Self-harm thoughts in postpartum women in Lithuania: prevalence and associated factors

Background

Postpartum mental health problems are a critical public health concern, with serious consequences including self-harm and adverse outcomes for both mother and child. This study aimed to assess the prevalence of self-harm thoughts and associated factors among postpartum women in Lithuania.

Methods

A cross-sectional study was conducted in autumn 2024 using an anonymous online questionnaire distributed via social media. The survey included socio-demographic, behavioral, and psychosocial variables, a question on self-harm thoughts, and assessment of postpartum depression using the Edinburgh Postnatal Depression Scale. A total of 1,010 women within six months postpartum participated. Mann–Whitney and Fisher’s exact tests were used.

Results

Overall, 18.7% reported self-harm thoughts. These were reported by 2.4% of women without postpartum depression and 32% of those with postpartum depression (p < 0.001). Higher prevalence was observed among women with a history of pregnancy termination (p = 0.008), prior mental health care (p < 0.001), alcohol use postpartum (p < 0.001), and smoking (p < 0.001). Married women reported such thoughts more often than those in non-registered partnerships (p = 0.02). Breastfeeding and partner/family support were protective (p = 0.03; p < 0.001). No associations were found with age, education, socioeconomic status, physical activity, number of pregnancies, residence, miscarriage history, pregnancy complications, or newborn health.

Conclusions

Nearly one in five women experienced self-harm thoughts within six months postpartum. Women with postpartum depression had a markedly higher prevalence (32% vs 2.4%). Behavioral factors and lack of psychosocial support increased risk, while social support was protective.

Key messages

• Self-harm thoughts affect nearly one in five women within six months postpartum and are strongly associated with postpartum depression.

• Psychosocial support and modifiable health behaviors play an important role in reducing self-harm risk during the postpartum period.