Wearing a happy mask: mother’s expressions of suicidality with postpartum depression

Praetorius, Regina T.; Maxwell, December; Alam, Komal

doi:10.1080/15332985.2020.1769003

Cited by 10 publications

(19 citation statements)

References 69 publications

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“…However, the authors did not explore the interplay between risk factors for suicide or the processes that could result in a perinatal woman feeling suicidal. In the only review of qualitative literature on this topic to date, Praetorius, Maxwell and Alam [ 18 ] conducted a meta-synthesis of eight qualitative studies, one of which was a grounded theory study, to investigate the lived experiences of mothers with postpartum depression who also experienced suicide ideation. Six themes were identified, which describe mothers hiding their suicidal feelings to adhere to the cultural expectations of motherhood, an incongruence between the expectations and reality of motherhood, loss of control, the overwhelm of motherhood on top of pre-birth responsibilities, lack of sleep, and social support as a buffer to suicidal thoughts.…”

Section: Introductionmentioning

confidence: 99%

“…In the original ITS , liability and self-hatred are indicators of perceived burdensomeness. Praetorius, Maxwell and Alam [ 18 ] propose two additional aspects that contribute to liability and self-hatred: feeling like a ‘mommy failure’, and the ‘baby burden’ (unexpected challenges related to the baby that make motherhood more difficult, including breastfeeding difficulties and the baby’s temperament). The authors highlight that many aspects of the perinatal period can increase a woman’s physical pain tolerance which may contribute to a woman’s acquired capability for suicide.…”

Section: Introductionmentioning

confidence: 99%

“…The authors highlight that many aspects of the perinatal period can increase a woman’s physical pain tolerance which may contribute to a woman’s acquired capability for suicide. Praetorius, Maxwell and Alam [ 18 ] also suggested that the exhaustion associated with transitioning to becoming a mother contributes to the acquired capability for suicide although their description of why this is the case is unclear and does not account for those women who have older children, having previously experienced matrescence.…”

Section: Introductionmentioning

confidence: 99%

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What makes a perinatal woman suicidal? A grounded theory study

et al. 2022

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Background Suicide is a leading cause of maternal death during pregnancy and up to a year after birth. Psychological and psychosocial risk factors for maternal suicide ideation and behaviour have been identified but do not account for why mothers begin to experience suicidal thoughts. Qualitative research offers a way of identifying what might drive mothers to initially consider suicide and then go on to act on such thoughts; crucial for the development of assessments to identify, and interventions to target, maternal suicide ideation and behaviour. We aimed to develop a grounded theory outlining what makes women think about suicide and/or engage in suicidal behaviour during pregnancy and the first 12 months following birth? Method Semi-structured interviews were conducted with 12 mothers in the UK who had suicidal thoughts during pregnancy and/or the first year following birth. A constructivist approach to grounded theory was adopted which guided the data collection and analysis processes. Results We developed a model outlining the theorised process of psychological factors that culminates in mothers experiencing suicidal thoughts and then making a suicide attempt during the perinatal period. The process was initiated when mothers felt attacked by motherhood which led to feeling like a failure, self-identifying as a “bad mother” and subsequent appraisals of entrapment and/or defeat. When nothing resolved the distress and as mothers collated reasons for why they perceived they needed to die, suicidal behaviour became a viable and appealing option. We theorised that mothers might make a suicide attempt when they entered a state of intense “darkness” brought on by a trigger, followed by a temporary lapse in the conflict between the desire to live and desire to die and an opportunity to attempt. Conclusions Participants stressed the rapid onset of suicidal thoughts. We suggest that healthcare professionals enquire about the mother’s feelings towards the baby and of isolation, how she views herself as a mother, feelings of entrapment and defeat during routine contacts to aid identification and prevention of suicidal ideation/behaviour. Suggested interventions to prevent suicidal thoughts and behaviour include helping women manage their expectations for pregnancy and the postpartum period.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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What makes a perinatal woman suicidal? A grounded theory study

et al. 2022

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“…Praetorius, Maxwell (18) built on Joiner's (8) ITS in which they describe 'mommy failure', baby burden and thwarted motherhood as additional elements, speci c to mothers with postpartum depression, that contribute to the feelings of perceived burdensomeness, thwarted belongingness and capability that result in suicidal behaviour. Praetorius, Maxwell (18) do not mention the crucial element of entrapment and defeat that we found to be so important to mothers in the current study. Moreover, we found mothers experienced intense con ict when considering attempting suicide and that they needed to be relieved of this con ict in order to act on their thoughts; this important stage does not feature in Praetorius et al's (18) augmented ITS model.…”

Section: Discussionmentioning

confidence: 54%

“…However, the authors did not explore the interplay between risk factors for suicide or the processes that could result in a perinatal woman feeling suicidal. In the only review of qualitative literature on this topic to date, Praetorius, Maxwell (18) conducted a meta-synthesis of eight qualitative studies, one of which was a grounded theory study, to investigate the lived experiences of mothers with postpartum depression who also experienced suicide ideation. Six themes were identi ed, which describe mothers hiding their suicidal feelings to adhere to the cultural expectations of motherhood, an incongruence between the expectations and reality of motherhood, loss of control, the overwhelm of motherhood on top of pre-birth responsibilities, lack of sleep, and social support as a buffer to suicidal thoughts.…”

Section: Introductionmentioning

confidence: 99%

What Makes A Perinatal Woman Suicidal? A Grounded Theory Study

Reid

Pratt

Edge

et al. 2022

Preprint

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Background: Suicide is a leading cause of maternal death during pregnancy and up to a year after birth. Psychological and psychosocial risk factors for maternal suicide ideation and behaviour have been identified but do not account for why mothers begin to experience suicidal thoughts. Qualitative research offers a way of identifying what might drive mothers to initially consider suicide and then go on to act on such thoughts; crucial for the development of assessments to identify, and interventions to target, maternal suicide ideation and behaviour. We aimed to develop a grounded theory outlining what makes women think about suicide and/or engage in suicidal behaviour during pregnancy and the first 12 months following birth?Method: Semi-structured interviews were conducted with 12 mothers in the UK who had suicidal thoughts during pregnancy and/or the first year following birth. A constructivist approach to grounded theory was adopted which guided the data collection and analysis processes. Results: We developed a model outlining the theorised process of psychological factors that culminates in mothers experiencing suicidal thoughts and then making a suicide attempt during the perinatal period. The process was initiated when mothers felt attacked by motherhood which led to feeling like a failure, self-identifying as a “bad mother” and subsequent appraisals of entrapment and/or defeat. When nothing resolved the distress and as mothers collated reasons for why they perceived they needed to die, suicidal behaviour became a viable and appealing option. We theorised that mothers might make a suicide attempt when they entered a state of intense “darkness” brought on by a trigger, followed by a temporary lapse in the conflict between the desire to live and desire to die and an opportunity to attempt.Conclusions: Participants stressed the rapid onset of suicidal thoughts. We suggest that healthcare professionals enquire about the mother’s feelings towards the baby and of isolation, how she views herself as a mother, feelings of entrapment and defeat during routine contacts to aid identification and prevention of suicidal ideation/behaviour. Suggested interventions to prevent suicidal thoughts and behaviour include helping women manage their expectations for pregnancy and the postpartum period.

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