Suicide is one of the leading causes of death among pregnant and recently pregnant women, says a new study published in the Canadian Medical Association Journal.

“We discovered that women who die by perinatal suicide are more likely to do so by violent means and they are less likely to seek mental health services a month before they die,” said Dr. Sophie Grigoriadis, the study’s lead author and the head of the Women's Mood and Anxiety Clinic at Sunnybrook Health Sciences Centre in Toronto.

Researchers tracked women in Ontario from 1994 to 2008. They found that five per cent of deaths during pregnancy or the first year after pregnancy were due to suicide.

And unlike women who were not pregnant who most often used drug overdoses to attempt to end their lives, pregnant women or new mothers used especially lethal methods to kill themselves, such as hanging, jumping or falling – which is usually instantly fatal.

That was the case in Toronto in 2000, when Dr. Suzanne Killinger Johnson ended her life and that of her six-month-old son. She jumped in front of a subway car in a case that highlighted the risks of post-partum depression.

Pregnant and recently pregnant women often suffer from sleep problems and hormonal shifts that can trigger anxiety and depression. Some studies suggest post-partum depression is common, affecting up to one in five new mothers.

Ottawa mother Clare Miller said she had a very normal pregnancy. But things changed about a month after her daughter was born.

“I felt this fog that just kind of enveloped me and stayed there. Nothing was enjoyable, nothing made me happy,” she told CTV News. “There was one moment I went to get groceries one day and I thought, I don’t want to go home.”

That thought frightened her.

“I have a daughter, I have a great family and a great husband -- why am I not enjoying it? Why do I feel this way?” she said.  

Miller sought help from family and friends, ending up in the offices of Family Services Ottawa, where she joined support groups with other new mothers and got counselling.

“I feel so different now that I have gotten help that it’s hard to remember because it’s so different from how I feel now,” she said.  

“It’s distressing to see the stats,” said Theresa Willoughby, a counsellor at Family Services Ottawa.

“The sooner that women reach out, the sooner that we can see what services are appropriate for the whole family. Whether you are feeling down or anxious or crying a lot, check it out with someone,” she added.

The study also found that 39 per cent of the women who died by suicide during pregnancy or the postpartum period sought mental health support in the last month of their lives.

Dr. Grigoriadis says that shows that mental health in women during pregnancy needs to be monitored closely and for at least a year afterward.  The study found that, on average, new mothers who died by suicide did so in the seven months after giving birth.

The goal of the new study was to better understand suicide in these women to develop better ways to prevent tragic deaths, said Dr. Grigoriadis.