This year’s theme for World Suicide Prevention Day is creating hope through action.
There is a lot we can do intentionally to decrease suicidality and enhance hope among the perinatal population.
According to this data analysis in Canadian Medical Association Journal, one in every 19 perinatal deaths is due to suicide, making suicide a leading cause of perinatal death. CMAJ notes that these findings speak to a need for stronger mental health support during and after pregnancy. Discussing perinatal health universally during prenatal support is a good starting point. Knowing what to watch out for, and raising awareness and discussion about is also essential.
This 2022 article by Ann-Marie Bright and colleagues presents a scoping review of almost 20 years of literature on perinatal suicidality. Their central finding is that “The minimization of women’s experiences may lead to detrimental consequences and there is a need for increased knowledge of mental health problems by those working with women in the perinatal period to ensure safety planning conversations occur with every woman meeting ‘at risk’ criteria.”
Suicidal ideation is having thoughts of committing suicide. These thoughts occur on a spectrum ranging in frequency, intensity, and intentionality. While suicidal ideation does not always lead to a suicide attempt, suicide attempts and completed suicides are always preceded by suicidal ideation. Early identification and intervention regarding suicidal ideation as an important way of preventing suicide.
Bright et. al divide the risk factors for suicidal ideation during the perinatal period into 3 categories:
- Biological, which includes:
- Nicotine and alcohol use
- Poor or low sleep
- Chronic illness
- Pregnancy conditions
- Complicated Birth
- Psychological, which includes
- Trauma history
- Prior history of mental illness
- Pregnancy and infant loss
- Suicide attempt history
- Feeling unprepared to parent
- Social, which includes
- Unemployed/low income
- Inadequate support system
- Intimate partner violence
- Refugee Status
- Unhealthy relationships
There are two key takeaways for doulas in these findings. Firstly, this is a pretty lengthy list of risk factors and it’s not exhaustive. Suicidal ideation could affect anyone, from any walk of life. We need to talk to all clients about mental health and raise awareness regarding red flags for mental ill health, and share local treatment options.
Secondly, some people are more likely to be at risk than others. People who are marginalized and who have survived abuse and violence may need some extra helping hands.
As birth workers, our role is in and of itself a powerful action against suicide. Support from a doula has been shown to significantly reduce postpartum depression and strengthen new parent relationships. Perhaps this is because having a doula can mitigate many of these risks identified by Bright et. al, such as complicated birth, feeling unprepared to parent, and an inadequate support system. We can’t underestimate the life-saving power and potential of this work. We need financial and infrastructural support to do this work and connect with the clients who need us the most.
To learn more about how you can support suicide awareness and prevention in your birthwork practice, check out resources at Canadian Association for Suicide Prevention.
This short video also provides excellent information on warning signs for postpartum depression. https://youtu.be/6kaCdrvNGZw?si=nBqLwhMLnFd–XK3
Keira Grant (she/her) brings a wealth of experience to her EDI Co-Lead role. She is a Queer, Black woman with a twenty-year track record in Equity, Diversity, and Inclusion (EDI) education, projects, and community-building initiatives. As a mom and partner, she uses her lived experience to provide support and reflection for her clients and her work. Keira is the owner of Awakened Changes Perinatal Doula Services.
People exhibiting symptoms of perinatal mental illness should be encouraged to seek medical attention immediately.