Suicide Among Women and the Role of Women's Health Care Providers

Importance: Suicide is a leading cause of death in the United States, with increasing rates among women. Women are more likely to experience suicidal ideation and engage in suicide behavior than men, and risk is elevated at key points where they may engage in care with a women's health care provider. Objective: This review describes the prevalence of and risk factors for suicide among women and highlights the role of obstetrician-gynecologists in suicide prevention. Evidence Acquisition: A PubMed, MEDLINE, and PsycINFO search was completed for English-language publications about suicide among women, including subtopics (eg, perinatal suicide, suicide during perimenopause). Results: There are overlapping risk factors that contribute to suicide among women, including intimate partner violence and substance use. Specific groups of women may present with unique risk factors, such as women veterans, women in rural areas, and women with preexisting mental health diagnoses, particularly serious mental illnesses. Some women at risk for suicide are not seen in clinical settings, and thus community interventions may be beneficial. There are roles for obstetrician-gynecologists within and outside of the clinic to prevent suicide. Conclusions and Relevance: Obstetrician-gynecologists can save lives by being aware of the prevalence of suicide ideation and behavior among women, understanding risk factors for suicide over the lifespan, regularly screening for these factors, asking directly about suicide ideation and intent, and being aware of clinical and community resources. Outside of the clinic, they can advocate for increased health care access and community-based interventions. These efforts can contribute to the reduction of preventable death and maternal mortality. Target Audience: Obstetricians and gynecologists, family physicians. Learning Objectives: After participating in this activity, physicians should be better able to distinguish how the prevalence of suicide in the United States varies across major demographic groups, including women; list factors associated with the greater prevalence of suicidal ideation and behavior among women; and identify the unique suicide risk factors among women across the reproductive life span, including pregnancy and the postpartum period.