Opinion | Minnesota could end maternal suicide but settles for ‘better than most’

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Minnesota has much of the infrastructure needed to eliminate maternal suicide — a leading cause of maternal mortality, according to the Centers for Disease Control and Prevention. But my experience as both a survivor and a health care insider showed me that simply having pieces of a puzzle isn’t enough, and that without real public pressure, our health care leaders will continue to decline to go the final mile.

I have a master’s in health care administration from the University of Minnesota, and my husband is a resident physician. If anyone is equipped to navigate the complex health care system, we are. But when our son was born in 2023, I developed severe postpartum anxiety that made it nearly impossible to eat, sleep or sit still. That anxiety led to depression, and before long I was suicidal.

We struggled to find help. I saw several doctors and took the standard screening questionnaires. I was told it would take months to get in with a therapist. I was given a crisis line number that wasn’t actually a crisis line. Eventually, I went to the ER and spent a few nights in a general inpatient psychiatry unit, separated from my husband and our newborn baby.

Each dead end reinforced the belief that I was alone, that nobody cared, or that there was nothing anyone could do. Being separated from my family took away the only things that brought me any relief — being with my husband and holding my baby.

In the end, I got lucky. Through desperate late-night internet searching, my family found Hennepin Healthcare’s Mother-Baby program, one of only a handful of its kind in the country. That was a portal to what felt like an underground world of maternal mental health treatment — one that ultimately saved my life.

I did my research and gathered data. I conducted a survey and heard from nearly 50 other Minnesotans, many of whom had also screened positive for postpartum depression, only to hit a dead end.

At my own organization, I met with leaders across relevant specialties. I shared my story, best practices and implementation guides. I also reached out to leaders at nearly all other major health systems around the state, trusting what I had always heard about Minnesota being a collaborative health care market.

What I encountered was a prime example of “Minnesota Nice” — surface-level kindness without actions to match. One leader told me she needed to focus all of her energy on recruiting. Another applauded me for my “commitment to improving health care” and dismissively noted that they already had “several initiatives in this important space” — with no indication what those might be. And after nearly 18 months of internal conversations, a top executive at my own organization told me I was “too close” to the topic to be at the table, and that I couldn’t simply invite myself into those discussions.

That was my cue that it was time to leave. It was also the moment I realized the problem isn’t a lack of awareness. It’s a lack of willingness to act.

I can’t help but wonder if some of the complacency stems from Minnesota’s impressive performance on paper. Our latest maternal mortality rate was 12 deaths per 100,000 live births — less than half the national rate, second only to California.

Minnesota already has much of the providers, processes and political will needed to end this crisis. But we still lack universal education on perinatal mental health for health care students and practicing providers, screening that captures conditions beyond depression, at least one specialized inpatient unit for the most critically ill perinatal patients, and tighter collaboration between systems so patients are guided to the most appropriate care.

Above all, we need humility from our health care leaders that “better than most states” means little in a country that leads high-income nations in maternal mortality.

Screening without an evidence-based follow-up plan is of limited value. The existence of intensive treatment programs does us no good if front line clinicians don’t know they exist.

Zero maternal suicide is within reach in Minnesota. How badly do we want it?