On October 4, 1974, Sexton had lunch with Kumin to revise galleys for Sexton's manuscript of The Awful Rowing Toward God, scheduled for publication in March 1975 (Middlebrook 396). On returning home she put on her mother's old fur coat, removed all her rings, poured herself a glass of vodka, locked herself in her garage, and started the engine of her car, committing suicide by carbon monoxide poisoning.
In an interview over a year before her death, she explained she had written the first drafts of The Awful Rowing Toward God in twenty days with "two days out for despair and three days out in a mental hospital." She went on to say that she would not allow the poems to be published before her death. She is buried at Forest Hills Cemetery & Crematory in Jamaica Plain, Boston, Massachusetts.