253477 Maternal Care Clinic Patients and the Experience of Perinatal Suicidality

Tuesday, November 1, 2011

Karen Tabb, MSW , School of Social Work, University of Washington, Seattle, WA
Yuqing Guo, MSN, PhC , Department of Obstetrics & Gynecology, Department of Psychiatry, University of Washington, Seattle, WA
Amelia R. Gavin, PhD , School of Social Work, University of Washington, Seattle, WA
David T. Takeuchi, PhD , School of Social Work, University of Washington, Seattle, WA
Hsiang Huang, MD , Department of Psychiatry & Behavioral Sciences, University of Washington, Seattle, WA
Kate Debiec, MD , Dept. of Obstetrics & Gynecology, University of Washington, Seattle, WA
Background: Perinatal suicidality, the 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. In 2006, the American College of Obstetricians and Gynecologists recommended screening for psychosocial risk factors during the perinatal period. Few investigations examine the patients' own views and experiences of maternal suicidality.

Methods: Between April and October 2010, 14 patient participants at a single university based medical center were identified for a follow-up semi-structured interview if they screened positive for suicidal ideation using the Patient Health Questionnaire short-form. In-depth interviews, were conducted with patients either in-clinic with antenatal women and in-home with postnatal women, followed an interview guide and lasted 15 to 90 minutes. All interviews were transcribed and analyzed verbatim using thematic network analysis (Attride-Stirling, 2001).

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 attempts in the family), and pregnancy complications. The network of themes includes suicidality and the perinatal experience, patient descriptions of changes in mood symptoms, illustrations of situational coping, and reported mental health service use.

Discussion: The interview themes show that pregnancy represents a critical time period to screen for suicide and to establish treatment for mothers. Study findings may assist clinicians including physicians, nurses, and social workers in the development of interventions designed to identify, assess and prevent suicidality among perinatal women.

Learning Areas:
Diversity and culture
Ethics, professional and legal requirements
Planning of health education strategies, interventions, and programs
Public health or related nursing
Social and behavioral sciences

Learning Objectives:
1. Define perinatal suicidality 2. Discuss the relevance mental health screening in a prenatal setting 3. List examples of themes found in data 4. Describe thematic analysis as methodological approach to analyze interview data 5. Provide at least two clinical implications for screening for suicidal ideation in a prenatal clinic

Keywords: Screening, Maternal Health

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am the PI on the interview study.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.