Work

Maternal suicidality in Pakistan: Developing a critical feminist grounded theory to inform suicide prevention programs

Year: 2024

Type: article

Abstract: South Asia has the highest rate of suicide fatalities for women globally. However, the underlying factors and processes that contribute to suicidal behavior among women in Pakistan remain underexplored and existing interventions worldwide are dominated by Western-informed suicide theories. We employed a decolonized form of grounded theory, informed by critical feminist theory and Pakistani feminist scholarship, to explore the experiences of suicidal thoughts and behaviors among 12 mothers with a chronic history of suicidality in rural Rawalpindi, Pakistan. Data were collected using in-depth interviews and analyzed in Urdu by female Pakistani scholars. Results generated a grounded theory of suicide among women in Pakistan characterized by four key dimensions: susraal (in-laws’ home) creates an intolerable and lonely ecosystem; struggle negotiating the morality of motherhood vis-a-vis psychological and social suffering; diminished sabr (patience), unresolved grief, and longing for sukoon (peace); and religious faith anchoring women’s value for her life and afterlife. Women's suicidal thoughts and behaviors were largely contextualized by their positionality within their susraal characterized by neglect, invalidation, abuse, and loneliness. Resulting from these dynamics were feelings of abandonment, resentment, disrespect, and helplessness, reducing women’s threshold for maintaining sabr . While suicide attempts were prompted by anger and the desire to escape, women described that suicidal death threatened their relationship with Allah and peace in their afterlife. Among women’s reasons for living, a unique duty toward their children was the strongest reason followed by trust in Allah's plan. This study advances suicide theory, providing a decolonized approach to illuminate insights into the complex and context-specific factors that influence suicide among women in Pakistan. Findings can help guide the development of culturally appropriate suicide prevention interventions sensitive to Pakistan’s unique sociocultural and religious context and ultimately, reduce the burden of suicide. • South Asia has the highest female suicide rate globally, with rising cases in Pakistan. • We used a decolonized, critical feminist grounded theory approach to study suicidality leveraging in-depth life history interviews with 12 Pakistani mothers with lived experience of suicide. • Suicidality was shaped by abuse, neglect, and isolation within women's susraal (in-laws' home). • Religious faith and a moral sense of maternal duty were key factors in resisting suicidal actions. • This study advances suicide theory by offering a decolonized perspective that sheds light on the complex, context-specific factors affecting suicide among women in Pakistan.

Source: SSM - Mental Health

DOI: 10.1016/j.ssmmh.2024.100356