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Suicide during pregnancy and in the first postnatal year
1Department of Psychiatry, Institute of Psychiatry, London.
BMJ (Clinical Research Ed.)
|January 19, 1991
Summary
Maternal suicide risk is low during pregnancy and the year after childbirth, contrary to expectations given high rates of psychiatric morbidity. Motherhood appears protective, suggesting a focus on dependants for suicide prevention.
Area of Science:
- Public Health
- Epidemiology
- Psychiatry
Background:
- Childbearing women experience significant psychiatric morbidity.
- Suicide risk during pregnancy and the postpartum period requires careful evaluation.
Purpose of the Study:
- To calculate age-adjusted mortality ratios for suicide in women during pregnancy and the first year postpartum.
- To identify characteristics of maternal suicide.
Main Methods:
- Retrospective population-based study using data from England and Wales (1973-1984).
- Analysis of suicide mortality ratios for women aged 15-44 during pregnancy and the year after childbirth.
- Examination of ratios by age, marital status, and outcome of pregnancy (stillbirth).
Main Results:
- The standardized mortality ratio for postnatal suicide was 0.17 (one-sixth of expected).
- Suicide risk was elevated sixfold after stillbirth compared to general postnatal suicide.
- Teenage mothers and unmarried mothers showed less pronounced but still present reduced suicide ratios; teenagers had substantially increased risk during pregnancy.
Conclusions:
- Despite high psychiatric morbidity, women have a low risk of suicide during pregnancy and the first postpartum year.
- Motherhood appears protective against suicide; underreporting is unlikely to fully explain the low ratios.
- Focusing on the care of dependants may be crucial for suicide prevention strategies in clinical practice.