: Perinatal suicidal behaviour (defined as suicidal ideation, planning, attempts, death, and self-harm) is a leading cause of mortality and morbidity for women during the perinatal period. Research demonstrates that there can also be significant lifelong impacts for the children and partners of women who experience perinatal suicidal behaviour. It is therefore crucial that early intervention is timely, acceptable, and feasible.
Women are frequently screened for a variety of health conditions during the perinatal period, including for mental health. While there is no specific screening tool for perinatal suicidal behaviour, there are several questions across various mental health screening tools that include items about thoughts of self-harm or suicide, for example item-10 of the Edinburgh Postnatal Depression Scale. These are often cited as suicide risk screening tools for women during the perinatal period, although research demonstrates their poor predictive power for suicide risk.
The extant research also shows low acceptability of such screening tools among perinatal women. In recent research, the first author has confirmed these findings in a group of Australian women with lived experience of perinatal suicidal behaviour. Women cite vague or complicated language, fears of consequences (such as Child Protection Service involvement), or concerns about stigma and discrimination as some of the key barriers to screening acceptability. Many women disclosed not answering the suicidal or self-harm screening questions honestly, for fear of the aforementioned consequences. These fears are well-founded, particularly for Aboriginal people, who continue to suffer institutional racism and the ongoing harms of colonialism.
While there is some research problematising current perinatal suicidal behaviour screening, there is limited research proposing new best practise approaches, beyond suggestions for the development of a specific, validated perinatal suicidal behaviour screening tool.
This presentation will give an overview of the available evidence on screening for perinatal suicidal behaviour as well as first-hand lived-experience perspectives. The co-presenters will focus on what those who work with perinatal women can practically do to contribute to improving the safety and wellbeing of perinatal women, beyond a reliance on screening.