Prevention for Prenatal Care

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Preventing Interpersonal violence, homicide, and suicide in Pregnant Women and birthing persons

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The leading cause of maternal death is overdose, homicide, and suicide. Of these causes, unintentional drug overdose was the leading cause at 5.2 deaths per 100,000 live births, and homicide and suicide accounted for 3.9 deaths per 100,000 live births. Preventing these unnecessary deaths starts in the prenatal period. There are screenings that ask pregnant women about suicidal ideation and other common mental health conditions through the Patient Health Questionnaire (PHQ 2 or 9), the Generalized Anxiety Screener (GAD 3 or 7), and the Pregnancy/Postnatal Depression Scale (EPDS). However, these screenings lack thoroughness in their ability to create a full picture of a person's mental well-being due to the standardized nature of the screener. Earlier intervention in the pregnancy through asking about coping mechanisms, home life, financial stability, employment, and past trauma can create a clearer perspective of a pregnant person's emotional and mental well-being.

Prevention of homicide and interpersonal violence for pregnant women and birthing persons can lead to better mental health and maternal mortality outcomes for pregnant individuals. Homicides were committed 77% of the time with a firearm. Screening for firearms in the household or firearm use could prevent some of these deaths. Additionally, another mode of prevention can occur through state Red Flag laws. These laws help keep firearms out of the way of people who could harm someone.

Currently, most maternal deaths, 62%, occur after the 42 day period up until 1 year post-partum. The standard of care is one follow-up visit 6-weeks post-partum. The American College of Obstetricians and Gynecologists (ACOG) has recommended that this standard include more visits within a 12-week period, but this recommendation has not yet become the standard practice of care. Due to the limited amount of check-ups post-partum many women and birthing people may feel isolated at the beginning motherhood. 21.8% of American Indian/Alaska Native people reports symptoms of post-partum depression compared to 16.3% of Black, non-Hispanic, 15.4% Multiple Race, Non-Hispanic, 13.8% Hispanic, 11.7% White, and 8% Asian. Systemic racism can exacerbate symptoms of post-partum depression through making it harder to access medical care, implicit bias in providers, and race-based traumatic stress (RBTS). Creating more avenues for women and birthing people to have interactions with a doctor or trusted medical professional could create better mental health outcomes. Asking about existing support networks in place for these women and birthing people can also aid medical professionals in learning about gaps in their patients' network of care.

References

https://www.networkforphl.org/news-insights/we-need-to-talk-about-maternal-mortality-and-gun-violence/#:~:text=Homicide%20is%20a%20leading%20cause%20of%20maternal,are%20a%20danger%20to%20themselves%20or%20others

Hoke, Kathleen. 2025. We Need to Talk About Maternal Mortality and Gun Violence. The Network for Public Health Law.

ttps://www.nejm.org/doi/full/10.1056/NEJMc2512078

Azad, Hooman, et. al. 2026. Overdose, Homicide, and Suicide as Causes of Maternal Death in the United States. The New England Journal of Medicine.

https://policycentermmh.org/maternal-suicide-issue-brief/

Policy Center for Maternal Mental Health. 2024. Maternal Suicide in the U.S. – Opportunities for Improved Data Collection and Health Care System Change. Policy Center for Maternal Mental Health.

https://www.networkforphl.org/news-insights/we-need-to-talk-about-maternal-mortality-and-gun-violence/#:~:text=Homicide%20is%20a%20leading%20cause%20of%20maternal,are%20a%20danger%20to%20themselves%20or%20others

Hoke, Kathleen. 2025. We Need to Talk About Maternal Mortality and Gun Violence. The Network for Public Health Law.

https://www.medbridge.com/blog/closing-the-six-week-gap-in-postpartum-care-why-birth-recovery-needs-a-standard-of-care

Daroski, Kandis. 2026. Closing the Six-Week Gap in Postpartum Care: Why Birth Recovery Needs a Standard of Care. Medbridge.

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