Perinatal suicide in Ontario, Canada: A 15-year population-based study.

BACKGROUND: Death by suicide during the perinatal period has been understudied in Canada. We examined the epidemiology of and health service use related to suicides during pregnancy and the first postpartum year.

METHODS: In this retrospective, population-based cohort study, we linked health administrative databases with coroner death records (1994–2008) for Ontario, Canada. We compared sociodemographic characteristics, clinical features and health service use in the 30 days and 1 year before death between women who died by suicide perinatally, women who died by suicide outside of the perinatal period and living perinatal women.

INTERPRETATION: The perinatal suicide rate for Ontario during the period 1994–2008 was comparable to international estimates and represents a substantial component of Canadian perinatal mortality. Given that deaths by suicide occur throughout the perinatal period, all health care providers must be collectively vigilant in assessing risk.