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Women's experiences of attempted suicide in the perinatal period (ASPEN-study) - a qualitative study

Abstract:
Background
Suicide is a leading cause of maternal death during pregnancy and the year after birth (the perinatal period). While maternal suicide is a relatively rare event with a prevalence of 3.84 per 100,000 live births in the UK, the impact of maternal suicide is profound and long-lasting. Many more women will attempt suicide during the perinatal period, with a worldwide estimated prevalence of 680 per 100,000 in pregnancy and 210 per 100,000 in the year after birth. Qualitative research into perinatal suicide attempts is crucial to understand the experiences, motives and the circumstances surrounding these events, but this has largely been unexplored.

Aim
Our study aimed to explore the experiences of women and birthing people who had a perinatal suicide attempt and to understand the context and contributing factors surrounding their perinatal suicide attempt.

Methods
Through iterative feedback from a group of women with lived experience of perinatal mental illness and relevant stakeholders, a qualitative study design was developed. We recruited women and birthing people (N = 11) in the UK who self-reported as having undertaken a suicide attempt. Interviews were conducted virtually, recorded and transcribed. Using NVivo software, a critical realist approach to Thematic Analysis was followed, and themes were developed.

Results
Three key themes were identified that contributed to the perinatal suicide attempt. The first theme 'Trauma and Adversities' captures the traumatic events and life adversities with which participants started their pregnancy journeys. The second theme, 'Disillusionment with Motherhood' brings together a range of sub-themes highlighting various challenges related to pregnancy, birth and motherhood resulting in a decline in women's mental health. The third theme, 'Entrapment and Despair', presents a range of factors that leads to a significant deterioration of women's mental health, marked by feelings of failure, hopelessness and losing control.

Conclusions
Feelings of entrapment and despair in women who are struggling with motherhood, alongside a background of traumatic events and life adversities may indicate warning signs of a perinatal suicide. Meaningful enquiry around these factors could lead to timely detection, thus improving care and potentially prevent future maternal suicides.
Publication status:
Published
Peer review status:
Peer reviewed

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Publisher copy:
10.1186/s12888-024-05686-3

Authors

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Role:
Author
ORCID:
0000-0001-5202-2808
More by this author
Role:
Author
ORCID:
0009-0009-5817-156X
More by this author
Institution:
University of Oxford
Division:
MSD
Department:
Experimental Psychology
Role:
Author
ORCID:
0000-0002-3316-8155
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Role:
Author
ORCID:
0000-0002-1850-6101
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Role:
Author
ORCID:
0000-0001-9471-0908


More from this funder
Funder identifier:
https://ror.org/015ah0c92
Grant:
NIHR302565
NIHR200152
NIHR-INF-2170


Publisher:
BioMed Central
Journal:
BMC Psychiatry More from this journal
Volume:
24
Issue:
1
Article number:
255
Place of publication:
England
Publication date:
2024-04-03
Acceptance date:
2024-03-14
DOI:
EISSN:
1471-244X
Pmid:
38570802


Language:
English
Keywords:
Pubs id:
1989628
Local pid:
pubs:1989628
Deposit date:
2025-05-01
ARK identifier:

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