Suicide crises among women and mothers during and around the time of pregnancy: Prevalence and timing of initial contact with first responders and health services
by Carla Meurk, Susan Roberts, Michael Lam, Lisa Wittenhagen, Leonie Callaway, Katherine Moss, Jayne Lucke, Ruth Barker, Elissa Waterson, Catherine Rawlinson, Natasha Malmstrom, Edward Weaver, Elisabeth Hoehn, Emma Bosley, Shelby Watson and Ed Heffernan
Published 2 June 2022
Suicide is one of the leading causes of maternal mortality, having significant impacts on families and children. Maternal mental health and wellbeing is an important contributor to infant development, and both current and future wellbeing of their child. However, there is a lack of evidence to guide service delivery and a lack of tailored, appropriate services for women to access.
This paper examines prevalence, demographic characteristics and timing of initial contact with first responders and health services for a cohort of women who experienced suicidality during and around the time of pregnancy.
Research and findings
Data was drawn from the Partners in Prevention (PiP) study, a population-wide linked data set of suicide-related attendances by police or paramedics in Queensland, Australia from 2014-2017. Women who were between six months preconception and two years postpartum at the time of a suicide-related contact with police or paramedics were identified (PiP-Maternal). This cohort was compared to other girls and women who had a suicide-related contact with police or paramedics (PiP-Female).
The PiP-Maternal cohort was made up of 3,020 individuals and 3,400 births. Compared to the other women who had suicide-related contact with ambulance and police, women in the PiP-Maternal cohort were more likely to:
- Be younger (median age of 26 years, compared to 27 years for PiP-Female cohort)
- Be of Aboriginal and/or Torres Strait Islander descent (21.7%, compared to 14.2%)
- Live outside of a major city than the PiP-Female cohort (46.2%, compared to 38.1%)
- Re-present to ambulance or police following the initial contact (35.7%, compared to 33.2%).
Women in the PiP-Maternal cohort were less likely to:
- Be admitted to an emergency department within 24 hours (68%, compared to 79.9%)
- Have contact with a public mental health service within 14 days (30.5%, versus 34.23%).
There were high rates of out-of-hours calls to police and ambulance for both cohorts, and similar dispatch priority levels of calls.
Prevalence of suicidality based on this data for women who were pregnant and up to 2 years postpartum was 1.32%.
This study has revealed relatively high rates of out-of-hours contact with emergency services and low rates of follow-up. The high rates of re-presentation to police and ambulance services demonstrates a significant, unmet need. Women in the peripartum period tend to have increased levels of health service use associated with their pregnancy, which represents opportunity to be able to intervene. In particular there is a need for culturally responsive services that meet the needs of Aboriginal and/or Torres Strait Islander women and mothers.
The authors suggest future research is needed to more deeply examine these women’s health service pathways in and around a crisis.