Study shows pregnancy linked to lower rates of self-harm

Study to examine self-harm risk around pregnancy has shown that most women are generally less likely to harm themselves during and after pregnancy.

A research team at the University of Manchester revealed that in 1000 women, four are likely to self-harm over a year. This risk halves when women are pregnant to two according to the research published in the British Journal of Psychiatry.

The study involved analysing over 58,000 self-harm events in women aged 15 to 45 years between January 1990 and December 2017. The data was linked to 1.1 million pregnancies and their outcomes using the Clinical Practice Research Datalink and the Pregnancy Register.

Women with a diagnosis of psychiatric disorders are at a higher background risk of self-harm but their risk is more than halved when pregnant.

Even after pregnancy, women over the age of 30 are at a lower risk of self-harm. The risk reduction at three to six months after pregnancy is 13 per cent of women who are aged 30 to 34. This rises to 27 per cent for women who are aged 35 to 45 in comparison to women of the same age who were not pregnant.

It also found that mothers under the age of 30 are more likely to self-harm between three to six months after giving birth.

Mothers aged 15 to 19 are 66 per cent more likely and 20 to 24-year-olds are more likely to self-harm between three to six months of giving birth. 25 to 29 years old were 15 per cent more likely in comparison to the same age groups who were not pregnant. The study also revealed that there was a small increase in risk posed in post-pregnancy by primarily younger women aged 15 to 29 years.

Adolescent women with a history of self-harm were likely to continue harming themselves during pregnancy.

Pregnancy and self-harm risk

The team noted that identifying those at risk will allow doctors to target resources at women who may need them most of all.

Lead author Dr Holly Hope said: “This study – which is the largest of its kind – makes important 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.

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 a number of factors, including their education and employment choices.

Older women may be in a better financial and psychological position to care for themselves and their babies. 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.”

She added: “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 greatest 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 neighbourhoods 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.”

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