Pregnancy and motherhood are often portrayed as some of the happiest and most meaningful moments in a woman’s life. But for some mothers, the reality can be very different. Maternal suicide is a serious and often overlooked mental-health crisis, and it reminds us that becoming a mother does not automatically protect someone from depression, anxiety, trauma or other psychological struggles. Women in low- and middle-income countries are said to experience high levels of common mental disorders – anxiety and depression – during pregnancy and the first year after birth. The prevalence is estimated at nearly 20%, and is higher among women who are marginalised. We are in conversation with Dr Keitumetse Mashego as we unpack maternal suicide the risk factors, recognising warning signs, challenging the stigma around asking for help, and discussing how families, healthcare professionals and communities can better support mothers.