-control study. Am J Psychiatry. 1996;153(8):1009–14. [PubMed] [Google Scholar].

    Article  CAS  PubMed  Google Scholar 

  59. Appleby L, Mortensen PB, Faragher EB. Suicide and other causes of mortality after post-partum psychiatric admission. Br J Psychiatry. 1998;173:209–11. https://doi.org/10.1192/bjp.173.3.209.

    Article  CAS  PubMed  Google Scholar 

  60. Martin SL, Mackie L, Kupper LL, Buescher PA, Moracco KE. Physical abuse of women before, during, and after pregnancy. JAMA. 2001;285(12):1581–4. [PubMed: 11268265].

    Article  CAS  PubMed  Google Scholar 

  61. Saltzman LE, Johnson CH, Gilbert BC, Goodwin MM. Physical abuse around the time of pregnancy: an examination of prevalence and risk factors in 16 states. Matern Child Health J. 2003;7(1):31–43. [PubMed: 12710798].

    Article  PubMed  Google Scholar 

  62. Cheng D, Horon IL. Intimate-partner homicide among pregnant and postpartum women. Obstet Gynecol. 2010;115(6):1181–6. [PubMed: 20502288].

    Article  PubMed  Google Scholar 

  63. Alhusen JL, Frohman N, Purcell G. Intimate partner violence and suicidal ideation in pregnant women. Arch Womens Ment Health. 2015;18(4):573–8. https://doi.org/10.1007/s00737-015-0515-2.

    Article  PubMed  PubMed Central  Google Scholar 

  64. Orsolini L, Valchera A, Vecchiotti R, et al. Suicide during perinatal period: epidemiology, risk factors, and clinical correlates. Front Psychiatry. 2016;7:138. Published 2016 Aug 12. https://doi.org/10.3389/fpsyt.2016.00138.

    Article  PubMed  PubMed Central  Google Scholar 

  65. Comtois KA, Schiff MA, Grossman DC. Psychiatric risk factors associated with postpartum suicide attempt in Washington State, 1992–2001. Am J Obstet Gynecol. 2008;199(2):120.e1–120.e1205. https://doi.org/10.1016/j.ajog.2008.02.011.

    Article  Google Scholar 

  66. Gressier F, Guillard V, Cazas O, Falissard B, Glangeaud-Freudenthal NM, Sutter-Dallay AL. Risk factors for suicide attempt in pregnancy and the post-partum period in women with serious mental illnesses. J Psychiatr Res. 2017;84:284–91. https://doi.org/10.1016/j.jpsychires.2016.10.009.

    Article  PubMed  Google Scholar 

  67. Pinheiro RT, da Cunha Coelho FM, da Silva RA, et al. Suicidal behavior in pregnant teenagers in southern Brazil: social, obstetric and psychiatric correlates. J Affect Disord. 2012;136(3):520–5. https://doi.org/10.1016/j.jad.2011.10.037.

    Article  PubMed  Google Scholar 

  68. Farias DR, Pinto Tde J, Teofilo MM, et al. Prevalence of psychiatric disorders in the first trimester of pregnancy and factors associated with current suicide risk. Psychiatry Res. 2013;210(3):962–8. https://doi.org/10.1016/j.psychres.2013.08.053.

    Article  PubMed  Google Scholar 

  69. Dazzi T, Gribble R, Wessely S, Fear NT. Does asking about suicide and related behaviours induce suicidal ideation? What is the evidence? Psychol Med. 2014;44(16):3361–3. https://doi.org/10.1017/S0033291714001299.

    Article  CAS  PubMed  Google Scholar 

  70. Sudak D, Roy A, Sudak H, Lipschitz A, Maltsberger J, Hendin H. Deficiencies in suicide training in primary care specialties: a survey of training directors. Acad Psychiatry. 2007;31(5):345–9.

    Article  PubMed  Google Scholar 

  71. Bolster C, Holliday C, Shaw M. Suicide assessment and nurses: what does the evidence show? Online J Issues Nurs. 2015;20(1):2.

    PubMed  Google Scholar 

  72. Schmitz WM, Allen MH, Feldman BN, Gutin NJ, Jahn DR, Kleespies PM, et al. Preventing suicide through improved training in suicide risk assessment and care: an American Association of Suicidology task force report addressing serious gaps in U.S. mental health training. Suicide Life Threat Behav. 2012;42(3):292–304.

    Article  PubMed  Google Scholar 

  73. Zhu Y, Zhang C. Prevalence of gestational diabetes and risk of progression to type 2 diabetes: a global perspective. Curr Diab Rep. 2016;16(1):7. https://doi.org/10.1007/s11892-015-0699-x.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  74. Siu AL; US Preventive Services Task Force (USPSTF), Bibbins-Domingo K, et al. Screening for depression in adults: US preventive services task force recommendation statement. JAMA. 2016;315(4):380–7. https://doi.org/10.1001/jama.2015.18392.

  75. The Joint Commission. Detecting and treating suicidal ideation in all settings. Sentinel Event Alert. 2016;56:1–7.

    Google Scholar 

  76. Kroenke K, Spitzer RL, Williams JB. The PHQ-9: validity of a brief depression severity measure. J Gen Intern Med. 2001;16(9):606–13. https://doi.org/10.1046/j.1525-1497.2001.016009606.x. [PMC free article] [PubMed] [CrossRef] [Google Scholar].

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  77. Simon GE, Rutter CM, Peterson D, et al. Does response on the PHQ-9 Depression Questionnaire predict subsequent suicide attempt or suicide death? Psychiatr Serv. 2013;64(12):1195–202. https://doi.org/10.1176/appi.ps.201200587.

