The recent deaths of Lisa Gibson and her two young children in Winnipeg highlight the need to carefully investigate maternal deaths on a case-by-case basis, a Canadian medical journal editor says.

The body of the 32-year-old mother was found in the Red River in July three days after two-year-old daughter, Anna, and three-month-old son, Nicholas, died in hospital after emergency personnel found the children unresponsive in the family's home.

Family members say Gibson had sought help for postpartum depression. The official cause of her death is under investigation by Manitoba's Chief Medical Examiner.


Family and friends gathered at a memorial service for Lisa Gibson and her children Anna and Nicholas on Aug. 1 in Stonewall, Man. The official cause of the mother's death is under investigation. (John Woods/Canadian Press)

In today's issue of the Canadian Medical Association Journal, an editor argues that Canada needs to do more to understand and prevent maternal suicide, with regular in-depth audits of deaths. She also wants health care providers to be more diligent in detecting postpartum depression.

In the UK and several other countries, maternal deaths are analyzed on a case-by-case basis to identify contributing factors. This does not happen in Canada, according to the editorial.

"How could we do better?" Kirsten Patrick, a deputy editor at the CMAJ asks. "First, we must examine individual cases to inform strategies aimed at preventing such unnecessary and tragic loss of life. The deaths of Ms. Gibson and her children are a tragedy. It is criticial that these deaths and other maternal deaths be carefully investigated and reported to see if there are potential failings in care — not to lay blame, but to learn and to consider what might be done differently in future."

Patrick said Canada also needs to do more to find out what barriers prevent women with postpartum depression from receiving effective treatment.

She also urged doctors to be vigilant in recognizing postpartum depression and referring women to the appropriate supports.

A report that audited maternal deaths in the United Kingdom from 2000 through 2002 found that psychiatric illness was the largest cause of maternal death during that period.