Self-Harm and Suicidal Thoughts On the Rise a Year Before and After Giving Birth

Many health providers have categorized the onset of postpartum depression as the "baby blues." This softening of the disorder is sometimes accompanied with the promise of symptoms clearing up within a few weeks. In reality, when discussing concerns around pregnancy and mental health, postpartum depression is one that should be seriously considered.

Suicide is one of the leading factors of postpartum death and researchers have found that since 2001, the rates have increased. A recent study published in JAMA Psychiatry showed that depression is something that should be assessed both before giving birth and a year postpartum.

What Did The Study Show?

The study showed the results of 595,237 individuals who had children and were surveyed both one year before and after childbirth. Researchers conducted surveys during a minimum of either one inpatient or two outpatient visits. The findings of the study showed a substantial increase in suicidal thoughts within the 12 months following birth. 

Researchers utilized the Maternal Behavioral Health Policy Evaluation (MAPLE) study to dissect trends of suicide and self-harm related events among childbearing individuals, ranging from 15-44 years in age the year before and after birth of a child.

Dr. Zaher Merhi, OBGYN, REI, HCLD, and founder of Rejuvenating Fertility Center says, “Chronic depression is considered one of the highest risk factors for postpartum depression. The same goes for suicidality. Therefore, it is essential for patients with a previous history of depression to discuss this with their physician as soon as possible, and it is equally important for physicians to screen their patients for past medical and psychiatric history.”

Factors in Postpartum Depression and Suicidality

The data within this study showed that rates of postpartum self-harm and suicidality were higher in marginalized populations such as low-income and Black communities, coinciding with the issues around the U.S.'s high rates of Black maternal mortality.

“Just like with the majority of pathologies in medicine, the medical background of the patient plays an important role in increasing or decreasing the risk of suicide and its consequences. Background includes family history, personal history, and also race. As such, race plays a part in suicide. Having a lower socio-economic status has been shown to be related to higher risk of suicide.” says Merhi. 

Previous mental health disorders or navigating suicidality or depression prior to conception and birth are also risk factors for postpartum onset. According to Merhi, other potential factors for postpartum depression and suicidality include:

• Previous history of depression and anxiety (especially during pregnancy)
• Moderate to severe PMS
• Negative feelings towards the pregnancy (unwanted, unplanned…)
• History of sexual abuse
• Risky pregnancy (gestational complications, emergency cesarean, hospitalization, and obstetric hemorrhages)
• Lack of support
• Low Birth weight 
• Insomnia during pregnancy and postpartum
• Domestic violence
• Smoking

Studies such as this have the potential to result in positive outcomes for childbearing individuals. This data can be utilized to influence policy and clinical changes and interventions to support potential parents, especially those with increased risk factors of suicidality.

Health and insurance plans would also benefit from this data, as interventions prior to childbirth could also be assessed and altered. “The most important thing to do is to look for risk factors. If they are present, then expectant parents should seek support, whether from family members, friends, online support group, professional health care workers etc. Remember, it is always better to be safe than sorry. Take care of yourself, so you can take care of your baby and your family.” says Merhi.