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Friday, November 13, 1998 Published at 02:30 GMT


Health

Painful birth could lead to adult suicide

Traumatic birth has been linked to problems in later life

Scientists have discovered that a painful birth may make an individual more likely to commit violent suicide in adult life.

Researchers from Sweden studied the records of 645 babies born in the country between 1945 and 1980.

Of those 242 committed suicide by violent means between 1978 and 1995.

They discovered that people who subsequently committed suicide were more likely to have been exposed to birth complications, and were subjected to twice as many interventions at birth as their siblings, including forceps delivery.

They also found that the mothers of these babies were, on average, given fewer painkillers.

The use of painkilling opiates reduced the suicide risk by approximately a half.


[ image: Could a painful birth damage the mother-child relationship?]
Could a painful birth damage the mother-child relationship?
The authors, Bertil Jacobson and Marc Bygdeman, writing in the British Medical Journal, concluded that obstetric procedures should be chosen to minimise pain and discomfort to the infant.

"It seems important that an obstetric procedure, of only a couple of hours at birth, might have a long-term protective effect in adulthood," they report.

They speculate that a difficult birth may be just the first sign that a child is vulnerable and at high risk.

Alternatively, they argue a painful birth may damage the mother-child relationship.

"It could be that painful deliveries make women ambivalent towards their infants, and as a consequence they are less motivated to provide good child care," they write.

They also put forward the theory that, when committing suicide, some people unconsciously recreate the traumatic sensation of their birth.

Scepticism

However, reviewing the research Professor Louis Appleby, of the School of Psychiatry and Behavioural Sciences, University of Manchester, was sceptical of the idea that the birth experience was imprinted on a baby's mind for the rest of its life.

"Any link between obstetric care and violent suicide is more likely to occur through mental illness," he writes.

"Considerable evidence exists that obstetric complications are associated with schizophrenia."

Professor Appleby said a recent study found a link between schizophrenia and impaired development of the brain, possibly caused by oxygen starvation in the womb.

Professor Appleby writes: "Even an indirect link between peri-natal trauma and suicide may be important, although the potential to reduce the numbers of violent suicides through improved obstetric care is then far less than the attributable risks calculated by Jacobson and Bygdeman would suggest.

"The key issues for suicide prevention remain: to understand and reverse the doubling of suicide rates in young men over the past two decades; to develop services that will reduce risk after deliberate self harm; and to find the evidence on interventions that will make mental health care safer."



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