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The midwife's role in suicide prevention

02 January 2018

Literature Review

02 January 2018

Volume 26 · Issue 1

ISSN (print): 0969-4900

ISSN (online): 2052-4307

Abstract

Background

Suicide has been found to be the leading cause of maternal death in the UK and has since been reclassified as a ‘direct’ cause of maternal death, with rates remaining unchanged since 2003.

Aim

To examine the literature and consider what midwives can do to reduce the rates of maternal suicide.

Methods

Qualitative and quantitative research were included into this literature review. Research from 2003-2017 was accessed via a university database.

Findings

Three key themes became apparent: the characteristics associated with women dying from suicide, risk factors, and the attitudes and perceptions of midwives and effective screening.

Conclusion

Suicide has devastating consequences for the woman, her family and her community. Every step must be taken to reflect on and improve midwifery practice, to finally begin reducing rates.

Pregnancy and transition to motherhood is traditionally perceived as a happy event, yet 20% of mothers experience mental illness (National Institute for Health and Clinical Excellence (NICE), 2015). The latest ‘Mothers and Babies: Reducing Risk through Audits and Confidential Enquires across the United Kingdom (MBRRACE-UK)’ report found that 111 new mothers died from suicide between 2009 and 2014, making suicide the leading cause of maternal death; with rates peaking at 3 months postpartum (Ratnaike, 2008; Knight et al, 2016).

MBRRACE once considered suicide as an ‘indirect’ cause of maternal death; however, in 2015, the World Health Organization (WHO) recognised its significance and direct link with pregnancy (WHO, 2015), and suicide was therefore reclassified as a ‘direct’ cause of maternal death (Knight et al, 2016). As the rates of maternal suicide in the UK have remained unchanged since 2003 (Iacobucci, 2016), it has been argued that maternity services should make suicide prevention a key clinical focus (Gentile, 2011).

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Suicide

Depression

Postnatal

Postpartum psychosis

Pregnancy