Around half of suicides by women while pregnant or after giving birth could be prevented by better standards of care, experts have said.

The Confidential Enquiry into Maternal Deaths, based at the University of Oxford and partially funded by NHS England, found that women who suffer serious mental health problems during or after pregnancy are being let down by a lack of resources and failures to spot warning signs.

The researchers examined all 101 suicides by women in the UK and Ireland during pregnancy or up to one year after the end of pregnancy between 2009 and 2013 inclusive. They discovered that only 15% had contact with specialist perinatal mental health services despite the fact that half of the women who killed themselves had previously suffered from depressive illness.

Professor Marian Knight, who led the study, said: “With improvements in care we can prevent about half of the suicides in the future. The main issue for me is women had symptoms for a long time and would present themselves at different parts of the health service. They might present to A&E, they might present to a GP, so there were lots of opportunities … where if someone had recognised the symptoms that would have allowed the woman, if it was available, to get the specialist perinatal care she needed.”

Even if their symptoms were recognised, Knight and colleagues said, if the women who killed themselves became ill today 40% would not be able to get any specialist perinatal mental health care and only 25% would get the highest standard of care.

This is because in 236 clinical commissioning group/health board areas, only 57 meet the national standards for specialised perinatal mental health teams, while 96 have no provision at all, according to the Maternal Mental Health Alliance.

The lack of provision is despite the fact that around 15% of women experience mental health illness during or within a year after pregnancy.

In the five-year period examined by the report, another 58 women died as a result of substance misuse and two from other mental-health related issues, taking the total number of mental health-related deaths to 161, equivalent to 17% of the total number of maternal deaths. That represents a rate of 3.7 deaths from mental health-related causes per 100,000 maternities during the period studied.

The suicide rate is lower than among the general population but the proportion of violent suicides is higher. Co-author Prof Jenny Kurinczuk said among the cases studied there was a “violent element and unequivocal intention to die which is quite unusual in respect to women”.

The lack of perinatal services means that mental health crisis teams, designed to offer urgent help, often step in but the report found that they “may not have the necessary understanding of the distinctive features of severe perinatal mental illness, including the rapidity of change of mental state”. As such it recommends additional training for such teams.

Other recommendations include robust enquiries about mental health at booking assessments – usually held about 10 weeks into pregnancy – and early involvement of senior staff in assessment. Concerns were raised that some women’s symptoms of underlying mental illness were written off as anxiety, or they were merely described as being “impulsive” or having “no planning [in place]”.

The authors also urged women and their families to speak up about any mental health fears.

Responding to the report, a number of the royal colleges, representing healthcare professionals, urged greater investment in mental health services that would enable more training for staff and increased patient contact.

Prof Ian Jones, vice-chair of the perinatal faculty at the Royal College of Psychiatrists, said: “For every woman who dies, there are many more who are near misses. It is vital that the messages are heard and the lessons are learnt – not only by specialist perinatal clinicians but mental health teams more generally, in addition to antenatal services and primary care. The findings of the report remind us that pregnancy and childbirth are not for all women times of joy but may herald episodes of severe mental illness.”

An NHS England spokeswoman said: “We’re committed to improving access to high quality, timely care for women and their children both in the community and through specialist support, such as mother and baby units.

“We will use the extra funding announced in the spring Budget to help improve outcomes for women and families. Recognition of perinatal mental health as a priority area of investment in the recent spending review should also enable us to develop a broader transformation programme for services by 2020.”

• In the UK and Ireland the Samaritans can be contacted on 116 123. In the US, the National Suicide Prevention Hotline is 1-800-273-8255. In Australia, the crisis support service Lifeline is on 13 11 14. Hotlines in other countries can be found here.