Margaret Oates, consultant in perinatal psychiatry, at Queen's Medical College, in Nottingham, said nearly 30 maternal deaths each year could be prevented.

Most of the women died violent deaths, shooting, stabbing or hanging themselves or throwing themselves from high buildings.

They hanged themselves, jumped off bridges, drowned, cut their throats and threw themselves in front of fast moving vehicles

Margaret Oates Consultant in perinatal psychiatry

Mrs Oates said half the women who died, revealed following the Confidential Enquiries into Maternal Deaths in the UK (1997-99), had already suffered psychosis in a previous pregnancy.

They should have been more closely monitored following subsequent births, she added.

"They hanged themselves, jumped off bridges, drowned, cut their throats and threw themselves in front of fast moving vehicles.

"They weren't testing the waters or crying for help.

"They wanted to die and this is a sign of severe mental illness.

"Of the suicides half of them had previous problems, most of them with their last baby and so people knew that they were at risk and yet this was not picked up."

She said that one middle-class woman suffered serious mental health problems six days after giving birth to her first baby.

Counselling

Six days after the second birth she suffered similar problems and committed suicide - 14 days later she received an appointment for mental health counselling.

"She must have thought here we go again and couldn't stand it," said Mrs Oates.

"There was a 50/50 risk of it happening again."

But Mrs Oates said a better system of screening would help pick up problems.

"People should be asked if they have had a serious mental health problem after a previous baby."

But she said screening would only be useful if health workers and midwives were properly trained in how to cope with suicide risk women.

Briege Coyle from the Community Practitioner's and Health Visitors Association, which highlighted the problem, said health workers needed more training.

Screening

"It is something health visitors and midwives need to be aware of and cover more in their training," she said.

"There is a need for national guidelines for the management of maternal mental health in primary care.

"Antenatal women with a past history of mental health problems of puerperal psychosis would then stand a better chance of having potential problems identified early on."

Carol Bates of the Royal College of Midwives, said it was often difficult for them to identify psychosis because there were too few midwives and each mother often saw several of them during her pregnancy, meaning that she had little time to build up a rapport.

She added that poor communication between mental health staff and GPs meant that previous psychiatric problems were often not filtered through to midwives.