Views and Experiences of Suicidal Ideation During Pregnancy and the Postpartum: Findings from Interviews with Maternal Care Clinic Patients

Abstract

Introduction: Perinatal suicidality (i.e., thoughts of death, suicide attempts, or self-harm during the period immediately before and up to 12 months after the birth of a child) is a significant public health concern. Few investigations have examined the patients' own views and experiences of maternal suicidal ideation. Methods: Between April and October 2010, researchers identified 14 patient participants at a single university-based medical center for a follow-up, semi-structured interview if they screened positive for suicidal ideation on the Patient Health Questionnaire-9 (PHQ-9) short form. In-depth interviews followed a semi-structured interview guide. Researchers transcribed all interviews verbatim and analyzed transcripts using thematic network analysis. Results: Participants described the experience of suicidality during pregnancy as related to somatic symptoms, past diagnoses, infanticide, family psychiatric history (e.g., completed suicides and family member attempts), and pregnancy complications. The network of themes included the perinatal experience, patient descriptions of changes in mood symptoms, illustrations of situational coping, and reported mental health service use. Implications: The interview themes suggested that in this small sample, pregnancy represented a critical time period to screen for suicide and to establish treatment for the mothers in the study. These findings may assist health care professionals in the development of interventions designed to identify, assess, and prevent suicidality among perinatal women.

Keywords:

• suicidal ideation
• pregnancy
• suicidality
• psychosocial screening
• maternal mental health

Acknowledgments

This study was made possible by grants from the National Institutes of Health National Center for Research Resources funding sources TL1 RR025016 and 1KL2RR025015-01 and Health Services Division of NIMH: T32 MH20021-14, K24 MH069471 (Dr. Katon). There are no conflicting interests.