The DOI matches its Crossref record; 16 of the 16 references it cites were found in a registry or an index.
Perinatal psychiatric disorders: a leading cause of maternal morbidity and mortality
Abstract
The Confidential Enquiry into Maternal Deaths 1997 to 1999 finds that psychiatric disorder, and suicide in particular, is the leading cause of maternal death. Suicide accounted for 28% of maternal deaths. Women also died from other complications of psychiatric disorder and a significant minority from substance misuse. Some of the findings of the Confidential Enquiry confirm long established knowledge about postpartum psychiatric disorder. The findings highlight the severity and early onset of serious postpartum mental illness and of the risk of recurrence following childbirth faced by women with a previous history of serious mental illness either following childbirth or at other times. These findings led to the recommendation that all women should be asked early in their pregnancy about a previous history of serious psychiatric disorder and that management plans should be in place with regard to the high risk of recurrence following delivery. Other findings of the Enquiry were new and challenged some of the accepted wisdoms of obstetrics and psychiatry. It is likely that the suicide rate following delivery is not significantly different to other times in women's lives and for the first 42 days following delivery may be elevated. This calls into question the so-called 'protective effect of maternity'. The overwhelming majority of the suicides died violently, contrasting with the usual finding that women are more likely to die from an overdose of medication. Compared to other causes of maternal death, the suicides were older and socially advantaged. The Enquiry findings suggest that the risk profile for women at risk of suicide following delivery may be different to that in women at other times and in men. None of the women who died had been admitted at any time to a Mother and Baby Unit and their psychiatric care had been undertaken by General Adult Services. None of the women who died had had a previous episode correctly identified and none had had adequate plans for their proactive care. The conclusion is that there is a need for both Psychiatry and Obstetrics to acknowledge the substantial risk that women with a previous psychiatric history of serious mental illness face following delivery.
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“Suicide has been identified as a leading cause of maternal death in some developed countries [41]”
From The global prevalence of postpartum psychosis: a systematic review (2017) · cites this paper as [41]
In the citing paper
“Psychological distress among perinatal women correlates with increased maternal morbidity and mortality rates (Khalifa et al., 2016; Oates, 2003), poor infant health outcomes (Gelaye et al., 2016), and adverse early childhood developmental trajectories encompassing cognitive, emotional, and developmental delays (Slomian et al., 2019), making it a substantial public health concern.”
From Developing and validating the Sierra Leone perinatal psychological distress scale through an emic-etic approach (2025) · cites this paper as Oates, 2003
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The historiography of puerperal psychosis: a Cinderella sub-specialty
Hollingworth, T. (2023) · British Journal of Midwifery · doi:10.12968/bjom.2023.31.4.226
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Gaucher, L., Barasinski, C., Dupont, C., Razurel, C., Savelon, S. V., Cortet, M., Nicolas Franck, B., Haesebaert, F., & Haesebaert, J. (2024) · doi:10.22541/au.170668412.25303526/v1
Postpartum suicidal ideation in Austria and Germany during the COVID-19 pandemicPreprint
Florea, C., Preiß, J., Angerer, M., & Schabus, M. (2024) · medRxiv · doi:10.1101/2024.03.15.24304383
“Thoughts of suicide and self-harm are an indicator for future suicidal attempts (Orsolini et al., 2016), and during the postpartum period, suicide is one of the leading causes of maternal death in high-income countries (Oates, 2003).”
BackgroundChernykh, O. A., Lakhin, R. E., & Shchegolev, A. V. (2024) · Russian Sklifosovsky Journal Emergency Medical Care · doi:10.23934/2223-9022-2024-13-1-56-63
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Psychiatric Emergencies in Perinatal Women: A Retrospective Analysis
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Understudied Populations Within the Sexual Assault Literature
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RetractedSwales, D. A., Prim, J., Hellberg, S. N., Napolitano, S. C., Brown, R. D., Richardson, E., Schiff, L. D., Rubinow, D. R., & Schiller, C. E. (2025) · Journal of Affective Disorders · doi:10.1016/j.jad.2025.120996
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Perinatal Mental Health: Addressing Service Gaps and Advancing Anti-Oppressive Practice
Huang, F. (2025) · Essential clinical social work series · doi:10.1007/978-3-031-91391-4_5
Yazdkhasti, M., Kalhor, M., Simbar, M., Hajian, S., kiani, Z., Amirian, A., Ebrahimi, E. S., Mohammadi, N., Ezadi, Z., & Jafari, M. (2026) · BMC Pregnancy and Childbirth · doi:10.1186/s12884-026-08799-7 · Cited by 1
“This decision is accompanied by psychological stress and may affect the likelihood of postpartum depression [1, 2, 7].”
Trisha, M. S., Nahid, M. H., & Murray, R. L. (2026) · Social Psychiatry and Psychiatric Epidemiology · doi:10.1007/s00127-026-03198-x
“Beyond economics, maternal suicide remains a leading cause of perinatal mortality in high-income countries, indicating critical gaps in detection and crisis response [ 21 ].”
Mental health disorders, substance use, and pregnancy-associated mortality
Lee, R., Suarez, E. A., Rosenfeld, E. B., Joseph, K. S., Keyes, K. M., & Ananth, C. V. (2026) · International Journal of Epidemiology · doi:10.1093/ije/dyag112
Postpartum Suicidality beyond Depression: a Systematic Review of Risk Profiles and Prevention Gaps
Baldini, V., Gnazzo, M., Varallo, G., Ronchi, D. D., Carotenuto, M., & Fiorillo, A. (2026) · Current Psychiatry Reports · doi:10.1007/s11920-026-01706-z
“Suicide has become one of the leading causes of maternal mortality in high-income countries, accounting for up to 20% of postpartum deaths [27, 36, 37], particularly during the late postpartum period (defined here as after six weeks and up to 18 months after childbirth), when routine medical and…”
Belay, D. M., Dadi, A. F., Unger, H. W., Gele, S. H., Derseh, B. T., Leckning, B., & Guthridge, S. (2026) · Archives of Women s Mental Health · doi:10.1007/s00737-026-01774-3
“These disruptions negatively affect maternal mental health (Moura et al. 2016) and indirectly contribute to maternal death (Oates 2003 ).”
Metadata
- Authors
- Oates, M.
- Affiliations
- University of Nottingham (GB)
- Corresponding author
- Oates, Margaret
- Venue
- British Medical Bulletin
- Publisher
- Oxford University Press (OUP)
- Published
- 2003-12-01
- Volume
- 67
- Issue
- 1
- Pages
- 219-229
- ISSN
- 0007-1420 (ISSN-L)
- 1471-8391
- OpenAlex
- W2137670496
- Cited by
- 317
- References
- 16
- Citations by year
- 2026: 8 · 2025: 12 · 2024: 16 · 2023: 13 · 2022: 17 · 2021: 20 · 2020: 17 · 2019: 22 · 2018: 18 · 2017: 18 · 2016: 21 · 2015: 21 · 2014: 21 · 2013: 18 · 2012: 12
- FWCI
- 4.06
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- British Medical Bulletin (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Maternal Mental Health During Pregnancy and Postpartum
- Social Sciences › Sociology and Political Science › Homicide, Infanticide, and Child Abuse
- Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Maternal and fetal healthcare
- Keywords
- perinatal psychiatric disorders, maternal mortality, maternal suicide, postpartum mental disorders, severe mental illness, substance abuse, confidential enquiry into maternal deaths, maternal morbidity
- MeSH terms
- Female, Humans, Maternal Mortality, Pregnancy, Psychotic Disorders, Puerperal Disorders, Recurrence, Risk, Suicide
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