For women, self-harm is associated with up to 50 times higher risk of suicide. Between 2014 and 2016, 2.9 deaths per 100,000 maternities were suicides, representing 18% of all maternal deaths in the UK.
It is mandatory to prioritize women who self-harm themselves during pregnancy. They should also be targeted for intervention.
A new study by the University of Manchester determined: 1. If women’s risk of self-harm changes in pregnancy and the first postpartum year. 3. If risk varies by mental illness, age, and birth outcome.
Scientists found that most women are generally less likely to self-harm during and after pregnancy. Only 4 in 1000 women are likely to self-harm over a year and this risk halves in pregnancy to 2.
Indeed, even after pregnancy, women over 30 years old are at lower risk of self-harm. The risk reduction at 3-6 months after pregnancy is 13% for women over 30 to 34 and 27% for women over 35 to 45, compared to women of a similar age who were not pregnant.
The study is the largest ever UK study, which reported 57,791 self-harm events in women aged 15 to 45 between January 1990 and December 2017. The data were linked to 1.1 million pregnancies and outcomes, utilizing the Clinical Practice Research Datalink and Pregnancy Register.
Scientists also found that:
- Overall, there was a slight increase in the risk of self-harm post-pregnancy, but this risk was carried primarily by young women aged 15 to 29 years.
- Unlike older women, adolescent women aged 15-19 with a history of self-harm are likely to continue to self-harm during pregnancy.
Lead author Dr. Holly Hope said: “This study – which is the largest of its kind – makes essential advances in our understanding of how pregnancy and the first year after giving birth affect self-harm risk.”
“As we already know, self-harm among young women generally in the UK is increasing, and self-harm is associated with up to 50 times higher risk of suicide in women, that’s important.”
“Significantly, we find that the risk of self-harm is indeed higher among women under 30 after giving birth, but reassuringly, for women over 30, the risks of self-harm decrease both during and after pregnancy.”
“Latterly, women are increasingly likely to wait a few years until they have a baby, which could be down to several factors, including their education and employment choices.
“Older women may be in a better financial and psychological position to care for themselves and their baby.
“Hormonal changes during pregnancy are intended to promote maternal attachment and increase a sense of wellbeing. However, this mechanism might be overridden by other factors in some younger women.”
“Older women might also be in a better position to take advantage of health services which do a good job in signposting them to services if they need help.”
“This study shows us more clearly than before, in a contemporary population of women becoming pregnant, where the most significant risks of self-harm lie, which means resources might be more focussed on those at-risk age groups so they can be monitored more effectively and referred for help more efficiently.
“The most deprived neighborhoods where teenage pregnancy is more common might benefit from a similar focus.”
Dr. Jo Black, chair of the Perinatal Faculty at the Royal College of Psychiatrists, said: “By highlighting where resources are needed most, the findings could help ensure funding is better targeted to reach those at greatest risk.”
- Holly Hope et al. Self-harm risk in pregnancy: recurrent-event survival analysis using UK primary care data. DOI: 10.1192/bjp.2022.31