    Article  PubMed  PubMed Central  Google Scholar 

  78. Cox JL, Holden JM, Sagovsky R. Detection of postnatal depression. Development of the 10-item Edinburgh Postnatal Depression Scale. Br J Psychiatry. 1987;150:782–6. https://doi.org/10.1192/bjp.150.6.782. [PubMed] [CrossRef] [Google Scholar].

    Article  CAS  PubMed  Google Scholar 

  79. Zhong QY, Gelaye B, Rondon MB, et al. Using the Patient Health Questionnaire (PHQ-9) and the Edinburgh Postnatal Depression Scale (EPDS) to assess suicidal ideation among pregnant women in Lima, Peru. Arch Womens Ment Health. 2015;18(6):783–92. https://doi.org/10.1007/s00737-014-0481-0.

    Article  PubMed  Google Scholar 

  80. Petrik ML. Balancing patient care and confidentiality: considerations in obtaining collateral information. J Psychiatr Pract. 2015;21(3):220–4. https://doi.org/10.1097/PRA.0000000000000072.

    Article  PubMed  Google Scholar 

  81. Rodriguez-Cabezas L, Clark C. Psychiatric emergencies in pregnancy and postpartum. Clin Obstet Gynecol. 2018;61(3):615–27. https://doi.org/10.1097/GRF.0000000000000377.

    Article  PubMed  Google Scholar 

  82. Simon RI. The suicide prevention contract: clinical, legal, and risk management issues. J Am Acad Psychiatry Law. 1999;27(3):445–50.

    CAS  PubMed  Google Scholar 

  83. Stanley B, Brown G. Safety planning intervention: a brief intervention to mitigate suicide risk. Cogn Behav Pract. 2011;19(2):256–64.

    Article  Google Scholar 

  84. Simon TR, Swann AC, Powell KE, Potter LB, Kresnow M, O’Carroll PW. Characteristics of impulsive suicide attempts and attempters. SLTB. 2001;32(Suppl):49–59.

    CAS  Google Scholar 

  85. Jobes DA, Gregorian MJ, Colborn VA. A stepped care approach to clinical suicide prevention. Psychol Serv. 2018;15(3):243–50. https://doi.org/10.1037/ser0000229.

    Article  PubMed  Google Scholar 

  86. Intensive Perinatal Psych Treatment in the US | Postpartum Support International (PSI). (2020). Retrieved 1 Aug 2020, from Postpartum Support International - PSI website: https://www.postpartum.net/get-help/intensive-perinatal-psych-treatment-in-the-us/.

  87. Pirkola S, Sohlman B, Wahlbeck K. The characteristics of suicides within a week of discharge after psychiatric hospitalisation - a nationwide register study. BMC Psychiatry. 2005;5:32.

    Article  PubMed  PubMed Central  Google Scholar 

  88. Goldacre M, Seagroatt V, Hawton K. Suicide after discharge from psychiatric inpatient care. Lancet. 1993;342:283–6.

    Article  CAS  PubMed  Google Scholar 

  89. D’Anci KE. Treatments for the prevention and management of suicide: a systematic review. Ann Intern Med. 2019;171(5):334–42. https://doi.org/10.7326/M19-0869.

    Article  PubMed  Google Scholar 

  90. Tondo L, Isacsson G, Baldessarini RJ. Suicidal behaviour in bipolar disorder: risk and prevention. CNS Drugs. 2003;17:491–511.

    Article  CAS  PubMed  Google Scholar 

  91. Baldessarini RJ, Tondo L, Hennen J. Lithium treatment and suicide risk in major affective disorders: update and new findings. J Clin Psychiatry. 2003;64(suppl 5):44–52.

    CAS  PubMed  Google Scholar 

  92. Tondo L, Baldessarini RJ. Reduced suicide risk during lithium maintenance treatment. J Clin Psychiatry. 2000;61 Suppl 9:97–104.

    CAS  PubMed  Google Scholar 

  93. Ward HB, Fromson JA, Cooper JJ, De Oliveira G, Almeida M. Recommendations for the use of ECT in pregnancy: literature review and proposed clinical protocol [published correction appears in Arch Womens Ment Health. 2018 Jun 23;:]. Arch Womens Ment Health 2018;21(6):715–722. doi:https://doi.org/10.1007/s00737-018-0851-0.

  94. Taylor R, Galvez V, Loo C. Transcranial magnetic stimulation (TMS) safety: a practical guide for psychiatrists. Australas Psychiatry. 2018;26(2):189–92. https://doi.org/10.1177/1039856217748249.

    Article  PubMed  Google Scholar 

  95. Cox EQ, Killenberg S, Frische R, et al. Repetitive transcranial magnetic stimulation for the treatment of postpartum depression. J Affect Disord. 2020;264:193–200. https://doi.org/10.1016/j.jad.2019.11.069.

    Article  CAS  PubMed  Google Scholar 

  96. American College of Obstetricians and Gynecologists. ACOG Committee opinion no. 736. Obstet Gynecol. 2018;131:e140–50.

    Article  Google Scholar 

  97. Spinelli MG. Maternal infanticide associated with mental illness: prevention and the promise of saved lives. Am J Psychiatry. 2004;161(9):1548–57.

    Article  PubMed  Google Scholar 

  98. Building U.S. Capacity to Review and Prevent Maternal Deaths (2018) Report from nine maternal mortality review committees. Retrieved from http://reviewtoaction.org/Report_from_Nine_MMRCs.

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  1. Department of Psychiatry, The University of North Carolina at Chapel Hill, Chapel Hill, NC, USA

    Rachel M. Frische

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    Elizabeth Cox

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Frische, R.M. (2021). Care of the Suicidal Patient in Pregnancy or During the Postpartum Period. In: Cox, E. (eds) Women's Mood Disorders. Springer, Cham. https://doi.org/10.1007/978-3-030-71497-0_18

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